I 

110TH CONGRESS 

1ST SESSION H. R. 1532 

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

toward the goal of eliminating tuberculosis, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 15, 2007 

Mr. GENE GREEN of Texas (for himself, Mrs. WILSON of New Mexico, and 

Ms. BALDWIN) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act with respect to 

making progress toward the goal of eliminating 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, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Comprehensive Tuberculosis Elimination Act of 2007’’. 

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

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

TITLE I—CENTERS FOR DISEASE CONTROL AND PREVENTION 


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Subtitle A—National Program for Elimination of Tuberculosis 

Sec. 101. National program. 

Subtitle B—Interagency Collaboration 

Sec. 111. Advisory council for elimination of tuberculosis. 

Subtitle C—New Tools for Tuberculosis Elimination 

Sec. 121. New tools. 

Subtitle D—Authorizations of Appropriations 

Sec. 131. Authorizations of appropriations. 

TITLE II—NATIONAL INSTITUTES OF HEALTH 

Sec. 201. Activities of National Heart, Lung, and Blood Institute. 

Sec. 202. Activities of National institute of Allergy and Infectious Diseases. 

Sec. 203. John E. Fogarty International Center for Advanced Study in the 

Health Sciences. 

Sec. 204. Loan repayment programs regarding research on tuberculosis. 

Sec. 205. Authorization of appropriations. 

1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) Each year approximately 9 million people 

4 become ill with active tuberculosis (‘‘TB’’), and 2 

5 million of those people die. This is a direct result of 

6 the disease having the ability to develop resistance 

7 to treatments and to travel easily across borders. 

8 (2) In 2005, there were 14,093 cases of active 

9 TB reported in the United States. However, the de10 cline of 3.8 percent in the national TB case rate 

11 from 2004 to 2005 was one of the smallest declines 

12 in more than a decade. 

13 (3) In addition to those with active TB, an esti14 mated 10 to 15 million people in the United States 

15 have latent TB. 


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1 (4) The increasing occurrence of multidrug re2 sistant (‘‘MDR’’) TB, including extensively drug re3 sistant (‘‘XDR’’) TB—which is resistant to at least 

4 two main first-line drugs and additionally to three or 

5 more of the six classes of second-line drugs—raises 

6 concerns of a future epidemic of virtually untreat7 able TB. 

8 (5) The Centers for Disease Control and Pre9 vention is increasingly relied upon globally for its ex10 pertise and technical assistance in global tuber11 culosis preparedness and outbreak response capacity 

12 to identify and investigate outbreaks of multidrug 

13 resistant and extensively drug resistant TB. 

14 (6) New tools are needed to more effectively 

15 prevent, diagnose, and treat TB. The standard 

16 method of diagnosing TB is over 100 years old, and 

17 fails to adequately detect TB in children and those 

18 co-infected with HIV/AIDS. The newest class of 

19 anti-TB drug is 40 years old, while rates of 

20 multidrug resistant TB are rising globally. 


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1 TITLE I—CENTERS FOR DISEASE 

2 CONTROL AND PREVENTION 

3 Subtitle A—National Program for 

4 Elimination of Tuberculosis 

5 SEC. 101. NATIONAL PROGRAM. 

6 Section 317E of the Public Health Service Act (42 

7 U.S.C. 247b–6) is amended— 

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

9 inserting the following: ‘‘NATIONAL PROGRAM FOR

10 ELIMINATION OF TUBERCULOSIS’’; and 

11 (2) by amending subsection (b) to read as fol12 lows: 

13 ‘‘(b) RESEARCH AND DEVELOPMENT; DEMONSTRA14 TION PROJECTS; EDUCATION AND TRAINING.—With re15 spect to the prevention, control, and elimination of tuber16 culosis, the Secretary may, directly or through grants to 

17 public or nonprofit private entities, carry out the following: 

18 ‘‘(1) Research, with priority given to research 

19 and development concerning— 

20 ‘‘(A) clinical trials to evaluate the safety 

21 and effectiveness of new drugs, diagnostics, and 

22 vaccines for latent tuberculosis infection and ac23 tive tuberculosis; 

24 ‘‘(B) epidemiological studies of populations 

25 at risk of tuberculosis; and 


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1 ‘‘(C) field studies to evaluate the effective2 ness of new drugs, diagnostics, and vaccines, 

3 and evaluation of efforts to eliminate the dis4 ease. 

