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. 
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 ‘‘Stop Tuberculosis 
(TB) Now Act of 2007’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Tuberculosis is one of the greatest infec-
tious causes of death of adults worldwide, killing 1.6 
million people per year—one person every 20 sec-
onds. 
(2) One-third of the world’s population is in-
fected with the tuberculosis bacterium and an esti-
mated 8.8 million individuals develop active tuber-
culosis each year. 
(3) Tuberculosis is the leading infectious killer 
among individuals who are HIV-positive due to their 
weakened immune systems, and it is estimated that 
one-third of people with HIV infection have tuber-
culosis. 
(4) Today, tuberculosis is a leading killer of 
women of reproductive age. 
(5) There are 22 countries that account for 80 
percent of the world’s burden of tuberculosis. The 
People’s Republic of China and India account for 36 
percent of all estimated new tuberculosis cases each 
year.
(6) Driven by the HIV/AIDS pandemic, inci-
dence rates of tuberculosis in Africa have more than 
doubled on average since 1990. The problem is so 
pervasive that in August 2005, African Health Min-
isters and the World Health Organization (WHO) 
declared tuberculosis to be an emergency in Africa. 
(7) The wide extent of drug resistance, includ-
ing both multi-drug resistant tuberculosis (MDR– 
TB) and extensively drug resistant tuberculosis 
(XDR–TB), represents both a critical challenge to 
the global control of tuberculosis and a serious 
worldwide public health threat. XDR–TB, which is 
characterized as being MDR–TB with additional re-
sistance to multiple second-line anti-tuberculosis 
drugs, is associated with worst treatment outcomes 
of any form of tuberculosis. XDR–TB is converging 
with the HIV epidemic, undermining gains in HIV 
prevention and treatment programs and requires ur-
gent interventions. Drug resistance surveillance re-
ports have confirmed the serious scale and spread of 
tuberculosis with XDR–TB strains confirmed on six 
continents. Demonstrating the lethality of XDR–TB, 
an initial outbreak in Tugela Ferry, South Africa, in 
2006 killed 52 of 53 patients with hundreds more 
cases reported since that time. Of the world’s re-
gions, sub-Saharan Africa, faces the greatest gap in 
capacity to prevent, find, and treat XDR–TB. 
(8) With more than 50 percent of tuberculosis 
cases in the United States attributable to foreign- 
born individuals and with the increase in inter-
national travel, commerce, and migration, elimi-
nation of tuberculosis in the United States depends 
on efforts to control the disease in developing coun-
tries. Recent research has shown that to invest in 
tuberculosis control abroad, where treatment and 
program costs are significantly cheaper than in the 
United States, would be a cost-effective strategy to 
reduce tuberculosis-related morbidity and mortality 
domestically. 
(9) The threat that tuberculosis poses for 
Americans derives from the global spread of tuber-
culosis and the emergence and spread of strains of 
multi-drug resistant tuberculosis and extensively 
drug resistant tuberculosis, which are far more 
deadly, and more difficult and costly to treat. 
(10) DOTS (Directly Observed Treatment 
Short-course) is one of the most cost-effective health 
interventions available today and is a core compo-
nent of the new Stop TB Strategy.
(11) The Stop TB Strategy, developed by the 
World Health Organization, builds on the success of 
DOTS and ongoing challenges so as to serve all 
those in need and reach targets for prevalence, mor-
tality, and incidence reduction. The Stop TB Strat-
egy includes six components: 
(A) Pursuing high-quality expansion and 
enhancement of DOTS coverage. 
(B) Implementing tuberculosis and HIV 
collaborative activities, preventing and control-
ling multi-drug resistant tuberculosis, and ad-
dressing other special challenges. 
(C) Contributing to the strengthening of 
health systems. 
(D) Engaging all health care providers, in-
cluding promotion of the International Stand-
ards for Tuberculosis Care. 
(E) Empowering individuals with tuber-
culosis and communities. 
(F) Enabling and promoting research to 
develop new diagnostics, drugs, vaccines, and 
program-based operational research relating to 
tuberculosis. 
