110TH CONGRESS 

1ST SESSION H. R. 1567 

AN ACT 

To amend the Foreign Assistance Act of 1961 to provide 

increased assistance for the prevention, treatment, and 

control of tuberculosis, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
2 

•HR 1567 EH

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Stop Tuberculosis 

3 (TB) Now Act of 2007’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

6 (1) Tuberculosis is one of the greatest infec7 tious causes of death of adults worldwide, killing 1.6 

8 million people per year—one person every 20 sec9 onds. 

10 (2) One-third of the world’s population is in11 fected with the tuberculosis bacterium and an esti12 mated 8.8 million individuals develop active tuber13 culosis each year. 

14 (3) Tuberculosis is the leading infectious killer 

15 among individuals who are HIV-positive due to their 

16 weakened immune systems, and it is estimated that 

17 one-third of people with HIV infection have tuber18 culosis. 

19 (4) Today, tuberculosis is a leading killer of 

20 women of reproductive age. 

21 (5) There are 22 countries that account for 80 

22 percent of the world’s burden of tuberculosis. The 

23 People’s Republic of China and India account for 36 

24 percent of all estimated new tuberculosis cases each 

25 year. 
3 

•HR 1567 EH

1 (6) Driven by the HIV/AIDS pandemic, inci2 dence rates of tuberculosis in Africa have more than 

3 doubled on average since 1990. The problem is so 

4 pervasive that in August 2005, African Health Min5 isters and the World Health Organization (WHO) 

6 declared tuberculosis to be an emergency in Africa. 

7 (7) The wide extent of drug resistance, includ8 ing both multi-drug resistant tuberculosis (MDR– 

9 TB) and extensively drug resistant tuberculosis 

10 (XDR–TB), represents both a critical challenge to 

11 the global control of tuberculosis and a serious 

12 worldwide public health threat. XDR–TB, which is 

13 characterized as being MDR–TB with additional re14 sistance to multiple second-line anti-tuberculosis 

15 drugs, is associated with worst treatment outcomes 

16 of any form of tuberculosis. XDR–TB is converging 

17 with the HIV epidemic, undermining gains in HIV 

18 prevention and treatment programs and requires ur19 gent interventions. Drug resistance surveillance re20 ports have confirmed the serious scale and spread of 

21 tuberculosis with XDR–TB strains confirmed on six 

22 continents. Demonstrating the lethality of XDR–TB, 

23 an initial outbreak in Tugela Ferry, South Africa, in 

24 2006 killed 52 of 53 patients with hundreds more 

25 cases reported since that time. Of the world’s re-
4 

•HR 1567 EH

1 gions, sub-Saharan Africa, faces the greatest gap in 

2 capacity to prevent, find, and treat XDR–TB. 

3 (8) With more than 50 percent of tuberculosis 

4 cases in the United States attributable to foreign5 born individuals and with the increase in inter6 national travel, commerce, and migration, elimi7 nation of tuberculosis in the United States depends 

8 on efforts to control the disease in developing coun9 tries. Recent research has shown that to invest in 

10 tuberculosis control abroad, where treatment and 

11 program costs are significantly cheaper than in the 

12 United States, would be a cost-effective strategy to 

13 reduce tuberculosis-related morbidity and mortality 

14 domestically. 

15 (9) The threat that tuberculosis poses for 

16 Americans derives from the global spread of tuber17 culosis and the emergence and spread of strains of 

18 multi-drug resistant tuberculosis and extensively 

19 drug resistant tuberculosis, which are far more 

20 deadly, and more difficult and costly to treat. 

21 (10) DOTS (Directly Observed Treatment 

22 Short-course) is one of the most cost-effective health 

23 interventions available today and is a core compo24 nent of the new Stop TB Strategy. 
5 

•HR 1567 EH

1 (11) The Stop TB Strategy, developed by the 

2 World Health Organization, builds on the success of 

3 DOTS and ongoing challenges so as to serve all 

4 those in need and reach targets for prevalence, mor5 tality, and incidence reduction. The Stop TB Strat6 egy includes six components: 

7 (A) Pursuing high-quality expansion and 

8 enhancement of DOTS coverage. 

9 (B) Implementing tuberculosis and HIV 

10 collaborative activities, preventing and control11 ling multi-drug resistant tuberculosis, and ad12 dressing other special challenges. 

13 (C) Contributing to the strengthening of 

14 health systems. 

15 (D) Engaging all health care providers, in16 cluding promotion of the International Stand17 ards for Tuberculosis Care. 

18 (E) Empowering individuals with tuber19 culosis and communities. 

20 (F) Enabling and promoting research to 

21 develop new diagnostics, drugs, vaccines, and 

22 program-based operational research relating to 

23 tuberculosis. 

24 (12) The Global Plan to Stop TB 2006–2015: 

25 Actions for Life is a comprehensive plan developed 
6 

•HR 1567 EH

1 by the Stop TB Partnership that sets out the ac2 tions necessary to achieve the millennium develop3 ment goal of cutting tuberculosis deaths and disease 

4 burden in half by 2015 and thus eliminate tuber5 culosis as a global health problem by 2050. 