5 ‘‘(2) Demonstration projects for— 

6 ‘‘(A) the development of regional capabili7 ties to prevent, control and eliminate tuber8 culosis; 

9 ‘‘(B) the intensification of efforts— 

10 ‘‘(i) to prevent, detect, and treat tu11 berculosis among African Americans and 

12 other United States-born populations with 

13 documented health disparities; and 

14 ‘‘(ii) to reduce or eliminate racial dis15 parities in the incidence of tuberculosis in 

16 these populations; 

17 ‘‘(C) the intensification of efforts to con18 trol tuberculosis along the United States-Mexico 

19 border and among United States-Mexico bina20 tional populations; 

21 ‘‘(D) the intensification of efforts to pre22 vent, detect, and treat tuberculosis among for23 eign-born persons who are in the United States; 

24 and 


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1 ‘‘(E) collaboration with Immigration and 

2 Customs Enforcement to identify and treat im3 migrants with active or latent tuberculosis in4 fection. 

5 ‘‘(3) A public information and education pro6 gram. 

7 ‘‘(4) Education, training and clinical skills im8 provement activities for health professionals, includ9 ing allied health personnel and emergency response 

10 employees. 

11 ‘‘(5) Provide support for the Tuberculosis 

12 Trials Consortium, the Tuberculosis Epidemiologic 

13 Studies Consortium, and Regional Training and 

14 Medical Consultation Centers to carry out activities 

15 under paragraphs (1) through (4). 

16 ‘‘(6) Collaboration with international organiza17 tions and foreign countries in carrying out such ac18 tivities.’’. 

19 Subtitle B—Interagency 

20 Collaboration 

21 SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TU22 BERCULOSIS. 

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

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


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1 (1) by redesignating paragraph (5) as para2 graph (6); and 

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

4 inserting the following: 

5 ‘‘(2) DUTIES.—The Council shall provide advice 

6 and recommendations regarding the elimination of 

7 tuberculosis to the Secretary, the Assistant Sec8 retary for Health, and the Director of the Centers 

9 for Disease Control and Prevention. In addition, the 

10 Council shall, with respect to eliminating such dis11 ease, provide to the Secretary and other appropriate 

12 Federal officials advice on— 

13 ‘‘(A) coordinating the activities of the Pub14 lic Health Service and other Federal agencies 

15 that relate to the disease, including activities 

16 under subsection (b); and 

17 ‘‘(B) efficiently utilizing the Federal re18 sources involved. 

19 ‘‘(3) NATIONAL PLAN.— 

20 ‘‘(A) IN GENERAL.—In carrying out para21 graph (2), the Council shall make recommenda22 tions on the development, revision, and imple23 mentation of a national plan to eliminate tuber24 culosis in the United States. 


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

2 subparagraph (A), the Council shall consult 

3 with public and private entities, including— 

4 ‘‘(i) individuals who are scientists, 

5 physicians, and other health professionals, 

6 who are not officers or employees of the 

7 Federal Government and who represent the 

8 disciplines relevant to tuberculosis elimi9 nation; 

10 ‘‘(ii) members of public-private part11 nerships established to address the elimi12 nation of tuberculosis; 

13 ‘‘(iii) members of national and inter14 national nongovernmental organizations es15 tablished to address tuberculosis elimi16 nation; and 

17 ‘‘(iv) members from the general public 

18 who are knowledgeable with respect to tu19 berculosis elimination including individuals 

20 who have or have had tuberculosis. 

21 ‘‘(C) CERTAIN COMPONENTS OF PLAN.—In 

22 carrying out subparagraph (A), the Council 

23 shall— 


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1 ‘‘(i) consider the recommendations of 

2 the Institute of Medicine regarding the 

3 elimination of tuberculosis; 

4 ‘‘(ii) consider recommendations for 

5 the involvement of the United States in 

6 continuing global and cross-border tuber7 culosis control activities in countries where 

8 a high incidence of tuberculosis directly af9 fects the United States such as Mexico; 

10 and 

11 ‘‘(iii) review the extent to which 

12 progress has been made toward eliminating 

13 tuberculosis. 

14 ‘‘(4) ANNUAL REPORT.—The Council shall an15 nually submit to Congress and the Secretary a re16 port on the activities carried under this section, 

17 other than subsection (g). Each such report shall in18 clude the opinion of the Council on the extent to 

19 which its recommendations regarding the elimination 

20 of tuberculosis have been implemented, including 

21 with respect to— 

22 ‘‘(A) activities under subsection (b); and 

23 ‘‘(B) the national plan referred to in para24 graph (3). 


