I 
117TH CONGRESS 
1ST SESSION H. R. 5857 
To amend the Public Health Service Act to enhance the national strategy 
for combating and eliminating tuberculosis, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 4, 2021 
Mr. BERA (for himself and Mr. YOUNG) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to enhance the 
national strategy for combating and eliminating tuber-
culosis, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Comprehensive TB 
Elimination Act of 2021’’. 
SEC. 2. NATIONAL STRATEGY FOR COMBATING AND ELIMI-
NATING TUBERCULOSIS. 
(a) IN GENERAL.—Section 317E of the Public 
Health Service Act (42 U.S.C. 247b–6) is amended— 
(1) in subsection (a)— 
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(A) by striking ‘‘The Secretary’’ and in-
serting the following: 
‘‘(1) GRANTS.—The Secretary’’; and 
(B) by adding at the end the following: 
‘‘(2) PRIORITY.—In making grants under this 
subsection, the Secretary may give priority to State 
health departments proposing to focus on the pre-
vention, control, and elimination of tuberculosis in 
high-risk populations, including foreign-born, home-
less, incarcerated, HIV-tuberculosis co-infected, and 
medically underserved populations.’’; 
(2) in subsection (b)— 
(A) in paragraph (3)— 
(i) in subparagraph (C), by redesig-
nating clauses (i) and (ii) as subclauses (I) 
and (II), respectively, and adjusting the 
margins accordingly; and 
(ii) by redesignating subparagraphs 
(A) through (F) as clauses (i) through (vi), 
respectively, and adjusting the margins ac-
cordingly; 
(B) 
by 
redesignating 
paragraphs 
(1) 
through (8) as subparagraphs (A) through (H), 
respectively, and adjusting the margins accord-
ingly; 
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(C) in the matter preceding subparagraph 
(A), as so redesignated, by striking ‘‘With re-
spect to’’ and inserting the following: 
‘‘(1) IN GENERAL.—With respect to’’; 
(D) by striking subparagraph (B), as so 
redesignated, and inserting the following: 
‘‘(B) Research, investigations, experiments, 
demonstrations, and studies in the health 
sciences that are related to— 
‘‘(i) the development of new tools, in-
cluding vaccines and antimicrobial drugs, 
to prevent and treat tuberculosis; 
‘‘(ii) novel therapeutics for special 
populations, 
including 
pediatric 
popu-
lations, immunosuppressed individuals, and 
pregnant women; 
‘‘(iii) the development or testing of 
medical diagnostics to detect tuberculosis; 
‘‘(iv) research to address the epidemi-
ology, mechanisms, and pathogenesis of tu-
berculosis; 
‘‘(v) public health interventions to ad-
dress the prevention, treatment, and con-
trol of tuberculosis, such as directly ob-
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served therapy and non-pharmaceutical 
intervention; 
‘‘(vi) methods to enhance detection 
and response to outbreaks of tuberculosis, 
including multidrug resistant tuberculosis; 
and 
‘‘(vii) other relevant research areas.’’; 
(E) in subparagraph (C), as so redesig-
nated— 
(i) by redesignating clause (vi), as so 
redesignated, as clause (vii); 
(ii) in clause (v), as so redesignated, 
by striking ‘‘; and’’ and inserting ‘‘;’’; and 
(iii) by inserting after clause (v), as so 
redesignated, the following: 
‘‘(vi) the intensification of efforts to 
prevent, detect, and treat latent tuber-
culosis; and’’; 
(F) in subparagraph (D), as so redesig-
nated, by inserting before the period the fol-
lowing: ‘‘, including public awareness campaigns 
and development of educational, risk, and 
media communications, using materials in lan-
guages appropriate to target audiences.’’; 
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(G) in subparagraph (F), as so redesig-
nated, by striking ‘‘paragraphs (1) through 
(4)’’ and inserting ‘‘subparagraphs (A) through 
(D)’’; and 
(H) by adding at the end the following: 
‘‘(2) SELECTION.—In carrying out the activities 
described in paragraph (1), the Secretary— 
‘‘(A) is encouraged to give priority to pro-
grammatically relevant research so that new 
tools can be utilized in public health practice; 
and 
‘‘(B) may seek input from the Biomedical 
Advanced Research and Development Authority 
in identifying novel candidates to utilize in the 
efforts under this subsection to prevent, diag-
nose, and control tuberculosis.’’; 
(3) by redesignating subsections (c) through (h) 
as subsections (d) through (i), respectively; 
(4) by inserting after subsection (b) the fol-
lowing— 
‘‘(c) GRANTS FOR COORDINATION OF PROGRAMS AND 
SERVICES FOR PREVENTION, DIAGNOSIS, AND TREAT-
MENT.— 
‘‘(1) GRANTS.—The Secretary, acting through 
the Administrator of the Health Resources and Serv-
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ices Administration, may award grants to State and 
local governments, territories, Indian Tribes, Tribal 
organization, urban Indian health organizations, 
health service providers to Indian Tribes, Native Ha-
waiian health organizations, community health cen-
ters, and Federally qualified health centers for co-
ordinating the programs and services of such entities 
to ensure timely and appropriate prevention, risk- 
based screening, diagnosis, and treatment of latent 
and active tuberculosis. 
