Comprehensive Tuberculosis Elimination Act of 2008
PL 110-392 (H.R.1532), enacted 10/13/2008

122 STAT. 4195 
PUBLIC LAW 110–392—OCT. 13, 2008 
Public Law 110–392 
110th Congress 
An Act 
To amend the Public Health Service Act with respect to making progress toward 
the goal of eliminating tuberculosis, and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘Comprehensive 
Tuberculosis Elimination Act of 2008’’. 
(b) TABLE OF CONTENTS.—The table of contents for this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINA-
TION WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION 
AND OTHER APPROPRIATE AGENCIES 
Subtitle A—National Strategy for Combating and Eliminating Tuberculosis 
Sec. 101. National strategy. 
Subtitle B—Interagency Collaboration 
Sec. 111. Advisory Council for Elimination of Tuberculosis and the Federal Tuber-
culosis Task Force . 
Subtitle C—Evaluation of Public Health Authorities 
Sec. 121. Evaluation of public health authorities. 
Subtitle D—Authorization of Appropriations 
Sec. 131. Authorizations of appropriations. 
TITLE II—NATIONAL INSTITUTES OF HEALTH 
Sec. 201. Research and development concerning tuberculosis. 
42 USC 201 note. 
Comprehensive 
Tuberculosis 
Elimination 
Act of 2008. 
Oct. 13, 2008 
[H.R. 1532] 
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122 STAT. 4196 
PUBLIC LAW 110–392—OCT. 13, 2008 
TITLE 
I—DEPARTMENT 
OF 
HEALTH 
AND HUMAN SERVICES IN COORDINA-
TION WITH THE CENTERS FOR DIS-
EASE 
CONTROL 
AND 
PREVENTION 
AND OTHER APPROPRIATE AGENCIES 
Subtitle A—National Strategy for 
Combating and Eliminating Tuberculosis 
SEC. 101. NATIONAL STRATEGY. 
Section 317E of the Public Health Service Act (42 U.S.C. 247b– 
6) is amended— 
(1) by striking the heading for the section and inserting 
the following: ‘‘NATIONAL STRATEGY FOR COMBATING AND ELIMI-
NATING TUBERCULOSIS’’; 
(2) by amending subsection (b) to read as follows: 
‘‘(b) RESEARCH AND DEVELOPMENT; DEMONSTRATION PROJECTS; 
EDUCATION AND TRAINING.—With respect to the prevention, treat-
ment, control, and elimination of tuberculosis, the Secretary may, 
directly or through grants to public or nonprofit private entities, 
carry out the following: 
‘‘(1) Research, with priority given to research and develop-
ment concerning latent tuberculosis infection, strains of tuber-
culosis resistant to drugs, and research concerning cases of 
tuberculosis that affect certain populations at risk for tuber-
culosis. 
‘‘(2) Research and development and related activities to 
develop new tools for the elimination of tuberculosis, including 
drugs, diagnostics, vaccines, and public health interventions, 
such as directly observed therapy and non-pharmaceutical 
intervention, and methods to enhance detection and response 
to outbreaks of tuberculosis, including multidrug resistant 
tuberculosis. The Secretary is encouraged to give priority to 
programmatically relevant research so that new tools can be 
utilized in public health practice. 
‘‘(3) Demonstration projects for— 
‘‘(A) the development of regional capabilities to prevent, 
control, and eliminate tuberculosis and prevent multidrug 
resistant and extensively drug resistant strains of tuber-
culosis; 
‘‘(B) the intensification of efforts to reduce health 
disparities in the incidence of tuberculosis; 
‘‘(C) the intensification of efforts to control tuberculosis 
along the United States-Mexico border and among United 
States-Mexico binational populations, including through 
expansion of the scope and number of programs that— 
‘‘(i) detect and treat binational cases of tuber-
culosis; and 
‘‘(ii) treat high-risk cases of tuberculosis referred 
from Mexican health departments; 
‘‘(D) the intensification of efforts to prevent, detect, 
and treat tuberculosis among foreign-born persons who 
are in the United States; 
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122 STAT. 4197 
PUBLIC LAW 110–392—OCT. 13, 2008 
‘‘(E) the intensification of efforts to prevent, detect, 
and treat tuberculosis among populations and settings 
documented as having a high risk for tuberculosis; and 
‘‘(F) tuberculosis detection, control, and prevention. 
‘‘(4) Public information and education activities. 
‘‘(5) Education, training, clinical skills improvement activi-
ties, and workplace exposure prevention for health profes-
sionals, including allied health personnel and emergency 
response employees. 