6 (13) While innovations such as the Global Tu7 berculosis Drug Facility have enabled low-income 

8 countries to treat a standard case of tuberculosis 

9 with drugs that cost as little as $16 for a full course 

10 of treatment, there are still millions of individuals 

11 with no access to effective treatment. 

12 (14) As the global resource investment in fight13 ing tuberculosis increases, partner nations and inter14 national institutions must commit to a cor15 responding increase in the technical and program as16 sistance necessary to ensure that the most effective 

17 and efficient tuberculosis treatments are provided. 

18 (15) The Global Fund to Fight AIDS, Tuber19 culosis and Malaria is an important global partner20 ship established to combat these three infectious dis21 eases that together kill millions of people a year. Ex22 pansion of effective tuberculosis treatment programs 

23 constitutes a major component of Global Fund in24 vestment, along with integrated efforts to address 

25 HIV and tuberculosis in areas of high prevalence. 
7 

•HR 1567 EH

1 (16) The United States Agency for Inter2 national Development and the Centers for Disease 

3 Control and Prevention are actively involved with 

4 global tuberculosis control efforts. Because the glob5 al tuberculosis epidemic directly impacts tuberculosis 

6 in the United States, Congress has urged the Cen7 ters for Disease Control and Prevention each year to 

8 increase its involvement with international tuber9 culosis control efforts. 

10 (17) The United States Agency for Inter11 national Development is the lead United States Gov12 ernment agency for international tuberculosis ef13 forts, working in close partnership with the Centers 

14 for Disease Control and Prevention and with the 

15 President’s Emergency Plan for HIV/AIDS Relief. 

16 The goal of the United States Agency for Inter17 national Development is to contribute to the global 

18 reduction of morbidity and mortality associated with 

19 tuberculosis by building country capacity to prevent 

20 and cure tuberculosis and achieve global targets of 

21 70 percent case detection and 85 percent treatment 

22 success rates. The United States Agency for Inter23 national Development provides support for tuber24 culosis programs in countries that have a high bur-
8 

•HR 1567 EH

1 den of tuberculosis, a high prevalence of tuberculosis 

2 and HIV, and a high risk of MDR–TB. 

3 SEC. 3. ASSISTANCE TO COMBAT TUBERCULOSIS. 

4 (a) POLICY.—Subsection (b) of section 104B of the 

5 Foreign Assistance Act of 1961 (22 U.S.C. 2151b–3) is 

6 amended to read as follows: 

7 ‘‘(b) POLICY.—It is a major objective of the foreign 

8 assistance program of the United States to control tuber9 culosis. In all countries in which the Government of the 

10 United States has established development programs, par11 ticularly in countries with the highest burden of tuber12 culosis and other countries with high rates of tuberculosis, 

13 the United States Government should prioritize the 

14 achievement of the following goals by not later than De15 cember 31, 2015: 

16 ‘‘(1) Reduce by half the tuberculosis death and 

17 disease burden from the 1990 baseline. 

18 ‘‘(2) Sustain or exceed the detection of at least 

19 70 percent of sputum smear-positive cases of tuber20 culosis and the cure of at least 85 percent of those 

21 cases detected.’’. 

22 (b) AUTHORIZATION.—Subsection (c) of such section 

23 is amended— 

24 (1) in the heading, by striking ‘‘AUTHORIZA25 TION’’ and inserting ‘‘ASSISTANCE REQUIRED’’; and 
9 

•HR 1567 EH

1 (2) by striking ‘‘is authorized to’’ and inserting 

2 ‘‘shall’’. 

3 (c) PRIORITY TO STOP TB STRATEGY.—Subsection 

4 (e) of such section is amended— 

5 (1) in the heading, to read as follows: ‘‘PRI6 ORITY TO STOP TB STRATEGY.—’’; 

7 (2) in the first sentence, by striking ‘‘In fur8 nishing’’ and all that follows through ‘‘, including 

9 funding’’ and inserting the following: 

10 ‘‘(1) PRIORITY.—In furnishing assistance under 

11 subsection (c), the President shall give priority to— 

12 ‘‘(A) activities described in the Stop TB 

13 Strategy, including expansion and enhancement 

14 of DOTS coverage, treatment for individuals in15 fected with both tuberculosis and HIV and 

16 treatment for individuals with multi-drug resist17 ant tuberculosis (MDR–TB), strengthening of 

18 health systems, use of the International Stand19 ards for Tuberculosis Care by all providers, em20 powering individuals with tuberculosis, and ena21 bling and promoting research to develop new 

22 diagnostics, drugs, and vaccines, and program23 based operational research relating to tuber24 culosis; and 

25 ‘‘(B) funding’’; and 
10 

•HR 1567 EH

1 (3) in the second sentence— 

2 (A) by striking ‘‘In order to’’ and all that 

3 follows through ‘‘not less than’’ and inserting 

4 the following: 

5 ‘‘(2) AVAILABILITY OF AMOUNTS.—In order to 

6 meet the requirements of paragraph (1), the Presi7 dent— 

8 ‘‘(A) shall ensure that not less than’’; 

9 (B) by striking ‘‘for Directly Observed 

10 Treatment Short-course (DOTS) coverage and 

11 treatment of multi-drug resistant tuberculosis 

12 using DOTS–Plus,’’ and inserting ‘‘to imple13 ment the Stop TB Strategy; and’’; and 

14 (C) by striking ‘‘including’’ and all that 

15 follows and inserting the following: 

16 ‘‘(B) should ensure that not less than 

17 $15,000,000 of the amount made available to 

18 carry out this section for a fiscal year is used 

19 to make a contribution to the Global Tuber20 culosis Drug Facility.’’. 

