H. R. 1532 

One Hundred Tenth Congress 

of the 

United States of America 

AT THE SECOND SESSION 

Begun and held at the City of Washington on Thursday, 

the third day of January, two thousand and eight 

An Act 

To amend the Public Health Service Act with respect to making progress toward 

the goal of eliminating tuberculosis, and for other purposes. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

(a) SHORT TITLE.—This Act may be cited as the ‘‘Comprehensive 

Tuberculosis Elimination Act of 2008’’. 

(b) TABLE OF CONTENTS.—The table of contents for this Act 

is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION 

AND OTHER APPROPRIATE AGENCIES 

Subtitle A—National Strategy for Combating and Eliminating Tuberculosis 

Sec. 101. National strategy. 

Subtitle B—Interagency Collaboration 

Sec. 111. Advisory Council for Elimination of Tuberculosis and the Federal Tuberculosis Task Force . 

Subtitle C—Evaluation of Public Health Authorities 

Sec. 121. Evaluation of public health authorities. 

Subtitle D—Authorization of Appropriations 

Sec. 131. Authorizations of appropriations. 

TITLE II—NATIONAL INSTITUTES OF HEALTH 

Sec. 201. Research and development concerning tuberculosis. 
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TITLE I—DEPARTMENT OF HEALTH 

AND HUMAN SERVICES IN COORDINATION WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION 

AND OTHER APPROPRIATE AGENCIES 

Subtitle A—National Strategy for 

Combating and Eliminating Tuberculosis 

SEC. 101. NATIONAL STRATEGY. 

Section 317E of the Public Health Service Act (42 U.S.C. 247b– 

6) is amended— 

(1) by striking the heading for the section and inserting 

the following: ‘‘NATIONAL STRATEGY FOR COMBATING AND ELIMI- NATING TUBERCULOSIS’’; 

(2) by amending subsection (b) to read as follows: 

‘‘(b) RESEARCH AND DEVELOPMENT; DEMONSTRATION PROJECTS; 

EDUCATION AND TRAINING.—With respect to the prevention, treatment, control, and elimination of tuberculosis, the Secretary may, 

directly or through grants to public or nonprofit private entities, 

carry out the following: 

‘‘(1) Research, with priority given to research and development concerning latent tuberculosis infection, strains of tuberculosis resistant to drugs, and research concerning cases of 

tuberculosis that affect certain populations at risk for tuberculosis. 

‘‘(2) Research and development and related activities to 

develop new tools for the elimination of tuberculosis, including 

drugs, diagnostics, vaccines, and public health interventions, 

such as directly observed therapy and non-pharmaceutical 

intervention, and methods to enhance detection and response 

to outbreaks of tuberculosis, including multidrug resistant 

tuberculosis. The Secretary is encouraged to give priority to 

programmatically relevant research so that new tools can be 

utilized in public health practice. 

‘‘(3) Demonstration projects for— 

‘‘(A) the development of regional capabilities to prevent, 

control, and eliminate tuberculosis and prevent multidrug 

resistant and extensively drug resistant strains of tuberculosis; 

‘‘(B) the intensification of efforts to reduce health 

disparities in the incidence of tuberculosis; 

‘‘(C) the intensification of efforts to control tuberculosis 

along the United States-Mexico border and among United 

States-Mexico binational populations, including through 

expansion of the scope and number of programs that— 

‘‘(i) detect and treat binational cases of tuberculosis; and 

‘‘(ii) treat high-risk cases of tuberculosis referred 

from Mexican health departments; 

‘‘(D) the intensification of efforts to prevent, detect, 

and treat tuberculosis among foreign-born persons who 

are in the United States; 
H. R. 1532—3 

‘‘(E) the intensification of efforts to prevent, detect, 

and treat tuberculosis among populations and settings 

documented as having a high risk for tuberculosis; and 

‘‘(F) tuberculosis detection, control, and prevention. 

‘‘(4) Public information and education activities. 

‘‘(5) Education, training, clinical skills improvement activities, and workplace exposure prevention for health professionals, including allied health personnel and emergency 

response employees. 