‘‘(2) DEFINITION.—In this subsection, the term 
‘Federally qualified health center’ has the meaning 
given to such term in section 1861(aa) of the Social 
Security Act.’’; 
(5) in subsections (d), (e), and (f), as so redes-
ignated, by striking ‘‘(a) or (b)’’ each place it ap-
pears and inserting ‘‘(a), (b), or (c)’’; 
(6) in subsection (g)(4), as so redesignated, by 
adding at the end the following: 
‘‘(C) REPORT
TO
CONGRESS.—The Sec-
retary is encouraged to make the reports under 
subparagraph (A), or other publications rel-
evant to domestic tuberculosis surveillance, pub-
licly available on the internet website of the 
Centers for Disease Control and Prevention and 
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to disseminate such information to stake-
holders.’’; 
(7) in subsection (h), as so redesignated— 
(A) in paragraph (1)— 
(i) by striking ‘‘research into new 
tools under subsection (b)(2)’’ and insert-
ing ‘‘the research, investigations, experi-
ments, demonstrations, and studies in 
health science under subsection (b)(1)(B)’’; 
and 
(ii) by inserting ‘‘ensuring access to 
the products developed as a result of such 
research, investigations, experiments, dem-
onstrations, and studies and’’ after ‘‘advice 
regarding’’; and 
(B) in paragraph (3)— 
(i) by redesignating subparagraphs 
(D) and (E) as subparagraphs (E) and 
(F), respectively; and 
(ii) by inserting after subparagraph 
(C) the following: 
‘‘(D) members of the Biomedical Advanced 
Research and Development Authority;’’; and 
(8) in subsection (i)(1)(A), as so redesignated, 
by striking ‘‘$200,000,000’’ and all that follows 
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through the period and inserting ‘‘$142,200,000 for 
fiscal year 2022, $195,700,000 for fiscal year 2023, 
$225,000,000 for fiscal year 2024, $236,250,000 for 
fiscal year 2025, $248,062,500 for fiscal year 2026, 
and $260,465,625 for fiscal year 2027.’’. 
(b) 
NIH 
TUBERCULOSIS
ACTIVITIES.—Section 
424C(b) of the Public Health Service Act (42 U.S.C. 
285b–7c(b)) is amended by striking paragraph (1) and in-
serting the following: 
‘‘(1) enhancing basic, clinical, and operational 
research on tuberculosis, including with respect to— 
‘‘(A) drug-resistant tuberculosis; 
‘‘(B) infection with tuberculosis and la-
tency and progression of tuberculosis; and 
‘‘(C) pediatric tuberculosis;’’. 
SEC. 3. GAO STUDIES. 
(a) TUBERCULOSIS PREVENTION AND ELIMINATION 
STUDY.—Not later than 2 years after the date of enact-
ment of this Act, the Comptroller General of the United 
States shall issue a report on the coordination of efforts 
in the United States to— 
(1) prevent, control, and eliminate tuberculosis; 
and 
(2) implement the activities under section 317E 
of the Public Health Service Act (42 U.S.C. 247b– 
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6), as amended by this Act, and the National Action 
Plan for Combating Multidrug-Resistant Tuber-
culosis, issued in December 2015. 
(b) STUDY
ON TUBERCULOSIS ACTIVITIES.—Not 
later than 6 months after the date of enactment of this 
Act, the Comptroller General of the United States shall 
issue to the Committee on Energy and Commerce of the 
House of Representatives and the Committee on Health, 
Education, Labor, and Pensions of the Senate a report 
on the coordination of activities between the Food and 
Drug Administration and the Centers for Disease Control 
and Prevention with respect to— 
(1) shortages of critical tuberculosis drugs in 
the United States; 
(2) efforts to increase the availability of pedi-
atric tuberculosis drug formulations in the United 
States; 
(3) mitigating the cost of tuberculosis drugs for 
States, including efforts to ensure States have timely 
access to treatments for individuals with tuber-
culosis; and 
(4) consideration for the introduction in the 
United States of pediatric tuberculosis drug formu-
lations that are available in foreign countries. 
Æ 
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