21 (d) ASSISTANCE FOR WHO AND THE STOP TUBER22 CULOSIS PARTNERSHIP.—Such section is further amend23 ed— 

24 (1) by redesignating subsection (f) as sub25 section (g); and 
11 

•HR 1567 EH

1 (2) by inserting after subsection (e) the fol2 lowing new subsection: 

3 ‘‘(f) ASSISTANCE FOR WHO AND THE STOP TUBER4 CULOSIS PARTNERSHIP.—In carrying out this section, the 

5 President, acting through the Administrator of the United 

6 States Agency for International Development, is author7 ized to provide increased resources to the World Health 

8 Organization (WHO) and the Stop Tuberculosis Partner9 ship to improve the capacity of countries with high rates 

10 of tuberculosis and other affected countries to implement 

11 the Stop TB Strategy and specific strategies related to 

12 addressing extensively drug resistant tuberculosis (XDR– 

13 TB).’’. 

14 (e) DEFINITIONS.—Subsection (g) of such section, as 

15 redesignated by subsection (d)(1), is amended— 

16 (1) in paragraph (1), by adding at the end be17 fore the period the following: ‘‘, including low cost 

18 and effective diagnosis and evaluation of treatment 

19 regimes, vaccines, and monitoring of tuberculosis, as 

20 well as a reliable drug supply, and a management 

21 strategy for public health systems, with health sys22 tem strengthening, promotion of the use of the 

23 International Standards for Tuberculosis Care by all 

24 care providers, bacteriology under an external qual25 ity assessment framework, short-course chemo-
12 

•HR 1567 EH

1 therapy, and sound reporting and recording sys2 tems’’; and 

3 (2) by adding after paragraph (5) the following 

4 new paragraph: 

5 ‘‘(6) STOP TB STRATEGY.—The term ‘Stop TB 

6 Strategy’ means the six-point strategy to reduce tu7 berculosis developed by the World Health Organiza8 tion. The strategy is described in the Global Plan to 

9 Stop TB 2007–2016: Actions for Life, a comprehen10 sive plan developed by the Stop Tuberculosis Part11 nership that sets out the actions necessary to 

12 achieve the millennium development goal of cutting 

13 tuberculosis deaths and disease burden in half by 

14 2016.’’. 

15 (f) ANNUAL REPORT.—Clause (iii) of section 

16 104A(e)(2)(C) of the Foreign Assistance Act of 1961 (22 

17 U.S.C. 2151b–2(e)(2)(C)) is amended by adding at the 

18 end before the semicolon the following: ‘‘, including the 

19 percentage of such United States foreign assistance pro20 vided for diagnosis and treatment of individuals with tu21 berculosis in countries with the highest burden of tuber22 culosis, as determined by the World Health Organization 

23 (WHO)’’. 

24 (g) AUTHORIZATION OF APPROPRIATIONS.— 
13 

•HR 1567 EH

1 (1) IN GENERAL.—There are authorized to be 

2 appropriated to the President not more than 

3 $400,000,000 for fiscal year 2008 and not more 

4 than $550,000,000 for fiscal year 2009 to carry out 

5 section 104B of the Foreign Assistance Act of 1961 

6 (22 U.S.C. 2151b–3), as amended by subsections (a) 

7 through (e) of this section. 

8 (2) FUNDING FOR CDC.—Of the amounts ap9 propriated pursuant to the authorization of appro10 priations under paragraph (1), not more than 

11 $70,000,000 for fiscal year 2008 and not more than 

12 $100,000,000 for fiscal year 2009 shall be made 

13 available for the purpose of carrying out global tu14 berculosis activities through the Centers for Disease 

15 Control and Prevention. 

16 (3) ADDITIONAL PROVISIONS.—Amounts appro17 priated pursuant to the authorization of appropria18 tions under paragraph (1) and amounts made avail19 able pursuant to paragraph (2)— 

20 (A) are in addition amounts otherwise 

21 made available for such purposes; and 
14 

•HR 1567 EH

1 (B) are authorized to remain available 

2 until expended. 

Passed the House of Representatives November 5, 

2007. 

Attest: 

Clerk. 

110TH CONGRESS 

1ST SESSION H. R. 1567 

AN ACT 

To amend the Foreign Assistance Act of 1961 to 

other purposes. treatment, and control of tuberculosis, and for provide increased assistance for the prevention,