‘‘(6) Support of Centers to carry out activities under paragraphs (1) through (4). 

‘‘(7) Collaboration with international organizations and foreign countries in carrying out such activities. 

‘‘(8) Develop, enhance, and expand information technologies 

that support tuberculosis control including surveillance and 

database management systems with cross-jurisdictional 

capabilities, which shall conform to the standards and 

implementation specifications for such information technologies 

as recommended by the Secretary.’’; and 

(3) in subsection (d), by adding at the end the following: 

‘‘(3) DETERMINATION OF AMOUNT OF NONFEDERAL CONTRIBUTIONS.— 

‘‘(A) PRIORITY.—In awarding grants under subsection 

(a) or (b), the Secretary shall give highest priority to an 

applicant that provides assurances that the applicant will 

contribute non-Federal funds to carry out activities under 

this section, which may be provided directly or through 

donations from public or private entities and may be in 

cash or in kind, including equipment or services. 

‘‘(B) FEDERAL AMOUNTS NOT TO BE INCLUDED AS CONTRIBUTIONS.—Amounts provided by the Federal Government, or services assisted or subsidized to any significant 

extent by the Federal Government, may not be included 

in determining the amount of non-Federal contributions 

as described in subparagraph (A).’’. 

Subtitle B—Interagency Collaboration 

SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBERCULOSIS 

AND THE FEDERAL TUBERCULOSIS TASK FORCE. 

(a) IN GENERAL.—Section 317E(f) of the Public Health Service 

Act (42 U.S.C. 247b–6(f)) is amended— 

(1) by redesignating paragraph (5) as paragraph (6); and 

(2) by striking paragraphs (2) through (4), and inserting 

the following: 

‘‘(2) DUTIES.—The Council shall provide advice and recommendations regarding the elimination of tuberculosis to the 

Secretary. In addition, the Council shall, with respect to eliminating such disease, provide to the Secretary and other appropriate Federal officials advice on— 

‘‘(A) coordinating the activities of the Department of 

Health and Human Services and other Federal agencies 

that relate to the disease, including activities under subsection (b); 

‘‘(B) responding rapidly and effectively to emerging 

issues in tuberculosis; and 
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‘‘(C) efficiently utilizing the Federal resources involved. 

‘‘(3) COMPREHENSIVE PLAN.— 

‘‘(A) IN GENERAL.—In carrying out paragraph (2), the 

Council shall make or update recommendations on the 

development, revision, and implementation of a comprehensive plan to eliminate tuberculosis in the United States. 

‘‘(B) CONSULTATION.—In carrying out subparagraph 

(A), the Council may consult with appropriate public and 

private entities, which may, subject to the direction or 

discretion of the Secretary, include— 

‘‘(i) individuals who are scientists, physicians, 

laboratorians, and other health professionals, who are 

not officers or employees of the Federal Government 

and who represent the disciplines relevant to tuberculosis elimination; 

‘‘(ii) members of public-private partnerships or private entities established to address the elimination 

of tuberculosis; 

‘‘(iii) members of national and international nongovernmental organizations whose purpose is to eliminate tuberculosis; 

‘‘(iv) members from the general public who are 

knowledgeable with respect to tuberculosis elimination 

including individuals who have or have had tuberculosis; and 

‘‘(v) scientists, physicians, laboratorians, and other 

health professionals who reside in a foreign country 

with a substantial incidence or prevalence of tuberculosis, and who represent the specialties and disciplines relevant to the research under consideration. 

‘‘(C) CERTAIN COMPONENTS OF PLAN.—In carrying out 

subparagraph (A), the Council shall, subject to the direction 

or discretion of the Secretary— 

‘‘(i) consider recommendations for the involvement 

of the United States in continuing global and crossborder tuberculosis control activities in countries where 

a high incidence of tuberculosis directly affects the 

United States; and 

‘‘(ii) review the extent to which progress has been 

made toward eliminating tuberculosis. 