(12) The Global Plan to Stop TB 2006–2015: 
Actions for Life is a comprehensive plan developed
by the Stop TB Partnership that sets out the ac-
tions necessary to achieve the millennium develop-
ment goal of cutting tuberculosis deaths and disease 
burden in half by 2015 and thus eliminate tuber-
culosis as a global health problem by 2050. 
(13) While innovations such as the Global Tu-
berculosis Drug Facility have enabled low-income 
countries to treat a standard case of tuberculosis 
with drugs that cost as little as $16 for a full course 
of treatment, there are still millions of individuals 
with no access to effective treatment. 
(14) As the global resource investment in fight-
ing tuberculosis increases, partner nations and inter-
national institutions must commit to a cor-
responding increase in the technical and program as-
sistance necessary to ensure that the most effective 
and efficient tuberculosis treatments are provided. 
(15) The Global Fund to Fight AIDS, Tuber-
culosis and Malaria is an important global partner-
ship established to combat these three infectious dis-
eases that together kill millions of people a year. Ex-
pansion of effective tuberculosis treatment programs 
constitutes a major component of Global Fund in-
vestment, along with integrated efforts to address 
HIV and tuberculosis in areas of high prevalence.
(16) The United States Agency for Inter-
national Development and the Centers for Disease 
Control and Prevention are actively involved with 
global tuberculosis control efforts. Because the glob-
al tuberculosis epidemic directly impacts tuberculosis 
in the United States, Congress has urged the Cen-
ters for Disease Control and Prevention each year to 
increase its involvement with international tuber-
culosis control efforts. 
(17) The United States Agency for Inter-
national Development is the lead United States Gov-
ernment agency for international tuberculosis ef-
forts, working in close partnership with the Centers 
for Disease Control and Prevention and with the 
President’s Emergency Plan for HIV/AIDS Relief. 
The goal of the United States Agency for Inter-
national Development is to contribute to the global 
reduction of morbidity and mortality associated with 
tuberculosis by building country capacity to prevent 
and cure tuberculosis and achieve global targets of 
70 percent case detection and 85 percent treatment 
success rates. The United States Agency for Inter-
national Development provides support for tuber-
culosis programs in countries that have a high bur-
den of tuberculosis, a high prevalence of tuberculosis 
and HIV, and a high risk of MDR–TB. 
SEC. 3. ASSISTANCE TO COMBAT TUBERCULOSIS. 
(a) POLICY.—Subsection (b) of section 104B of the 
Foreign Assistance Act of 1961 (22 U.S.C. 2151b–3) is 
amended to read as follows: 
‘‘(b) POLICY.—It is a major objective of the foreign 
assistance program of the United States to control tuber-
culosis. In all countries in which the Government of the 
United States has established development programs, par-
ticularly in countries with the highest burden of tuber-
culosis and other countries with high rates of tuberculosis, 
the United States Government should prioritize the 
achievement of the following goals by not later than De-
cember 31, 2015: 
‘‘(1) Reduce by half the tuberculosis death and 
disease burden from the 1990 baseline. 
‘‘(2) Sustain or exceed the detection of at least 
70 percent of sputum smear-positive cases of tuber-
culosis and the cure of at least 85 percent of those 
cases detected.’’. 
(b) AUTHORIZATION.—Subsection (c) of such section 
is amended— 
(1) in the heading, by striking ‘‘AUTHORIZA-
TION’’ and inserting ‘‘ASSISTANCE REQUIRED’’; and
(2) by striking ‘‘is authorized to’’ and inserting 
‘‘shall’’. 