‘‘(6) Support of Centers to carry out activities under para-
graphs (1) through (4). 
‘‘(7) Collaboration with international organizations and for-
eign countries in carrying out such activities. 
‘‘(8) Develop, enhance, and expand information technologies 
that support tuberculosis control including surveillance and 
database 
management 
systems 
with 
cross-jurisdictional 
capabilities, which shall conform to the standards and 
implementation specifications for such information technologies 
as recommended by the Secretary.’’; and 
(3) in subsection (d), by adding at the end the following: 
‘‘(3) DETERMINATION OF AMOUNT OF NONFEDERAL CONTRIBU-
TIONS.— 
‘‘(A) PRIORITY.—In awarding grants under subsection 
(a) or (b), the Secretary shall give highest priority to an 
applicant that provides assurances that the applicant will 
contribute non-Federal funds to carry out activities under 
this section, which may be provided directly or through 
donations from public or private entities and may be in 
cash or in kind, including equipment or services. 
‘‘(B) FEDERAL AMOUNTS NOT TO BE INCLUDED AS CON-
TRIBUTIONS.—Amounts provided by the Federal Govern-
ment, or services assisted or subsidized to any significant 
extent by the Federal Government, may not be included 
in determining the amount of non-Federal contributions 
as described in subparagraph (A).’’. 
Subtitle B—Interagency Collaboration 
SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBERCULOSIS 
AND THE FEDERAL TUBERCULOSIS TASK FORCE. 
(a) IN GENERAL.—Section 317E(f) of the Public Health Service 
Act (42 U.S.C. 247b–6(f)) is amended— 
(1) by redesignating paragraph (5) as paragraph (6); and 
(2) by striking paragraphs (2) through (4), and inserting 
the following: 
‘‘(2) DUTIES.—The Council shall provide advice and rec-
ommendations regarding the elimination of tuberculosis to the 
Secretary. In addition, the Council shall, with respect to elimi-
nating such disease, provide to the Secretary and other appro-
priate Federal officials advice on— 
‘‘(A) coordinating the activities of the Department of 
Health and Human Services and other Federal agencies 
that relate to the disease, including activities under sub-
section (b); 
‘‘(B) responding rapidly and effectively to emerging 
issues in tuberculosis; and 
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122 STAT. 4198 
PUBLIC LAW 110–392—OCT. 13, 2008 
‘‘(C) efficiently utilizing the Federal resources involved. 
‘‘(3) COMPREHENSIVE PLAN.— 
‘‘(A) IN GENERAL.—In carrying out paragraph (2), the 
Council shall make or update recommendations on the 
development, revision, and implementation of a comprehen-
sive plan to eliminate tuberculosis in the United States. 
‘‘(B) CONSULTATION.—In carrying out subparagraph 
(A), the Council may consult with appropriate public and 
private entities, which may, subject to the direction or 
discretion of the Secretary, include— 
‘‘(i) individuals who are scientists, physicians, 
laboratorians, and other health professionals, who are 
not officers or employees of the Federal Government 
and who represent the disciplines relevant to tuber-
culosis elimination; 
‘‘(ii) members of public-private partnerships or pri-
vate entities established to address the elimination 
of tuberculosis; 
‘‘(iii) members of national and international non-
governmental organizations whose purpose is to elimi-
nate tuberculosis; 
‘‘(iv) members from the general public who are 
knowledgeable with respect to tuberculosis elimination 
including individuals who have or have had tuber-
culosis; and 
‘‘(v) scientists, physicians, laboratorians, and other 
health professionals who reside in a foreign country 
with a substantial incidence or prevalence of tuber-
culosis, and who represent the specialties and dis-
ciplines relevant to the research under consideration. 
‘‘(C) CERTAIN COMPONENTS OF PLAN.—In carrying out 
subparagraph (A), the Council shall, subject to the direction 
or discretion of the Secretary— 
‘‘(i) consider recommendations for the involvement 
of the United States in continuing global and cross- 
border tuberculosis control activities in countries where 
a high incidence of tuberculosis directly affects the 
United States; and 
‘‘(ii) review the extent to which progress has been 
made toward eliminating tuberculosis. 
‘‘(4) BIENNIAL REPORT.— 
‘‘(A) IN GENERAL.—The Council shall submit a biennial 
report to the Secretary, as determined necessary by the 
Secretary, on the activities carried under this section. Each 
such report shall include the opinion of the Council on 
the extent to which its recommendations regarding the 
elimination of tuberculosis have been implemented, 
including with respect to— 
‘‘(i) activities under subsection (b); and 
‘‘(ii) the national plan referred to in paragraph 
(3). 