‘‘(4) BIENNIAL REPORT.— 

‘‘(A) IN GENERAL.—The Council shall submit a biennial 

report to the Secretary, as determined necessary by the 

Secretary, on the activities carried under this section. Each 

such report shall include the opinion of the Council on 

the extent to which its recommendations regarding the 

elimination of tuberculosis have been implemented, 

including with respect to— 

‘‘(i) activities under subsection (b); and 

‘‘(ii) the national plan referred to in paragraph 

(3). 

‘‘(B) PUBLIC.—The Secretary shall make a report submitted under subparagraph (A) public. 

‘‘(5) COMPOSITION.—The Council shall be composed of— 

‘‘(A) ex officio representatives from the Centers for 

Disease Control and Prevention, the National Institutes 

of Health, the United States Agency for International 
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Development, the Agency for Healthcare Research and 

Quality, the Health Resources and Services Administration, 

the United States-Mexico Border Health Commission, and 

other Federal departments and agencies that carry out 

significant activities related to tuberculosis; 

‘‘(B) State and local tuberculosis control and public 

health officials; 

‘‘(C) individuals who are scientists, physicians, 

laboratorians, and other health professionals who represent 

disciplines relevant to tuberculosis elimination; and 

‘‘(D) members of national and international nongovernmental organizations established to address the elimination 

of tuberculosis.’’. 

(b) RULE OF CONSTRUCTION REGARDING CURRENT MEMBERSHIP.—With respect to the advisory council under section 317E(f) 

of the Public Health Service Act, the amendments made by subsection (a) may not be construed as terminating the membership 

on such council of any individual serving as such a member as 

of the day before the date of the enactment of this Act. 

(c) FEDERAL TUBERCULOSIS TASK FORCE.—Section 317E of the 

Public Health Service Act (42 U.S.C. 247b–6) is amended— 

(1) by redesignating subsection (g) as subsection (h); and 

(2) by inserting after subsection (f) the following subsection: 

‘‘(g) FEDERAL TUBERCULOSIS TASK FORCE.— 

‘‘(1) DUTIES.—The Federal Tuberculosis Task Force (in this 

subsection referred to as the ‘Task Force’) shall provide to 

the Secretary and other appropriate Federal officials advice 

on research into new tools under subsection (b)(2), including 

advice regarding the efficient utilization of the Federal 

resources involved. 

‘‘(2) COMPREHENSIVE PLAN FOR NEW TOOLS DEVELOPMENT.— 

In carrying out paragraph (1), the Task Force shall make 

recommendations on the development of a comprehensive plan 

for the creation of new tools for the elimination of tuberculosis, 

including drugs, diagnostics, and vaccines. 

‘‘(3) CONSULTATION.—In developing the comprehensive plan 

under paragraph (1), the Task Force shall consult with external 

parties including representatives from groups such as— 

‘‘(A) scientists, physicians, laboratorians, and other 

health professionals who represent the specialties and disciplines relevant to the research under consideration; 

‘‘(B) members from public-private partnerships, private 

entities, or foundations (or both) engaged in activities relevant to research under consideration; 

‘‘(C) members of national and international nongovernmental organizations established to address tuberculosis 

elimination; 

‘‘(D) members from the general public who are 

knowledgeable with respect to tuberculosis including 

individuals who have or have had tuberculosis; and 

‘‘(E) scientists, physicians, laboratorians, and other 

health professionals who reside in a foreign country with 

a substantial incidence or prevalence of tuberculosis, and 

who represent the specialties and disciplines relevant to 

the research under consideration.’’. 
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Subtitle C—Evaluation of Public Health 

Authorities 

SEC. 121. EVALUATION OF PUBLIC HEALTH AUTHORITIES. 

(a) IN GENERAL.—Not later than 180 days after the date of 

enactment of the Comprehensive Tuberculosis Elimination Act of 

2008, the Secretary of Health and Human Services shall prepare 

and submit to the appropriate committees of Congress a report 

that evaluates and provides recommendations on changes needed 

to Federal and State public health authorities to address current 

disease containment challenges such as isolation and quarantine. 