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1 ‘‘(5) COMPOSITION.—The Council shall be com2 posed of— 

3 ‘‘(A) representatives from the Centers for 

4 Disease Control and Prevention, the National 

5 Institutes of Health, the United States Agency 

6 for International Development, the Agency for 

7 Healthcare Research and Quality, the Health 

8 Resources and Services Administration, the 

9 United States-Mexico Border Health Commis10 sion, and other Federal departments and agen11 cies that carry out significant activities related 

12 to tuberculosis; 

13 ‘‘(B) State and local tuberculosis control 

14 and public health and officials; 

15 ‘‘(C) individuals who are scientists, physi16 cians, laboratorians, and other health profes17 sionals who represent disciplines relevant to tu18 berculosis elimination; 

19 ‘‘(D) members of national and inter20 national nongovernmental organizations estab21 lished to address the elimination of tuberculosis; 

22 and 

23 ‘‘(E) members from the general public who 

24 are knowledgeable with respect to the elimiVerDate Aug 31 2005 22:22 Mar 16, 2007 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1532.IH H1532

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1 nation of tuberculosis, including individuals who 

2 have or have had tuberculosis.’’. 

3 (b) RULE OF CONSTRUCTION REGARDING CURRENT

4 MEMBERSHIP.—With respect to the advisory council 

5 under section 317E(f) of the Public Health Service Act, 

6 the amendments made by subsection (a) may not be con7 strued as terminating the membership on such council of 

8 any individual serving as such a member as of the day 

9 before the date of the enactment of this Act. 

10 Subtitle C—New Tools for 

11 Tuberculosis Elimination 

12 SEC. 121. NEW TOOLS. 

13 Section 317E of the Public Health Service Act (42 

14 U.S.C. 247b–6) is amended— 

15 (1) by redesignating subsection (g) as sub16 section (h); and 

17 (2) by inserting after subsection (f) the fol18 lowing subsection: 

19 ‘‘(g) NEW TOOLS FOR ELIMINATION OF TUBER20 CULOSIS.— 

21 ‘‘(1) RESEARCH AND DEVELOPMENT ON DRUGS, 

22 DIAGNOSTICS, VACCINES, AND PUBLIC HEALTH

23 INTERVENTIONS.—The Secretary, acting through 

24 the Director of the Centers for Disease Control and 

25 Prevention, shall expand, intensify, and coordinate 


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1 research and development and related activities of 

2 such Centers to develop new tools for the elimination 

3 of tuberculosis, including drugs, diagnostics, vac4 cines, and public health interventions. 

5 ‘‘(2) FEDERAL TUBERCULOSIS TASK FORCE.— 

6 ‘‘(A) DUTIES.—The Federal Tuberculosis 

7 Task Force (established in December 2001 as 

8 part of the Centers for Disease Control and 

9 Prevention) (in this subsection referred to as 

10 the ‘Task Force’) shall provide to the Secretary 

11 and other appropriate Federal officials advice 

12 on the implementation of paragraph (1), includ13 ing advice regarding the efficient utilization of 

14 the Federal resources involved. 

15 ‘‘(B) NATIONAL PLAN FOR NEW TOOLS

16 DEVELOPMENT.—In carrying out paragraph 

17 (1), the Task Force shall make recommenda18 tions on the development of a national plan for 

19 the development of new tools for the elimination 

20 of tuberculosis, including drugs, diagnostics, 

21 and vaccines. 

22 ‘‘(C) CONSULTATION.—In developing the 

23 national plan under paragraph (1), the Task 

24 Force shall consult with— 


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1 ‘‘(i) scientists, physicians, and other 

2 health professionals and who represent the 

3 specialties and disciplines relevant to the 

4 research under consideration; 

5 ‘‘(ii) members from public-private 

6 partnerships or foundations (or both) en7 gaged in research relevant to research 

8 under consideration; 

9 ‘‘(iii) members of national and inter10 national nongovernmental organizations es11 tablished to address tuberculosis elimi12 nation; 

13 ‘‘(iv) members from the general public 

14 who are knowledgeable with respect to tu15 berculosis, including individuals who have 

16 or have had tuberculosis; and 

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

18 health professionals who reside in a foreign 

19 country with a substantial incidence or 

20 prevalence of tuberculosis, and who rep21 resent the specialties and disciplines rel22 evant to the research under consideration. 