‘‘(B) PUBLIC.—The Secretary shall make a report sub-
mitted under subparagraph (A) public. 
‘‘(5) COMPOSITION.—The Council shall be composed of— 
‘‘(A) ex officio representatives from the Centers for 
Disease Control and Prevention, the National Institutes 
of Health, the United States Agency for International 
Recommenda- 
tions. 
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122 STAT. 4199 
PUBLIC LAW 110–392—OCT. 13, 2008 
Development, the Agency for Healthcare Research and 
Quality, the Health Resources and Services Administration, 
the United States-Mexico Border Health Commission, and 
other Federal departments and agencies that carry out 
significant activities related to tuberculosis; 
‘‘(B) State and local tuberculosis control and public 
health officials; 
‘‘(C) 
individuals 
who 
are 
scientists, 
physicians, 
laboratorians, and other health professionals who represent 
disciplines relevant to tuberculosis elimination; and 
‘‘(D) members of national and international nongovern-
mental organizations established to address the elimination 
of tuberculosis.’’. 
(b) RULE
OF CONSTRUCTION REGARDING CURRENT MEMBER-
SHIP.—With respect to the advisory council under section 317E(f) 
of the Public Health Service Act, the amendments made by sub-
section (a) may not be construed as terminating the membership 
on such council of any individual serving as such a member as 
of the day before the date of the enactment of this Act. 
(c) FEDERAL TUBERCULOSIS TASK FORCE.—Section 317E of the 
Public Health Service Act (42 U.S.C. 247b–6) is amended— 
(1) by redesignating subsection (g) as subsection (h); and 
(2) by inserting after subsection (f) the following subsection: 
‘‘(g) FEDERAL TUBERCULOSIS TASK FORCE.— 
‘‘(1) DUTIES.—The Federal Tuberculosis Task Force (in this 
subsection referred to as the ‘Task Force’) shall provide to 
the Secretary and other appropriate Federal officials advice 
on research into new tools under subsection (b)(2), including 
advice regarding the efficient utilization of the Federal 
resources involved. 
‘‘(2) COMPREHENSIVE PLAN FOR NEW TOOLS DEVELOPMENT.— 
In carrying out paragraph (1), the Task Force shall make 
recommendations on the development of a comprehensive plan 
for the creation of new tools for the elimination of tuberculosis, 
including drugs, diagnostics, and vaccines. 
‘‘(3) CONSULTATION.—In developing the comprehensive plan 
under paragraph (1), the Task Force shall consult with external 
parties including representatives from groups such as— 
‘‘(A) scientists, physicians, laboratorians, and other 
health professionals who represent the specialties and dis-
ciplines relevant to the research under consideration; 
‘‘(B) members from public-private partnerships, private 
entities, or foundations (or both) engaged in activities rel-
evant to research under consideration; 
‘‘(C) members of national and international nongovern-
mental organizations established to address tuberculosis 
elimination; 
‘‘(D) members from the general public who are 
knowledgeable with respect to tuberculosis including 
individuals who have or have had tuberculosis; and 
‘‘(E) scientists, physicians, laboratorians, and other 
health professionals who reside in a foreign country with 
a substantial incidence or prevalence of tuberculosis, and 
who represent the specialties and disciplines relevant to 
the research under consideration.’’. 
Recommenda- 
tions. 
42 USC 247b–6 
note. 
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122 STAT. 4200 
PUBLIC LAW 110–392—OCT. 13, 2008 
Subtitle C—Evaluation of Public Health 
Authorities 
SEC. 121. EVALUATION OF PUBLIC HEALTH AUTHORITIES. 
(a) IN GENERAL.—Not later than 180 days after the date of 
enactment of the Comprehensive Tuberculosis Elimination Act of 
2008, the Secretary of Health and Human Services shall prepare 
and submit to the appropriate committees of Congress a report 
that evaluates and provides recommendations on changes needed 
to Federal and State public health authorities to address current 
disease containment challenges such as isolation and quarantine. 
(b) CONTENTS OF EVALUATION.—The report described in sub-
section (a) shall include— 
(1) an evaluation of the effectiveness of current policies 
to detain patients with active tuberculosis; 
(2) an evaluation of whether Federal laws should be 
strengthened to expressly address the movement of individuals 
with active tuberculosis; and 
(3) specific legislative recommendations for changes to Fed-
eral laws, if any. 
