I 
108TH CONGRESS 
1ST SESSION H. R. 2069
To amend the Foreign Assistance Act of 1961 to provide increased foreign 
assistance for tuberculosis prevention, treatment, and control, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 13, 2003
Mr. BROWN of Ohio (for himself and Mrs. WILSON of New Mexico) introduced 
the following bill; which was referred to the Committee on International 
Relations, and in addition to the Committee on Energy and Commerce, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To amend the Foreign Assistance Act of 1961 to provide 
increased foreign assistance for tuberculosis prevention, 
treatment, and control, 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’’. 
SEC. 2. FINDINGS. 
Congress finds the following:
(1)(A) Tuberculosis is a great health and eco-
nomic burden to impoverished nations and a health 
and security threat to the United States and other 
industrialized countries. 
(B) Tuberculosis is one of the greatest infec-
tious causes of death of adults worldwide, killing 
nearly 2,000,000 people per year—one person every 
15 seconds. 
(2) An estimated 8,000,000 individuals develop 
active tuberculosis each year. 
(3) Today, tuberculosis is the leading killer of 
women of reproductive age and of people who are 
HIV-positive. 
(4) Tuberculosis is spreading as a result of in-
adequate treatment and is a disease that knows no 
national borders. 
(5) With over 50 percent of tuberculosis cases 
in the United States attributable to foreign-born in-
dividuals and with the increase in international trav-
el, commerce, and migration, elimination of tuber-
culosis in the United States depends on efforts to 
control the disease in developing countries. 
(6) 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 (MDR–TB). 
(7) Up to 50,000,000 individuals may be in-
fected with multi-drug resistant tuberculosis. 
(8) In the United States, tuberculosis treat-
ment, normally about $2,000 per patient, increases 
to as much as $1,000,000 per patient to treat multi-
drug resistant tuberculosis, and treatment may not 
even be successful. 
(9) Without access to treatment, multi-drug re-
sistant tuberculosis is a virtual death sentence. 
(10) There is a highly effective and inexpensive 
treatment for standard tuberculosis. Recommended 
by the World Health Organization (WHO) as the 
best curative method for tuberculosis, this strategy, 
known as DOTS (Directly Observed Treatment 
Short-course), includes low-cost effective diagnosis, 
treatment, monitoring, and record keeping, as well 
as a reliable drug supply. A centerpiece of DOTS is 
observing patients to ensure that they take their 
medication and complete treatment. 
(11) DOTS is one of the most cost-effective 
health interventions available today. A full course of 
DOTS drugs costs as little as $10 in low-income 
countries.
(12) Proper DOTS treatment is imperative to 
prevent the development of dangerous multi-drug re-
sistant tuberculosis that arises through improper or 
incomplete tuberculosis treatment. 
(13) Building upon the DOTS strategy, DOTS-
Plus is a comprehensive tuberculosis management 
strategy that works as a supplement to the standard 
DOTS strategy to address areas where there is high 
prevalence of multi-drug resistant tuberculosis. 
(14) The Global Fund to Fight AIDS, Tuber-
culosis and Malaria is an important new global part-
nership established to combat these 3 infectious dis-
eases that together kill 6,000,000 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. 
(15) The Centers for Disease Control and Pre-
vention (CDC) is actively involved with global tuber-
culosis control efforts since the global tuberculosis 
epidemic directly impacts tuberculosis in the United 
States, and because Congress has strongly urged the 
CDC each year to increase its involvement with 
international tuberculosis control efforts.
(16) The CDC is assisting countries with a high 
burden of tuberculosis—
(A) to implement the World Health Orga-
nization-recommended control strategies, DOTS 
and DOTS-Plus; 
(B) to identify and treat persons with 
multi-drug resistant tuberculosis; and 
(C) to conduct research to identify new 
diagnostics, treatments, and interventions to 
control tuberculosis. 