23 ‘‘(3) GRANTS AND CONTRACTS.—The Secretary 

24 shall carry out paragraph (1) directly and through 


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1 awards of grants, cooperative agreements, and con2 tracts to public and private entities, including— 

3 ‘‘(A) public-private partnerships; 

4 ‘‘(B) academic institutions, including insti5 tutions of higher education; 

6 ‘‘(C) research institutions; and 

7 ‘‘(D) the Tuberculosis Trials Consortium 

8 and the Tuberculosis Epidemiologic Studies 

9 Consortium.’’. 

10 Subtitle D—Authorizations of 

11 Appropriations 

12 SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS. 

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

14 amended by section 121(1) of this Act, is amended by 

15 amending subsection (h) to read as follows: 

16 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

17 ‘‘(1) GENERAL PROGRAM.— 

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

19 carrying out this section, other than subsection 

20 (g), there are authorized to be appropriated 

21 $528,000,000 for fiscal year 2008, and such 

22 sums as may be necessary for each of the fiscal 

23 years 2009 through 2012. 

24 ‘‘(B) RESERVATION FOR EMERGENCY

25 GRANTS.—Of the amounts appropriated under 


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1 subparagraph (A) for a fiscal year, the Sec2 retary may reserve not more than 25 percent 

3 for emergency grants under subsection (a) for 

4 any geographic area in which there is, relative 

5 to other areas, a substantial number of cases of 

6 tuberculosis, multidrug resistant tuberculosis, 

7 or extensively resistant tuberculosis or a sub8 stantial rate of increase in such cases. 

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

10 appropriated under subparagraph (A) and not 

11 reserved under subparagraph (B), the Secretary 

12 shall give priority to allocating such amounts 

13 for grants under subsection (a). 

14 ‘‘(D) ALLOCATION OF FUNDS.— 

15 ‘‘(i) REQUIREMENT OF FORMULA.—Of 

16 the amounts appropriated under subpara17 graph (A), not reserved under subpara18 graph (B), and allocated by the Secretary 

19 for grants under subsection (a), the Sec20 retary shall distribute such amounts to 

21 grantees under subsection (a) on the basis 

22 of a formula. 

23 ‘‘(ii) RELEVANT FACTORS.—The for24 mula developed by the Secretary under 

25 clause (i) shall take into account the level 


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1 of tuberculosis morbidity in the respective 

2 geographic area and may consider other 

3 factors relevant to tuberculosis in such 

4 area. 

5 ‘‘(iii) NO CHANGE TO FORMULA RE6 QUIRED.—This subparagraph does not re7 quire the Secretary to modify the formula 

8 that was used by the Secretary to dis9 tribute funds to grantees under subsection 

10 (a) for fiscal year 2007. 

11 ‘‘(2) NEW TOOLS.— 

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

13 carrying out subsection (g), there are author14 ized to be appropriated $100,000,000 for fiscal 

15 year 2008, and such sums as may be necessary 

16 for each of the fiscal years 2009 through 2012. 

17 ‘‘(B) LIMITATION.—The authorization of 

18 appropriations established in subparagraph (A) 

19 for a fiscal year is effective only if the amount 

20 appropriated under paragraph (1) for such year 

21 equals or exceeds the amount appropriated to 

22 carry out this section for fiscal year 2007.’’. 


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1 TITLE II—NATIONAL INSTITUTES 

2 OF HEALTH 

3 SEC. 201. ACTIVITIES OF NATIONAL HEART, LUNG, AND 

4 BLOOD INSTITUTE. 

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

6 Service Act (42 U.S.C. 285b et seq.) is amended by insert7 ing after section 424B the following section: 

8 ‘‘SEC. 424C. TUBERCULOSIS. 

9 ‘‘(a) IN GENERAL.—The Director of the Institute 

10 shall expand, intensify, and coordinate research and devel11 opment and related activities of the Institute with respect 

12 to tuberculosis, including activities toward the goal of 

13 eliminating such disease. 

14 ‘‘(b) CERTAIN ACTIVITIES.—Activities under sub15 section (a) shall include— 

16 ‘‘(1) enhancing basic and clinical research on 

17 tuberculosis; and 

18 ‘‘(2) expanding research on the relationship be19 tween such disease and the human immunodeficiency 

20 virus. 