(c) UPDATE OF QUARANTINE REGULATIONS.—Not later than 240 
days after the date of enactment of this Act, the Secretary of 
Health and Human Services shall promulgate regulations to update 
the current interstate and foreign quarantine regulations found 
in parts 70 and 71 of title 42, Code of Federal Regulations. 
Subtitle D—Authorization of 
Appropriations 
SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS. 
Section 317E of the Public Health Service Act, as amended 
by section 111(c) of this Act, is amended by striking subsection 
(h) and inserting the following: 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) GENERAL PROGRAM.— 
‘‘(A) IN
GENERAL.—For the purpose of carrying out 
this section, there are authorized to be appropriated 
$200,000,000 for fiscal year 2009, $210,000,000 for fiscal 
year 2010, $220,500,000 for fiscal year 2011, $231,525,000 
for fiscal year 2012, and $243,101,250 for fiscal year 2013. 
‘‘(B) RESERVATION
FOR
EMERGENCY
GRANTS.—Of the 
amounts appropriated under subparagraph (A) for a fiscal 
year, the Secretary may reserve not more than 25 percent 
for emergency grants under subsection (a) for any 
geographic area, State, political subdivision of a State, 
or other public entity in which there is, relative to other 
areas, a substantial number of cases of tuberculosis, 
multidrug resistant tuberculosis, or extensively drug resist-
ant tuberculosis or a substantial rate of increase in such 
cases. 
‘‘(C) PRIORITY.—In allocating amounts appropriated 
under subparagraph (A), the Secretary shall give priority 
to allocating such amounts for grants under subsection 
(a). 
Deadline. 
Deadline. 
Reports. 
42 USC 264 note. 
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122 STAT. 4201 
PUBLIC LAW 110–392—OCT. 13, 2008 
‘‘(D) ALLOCATION OF FUNDS.— 
‘‘(i) REQUIREMENT OF FORMULA.—Of the amounts 
appropriated under subparagraph (A), not reserved 
under subparagraph (B), and allocated by the Secretary 
for grants under subsection (a), the Secretary shall 
distribute a portion of such amounts to grantees under 
subsection (a) on the basis of a formula. 
‘‘(ii) RELEVANT FACTORS.—The formula developed 
by the Secretary under clause (i) shall take into account 
the level of tuberculosis morbidity and case complexity 
in the respective geographic area and may consider 
other factors relevant to tuberculosis in such area. 
‘‘(iii) NO
CHANGE
TO
FORMULA
REQUIRED.—This 
subparagraph does not require the Secretary to modify 
the formula that was used by the Secretary to dis-
tribute funds to grantees under subsection (a) for fiscal 
year 2009. 
‘‘(2) LIMITATION.—The authorization of appropriations 
established in paragraph (1) for a fiscal year is effective only 
if the amount appropriated under such paragraph for such 
year equals or exceeds the amount appropriated to carry out 
this section for fiscal year 2009.’’. 
TITLE II—NATIONAL INSTITUTES OF 
HEALTH 
SEC. 201. RESEARCH AND DEVELOPMENT CONCERNING TUBER-
CULOSIS. 
Subpart 2 of part C of title IV of the Public Health Service 
Act (42 U.S.C. 285b et seq.) is amended by inserting after section 
424B the following section: 
‘‘SEC. 424C. TUBERCULOSIS. 
‘‘(a) IN GENERAL.—The Director of the National Institutes of 
Health may expand, intensify, and coordinate research and develop-
ment and related activities of the Institutes with respect to tuber-
culosis including activities toward the goal of eliminating such 
disease. 
‘‘(b) CERTAIN ACTIVITIES.—Activities under subsection (a) may 
include— 
‘‘(1) enhancing basic and clinical research on tuberculosis, 
including drug resistant tuberculosis; 
‘‘(2) expanding research on the relationship between such 
disease and the human immunodeficiency virus; and 
‘‘(3) developing new tools for the elimination of tuberculosis, 
including public health interventions and methods to enhance 
42 USC 285b–7c. 
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122 STAT. 4202 
PUBLIC LAW 110–392—OCT. 13, 2008 
LEGISLATIVE HISTORY—H.R. 1532 (S. 1551): 
HOUSE REPORTS: No. 110–873 (Comm. on Energy and Commerce). 
SENATE REPORTS: No. 110–329 accompanying S. 1551 (Comm. on Health, Edu-
cation, Labor, and Pensions). 
CONGRESSIONAL RECORD, Vol. 154 (2008): 
Sept. 23, 24, considered and passed House. 
Sept. 27, considered and passed Senate. 
detection and response to outbreaks of tuberculosis, including 
multidrug resistant tuberculosis.’’. 
Approved October 13, 2008. 
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