SEC. 3. FOREIGN ASSISTANCE FOR TUBERCULOSIS PRE-
VENTION, TREATMENT, AND CONTROL. 
(a) AMENDMENT TO FOREIGN ASSISTANCE ACT OF 
1961.—Chapter 1 of part I of the Foreign Assistance Act 
of 1961 (22 U.S.C. 2151 et seq.) is amended by inserting 
after section 104 the following new section: 
‘‘SEC. 104A. ASSISTANCE FOR TUBERCULOSIS PREVENTION, 
TREATMENT, AND CONTROL. 
‘‘(a) STATEMENT OF POLICY.—Congress recognizes 
the growing international problem of tuberculosis and the 
impact its continued existence has on those nations that 
had previously largely controlled the disease. Congress fur-
ther recognizes that the means exist to control and treat 
tuberculosis, and that it is therefore a major objective of 
the foreign assistance program to control the disease.
‘‘(b) ASSISTANCE.—
‘‘(1) IN
GENERAL.—In meeting the objective 
described in subsection (a), the President shall pro-
vide assistance for the prevention, treatment, and 
control of tuberculosis. 
‘‘(2) ADDITIONAL
REQUIREMENTS.—In car-
rying out paragraph (1), the President shall—
‘‘(A) coordinate with the World Health Or-
ganization (WHO), the Global Fund to Fight 
AIDS, Tuberculosis and Malaria, the Depart-
ment of Health and Human Services (including 
Centers for Disease Control and Prevention and 
the National Institutes of Health), and other 
organizations with respect to the development 
and implementation of a comprehensive tuber-
culosis control program; 
‘‘(B) set as a goal the detection of at least 
70 percent of the cases of infectious tuber-
culosis, the cure of at least 85 percent of the 
cases detected by focusing efforts on the use of 
the Directly Observed Treatment Short-course 
(DOTS) strategy or other internationally ac-
cepted primary tuberculosis control strategies, 
in those countries in which the United States 
Agency for International Development has es-
tablished development programs, by December 
31, 2010, and the reduction of tuberculosis-re-
lated deaths by 50 percent, by December 31, 
2010; and 
‘‘(C) give priority to activities that increase 
Directly 
Observed 
Treatment 
Short-course 
(DOTS) coverage and treatment of multi-drug 
resistant tuberculosis where needed using 
DOTS-Plus, including funding for the Global 
Tuberculosis Drug Facility, the Stop Tuber-
culosis Partnership, and the Global Alliance for 
TB Drug Development. 
‘‘(c) ALLOCATION OF FUNDS.—In carrying out sub-
section (b), the President shall ensure that—
‘‘(1) not less than 75 percent of the amount 
made available to carry out this section for a fiscal 
year shall be expended for antituberculosis drugs, 
supplies, direct patient services, and training in di-
agnosis and treatment for Directly Observed Treat-
ment Short-course (DOTS) coverage and treatment 
of multi-drug resistant tuberculosis using DOTS-
Plus; and 
‘‘(2) not less than 10 percent of the amount 
made available to carry out this section for a fiscal 
year shall be expended to provide a United States
contribution to the Global Tuberculosis Drug Facil-
ity. 
‘‘(d) ANNUAL REPORT.—Not later than January 31 
of each year, the President shall transmit to the appro-
priate congressional committees a report that contains a 
summary of all programs, projects, and activities carried 
out under this section for the preceding fiscal year, includ-
ing a description of the increase in the number of individ-
uals treated and cured through each program, project, and 
activity. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—There are authorized to be 
appropriated to the President to carry out this sec-
tion $200,000,000 for each of the fiscal years 2004 
and 2005. 
‘‘(2) 
AVAILABILITY.—Amounts 
appropriated 
pursuant to the authorization of appropriations 
under paragraph (1) are authorized to remain avail-
able until expended. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.—The term ‘appropriate congressional com-
mittees’ means the Committee on International Re-
lations of the House of Representatives and the 
Committee on Foreign Relations of the Senate.