(b) CONTENTS OF EVALUATION.—The report described in subsection (a) shall include— 

(1) an evaluation of the effectiveness of current policies 

to detain patients with active tuberculosis; 

(2) an evaluation of whether Federal laws should be 

strengthened to expressly address the movement of individuals 

with active tuberculosis; and 

(3) specific legislative recommendations for changes to Federal laws, if any. 

(c) UPDATE OF QUARANTINE REGULATIONS.—Not later than 240 

days after the date of enactment of this Act, the Secretary of 

Health and Human Services shall promulgate regulations to update 

the current interstate and foreign quarantine regulations found 

in parts 70 and 71 of title 42, Code of Federal Regulations. 

Subtitle D—Authorization of 

Appropriations 

SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS. 

Section 317E of the Public Health Service Act, as amended 

by section 111(c) of this Act, is amended by striking subsection 

(h) and inserting the following: 

‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

‘‘(1) GENERAL PROGRAM.— 

‘‘(A) IN GENERAL.—For the purpose of carrying out 

this section, there are authorized to be appropriated 

$200,000,000 for fiscal year 2009, $210,000,000 for fiscal 

year 2010, $220,500,000 for fiscal year 2011, $231,525,000 

for fiscal year 2012, and $243,101,250 for fiscal year 2013. 

‘‘(B) RESERVATION FOR EMERGENCY GRANTS.—Of the 

amounts appropriated under subparagraph (A) for a fiscal 

year, the Secretary may reserve not more than 25 percent 

for emergency grants under subsection (a) for any 

geographic area, State, political subdivision of a State, 

or other public entity in which there is, relative to other 

areas, a substantial number of cases of tuberculosis, 

multidrug resistant tuberculosis, or extensively drug resistant tuberculosis or a substantial rate of increase in such 

cases. 

‘‘(C) PRIORITY.—In allocating amounts appropriated 

under subparagraph (A), the Secretary shall give priority 

to allocating such amounts for grants under subsection 

(a). 
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‘‘(D) ALLOCATION OF FUNDS.— 

‘‘(i) REQUIREMENT OF FORMULA.—Of the amounts 

appropriated under subparagraph (A), not reserved 

under subparagraph (B), and allocated by the Secretary 

for grants under subsection (a), the Secretary shall 

distribute a portion of such amounts to grantees under 

subsection (a) on the basis of a formula. 

‘‘(ii) RELEVANT FACTORS.—The formula developed 

by the Secretary under clause (i) shall take into account 

the level of tuberculosis morbidity and case complexity 

in the respective geographic area and may consider 

other factors relevant to tuberculosis in such area. 

‘‘(iii) NO CHANGE TO FORMULA REQUIRED.—This 

subparagraph does not require the Secretary to modify 

the formula that was used by the Secretary to distribute funds to grantees under subsection (a) for fiscal 

year 2009. 

‘‘(2) LIMITATION.—The authorization of appropriations 

established in paragraph (1) for a fiscal year is effective only 

if the amount appropriated under such paragraph for such 

year equals or exceeds the amount appropriated to carry out 

this section for fiscal year 2009.’’. 

TITLE II—NATIONAL INSTITUTES OF 

HEALTH 

SEC. 201. RESEARCH AND DEVELOPMENT CONCERNING TUBERCULOSIS. 

Subpart 2 of part C of title IV of the Public Health Service 

Act (42 U.S.C. 285b et seq.) is amended by inserting after section 

424B the following section: 

‘‘SEC. 424C. TUBERCULOSIS. 

‘‘(a) IN GENERAL.—The Director of the National Institutes of 

Health may expand, intensify, and coordinate research and development and related activities of the Institutes with respect to tuberculosis including activities toward the goal of eliminating such 

disease. 

‘‘(b) CERTAIN ACTIVITIES.—Activities under subsection (a) may 

include— 

‘‘(1) enhancing basic and clinical research on tuberculosis, 

including drug resistant tuberculosis; 

‘‘(2) expanding research on the relationship between such 

disease and the human immunodeficiency virus; and 

‘‘(3) developing new tools for the elimination of tuberculosis, 

including public health interventions and methods to enhance 
H. R. 1532—8 

detection and response to outbreaks of tuberculosis, including 

multidrug resistant tuberculosis.’’. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.