(c) PRIORITY TO STOP TB STRATEGY.—Subsection 
(e) of such section is amended— 
(1) in the heading, to read as follows: ‘‘PRI-
ORITY TO STOP TB STRATEGY.—’’; 
(2) in the first sentence, by striking ‘‘In fur-
nishing’’ and all that follows through ‘‘, including 
funding’’ and inserting the following: 
‘‘(1) PRIORITY.—In furnishing assistance under 
subsection (c), the President shall give priority to— 
‘‘(A) activities described in the Stop TB 
Strategy, including expansion and enhancement 
of DOTS coverage, treatment for individuals in-
fected with both tuberculosis and HIV and 
treatment for individuals with multi-drug resist-
ant tuberculosis (MDR–TB), strengthening of 
health systems, use of the International Stand-
ards for Tuberculosis Care by all providers, em-
powering individuals with tuberculosis, and ena-
bling and promoting research to develop new 
diagnostics, drugs, and vaccines, and program- 
based operational research relating to tuber-
culosis; and 
‘‘(B) funding’’; and
(3) in the second sentence— 
(A) by striking ‘‘In order to’’ and all that 
follows through ‘‘not less than’’ and inserting 
the following: 
‘‘(2) AVAILABILITY OF AMOUNTS.—In order to 
meet the requirements of paragraph (1), the Presi-
dent— 
‘‘(A) shall ensure that not less than’’; 
(B) by striking ‘‘for Directly Observed 
Treatment Short-course (DOTS) coverage and 
treatment of multi-drug resistant tuberculosis 
using DOTS–Plus,’’ and inserting ‘‘to imple-
ment the Stop TB Strategy; and’’; and 
(C) by striking ‘‘including’’ and all that 
follows and inserting the following: 
‘‘(B) should ensure that not less than 
$15,000,000 of the amount made available to 
carry out this section for a fiscal year is used 
to make a contribution to the Global Tuber-
culosis Drug Facility.’’. 
(d) ASSISTANCE FOR WHO AND THE STOP TUBER-
CULOSIS PARTNERSHIP.—Such section is further amend-
ed— 
(1) by redesignating subsection (f) as sub-
section (g); and
(2) by inserting after subsection (e) the fol-
lowing new subsection: 
‘‘(f) ASSISTANCE FOR WHO AND THE STOP TUBER-
CULOSIS PARTNERSHIP.—In carrying out this section, the 
President, acting through the Administrator of the United 
States Agency for International Development, is author-
ized to provide increased resources to the World Health 
Organization (WHO) and the Stop Tuberculosis Partner-
ship to improve the capacity of countries with high rates 
of tuberculosis and other affected countries to implement 
the Stop TB Strategy and specific strategies related to 
addressing extensively drug resistant tuberculosis (XDR– 
TB).’’. 
(e) DEFINITIONS.—Subsection (g) of such section, as 
redesignated by subsection (d)(1), is amended— 
(1) in paragraph (1), by adding at the end be-
fore the period the following: ‘‘, including low cost 
and effective diagnosis and evaluation of treatment 
regimes, vaccines, and monitoring of tuberculosis, as 
well as a reliable drug supply, and a management 
strategy for public health systems, with health sys-
tem strengthening, promotion of the use of the 
International Standards for Tuberculosis Care by all 
care providers, bacteriology under an external qual-
ity assessment framework, short-course chemo-
therapy, and sound reporting and recording sys-
tems’’; and 
(2) by adding after paragraph (5) the following 
new paragraph: 
‘‘(6) STOP TB STRATEGY.—The term ‘Stop TB 
Strategy’ means the six-point strategy to reduce tu-
berculosis developed by the World Health Organiza-
tion. The strategy is described in the Global Plan to 
Stop TB 2007–2016: Actions for Life, a comprehen-
sive plan developed by the Stop Tuberculosis Part-
nership that sets out the actions necessary to 
achieve the millennium development goal of cutting 
tuberculosis deaths and disease burden in half by 
2016.’’. 
(f) ANNUAL
REPORT.—Clause (iii) of section 
104A(e)(2)(C) of the Foreign Assistance Act of 1961 (22 
U.S.C. 2151b–2(e)(2)(C)) is amended by adding at the 
end before the semicolon the following: ‘‘, including the 
percentage of such United States foreign assistance pro-
vided for diagnosis and treatment of individuals with tu-
berculosis in countries with the highest burden of tuber-
culosis, as determined by the World Health Organization 
(WHO)’’. 
(g) AUTHORIZATION OF APPROPRIATIONS.—