21 ‘‘(c) RESEARCH EDUCATION.— 

22 ‘‘(1) TUBERCULOSIS ACADEMIC AWARDS.—The 

23 Director of the Institute may provide awards to fac24 ulty of schools of medicine or osteopathic medicine 

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1 ricula in such schools designed to significantly in2 crease the opportunities for interested individuals, 

3 including students of the school and practicing phy4 sicians and nurses, to learn the principles and prac5 tices of preventing, managing, and controlling tuber6 culosis. 

7 ‘‘(2) TUBERCULOSIS/PULMONARY INFECTION

8 AWARDS.—The Director of the Institute may provide 

9 awards to support the career development of clini10 cally trained professionals who are committed to re11 search regarding pulmonary infections and tuber12 culosis by providing for supervised study and re13 search.’’. 

14 SEC. 202. ACTIVITIES OF NATIONAL INSTITUTE OF AL15 LERGY AND INFECTIOUS DISEASES. 

16 Section 447A of the Public Health Service Act (42 

17 U.S.C. 285f–2) is amended— 

18 (1) by striking ‘‘In carrying out section 446’’ 

19 and inserting ‘‘(a) In carrying out section 446’’; and 

20 (2) by inserting at the end the following: 

21 ‘‘(b) Activities under subsection (a) shall include ac22 tivities to develop a tuberculosis vaccine. Such activities 

23 shall be carried out in accordance with the blueprint for 

24 tuberculosis vaccine development described in the report 

25 prepared pursuant to the workshop convened in March 


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1 1998 by the Advisory Council for Elimination of Tuber2 culosis, the Director of the National Vaccine Program, 

3 and the Director of the Institute.’’. 

4 SEC. 203. JOHN E. FOGARTY INTERNATIONAL CENTER FOR 

5 ADVANCED STUDY IN THE HEALTH 

6 SCIENCES. 

7 Section 482 of the Public Health Service Act (42 

8 U.S.C. 287b) is amended— 

9 (1) by inserting ‘‘(a) IN GENERAL.—’’ before 

10 ‘‘The general purpose’’; 

11 (2) in subsection (a) (as so designated), by in12 serting after ‘‘Health Sciences’’ the following: ‘‘(in 

13 this subpart referred to as the ‘Center’)’’; and 

14 (3) by adding at the end the following sub15 section: 

16 ‘‘(b) TUBERCULOSIS.— 

17 ‘‘(1) IN GENERAL.—In carrying out subsection 

18 (a) with respect to tuberculosis, the Center shall ex19 pand, intensify, and coordinate international activi20 ties of the Center for research and training. 

21 ‘‘(2) INTERNATIONAL TRAINING PROGRAM.—In 

22 carrying out paragraph (1), the Center shall carry 

23 out an international training program regarding tu24 berculosis. Such program shall be modeled after the 

25 international training program carried out by the 


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1 Center with respect to the human immunodeficiency 

2 virus.’’. 

3 SEC. 204. LOAN REPAYMENT PROGRAMS REGARDING RE4 SEARCH ON TUBERCULOSIS. 

5 Part G of title IV of the Public Health Service Act 

6 (42 U.S.C. 288 et seq.) is amended— 

7 (1) by redesignating the second section 487F as 

8 section 487G; and 

9 (2) by inserting after section 487G (as so re10 designated) the following section: 

11 ‘‘LOAN REPAYMENTS REGARDING RESEARCH ON

12 TUBERCULOSIS

13 ‘‘SEC. 487H. In carrying out sections 487C, 487E, 

14 and 487F, the Secretary shall seek to ensure that, for fis15 cal year 2008 and subsequent fiscal years, a portion of 

16 amounts appropriated to carry out such sections is re17 served for the purpose of entering into contracts under 

18 which (in accordance with the section involved) individuals 

19 will conduct research on tuberculosis.’’. 

20 SEC. 205. AUTHORIZATION OF APPROPRIATIONS. 

21 For the purpose of carrying out this title and the 

22 amendments made by this title, there are authorized to 

23 be appropriated such sums as may be necessary. Such au24 thorization of appropriations shall be in addition to the 

25 authorization of appropriations established by section 


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1 402A(a) of the Public Health Service Act and any other 

2 authorization of appropriations available for such purpose. 

Æ 


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