What This Bill Does
This bill makes it a major goal of United States foreign assistance to help end tuberculosis (a serious infectious disease) worldwide. The bill requires the President to work with international organizations and other countries to prevent, diagnose, and treat tuberculosis in people globally.
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Who It Affects
- The President and United States foreign assistance programs
- United States government agencies including the State Department, Centers for Disease Control and Prevention, National Institutes of Health, Food and Drug Administration, National Science Foundation, and Department of Defense
- The World Health Organization and Stop TB Partnership (an international group of 1,600 organizations fighting tuberculosis)
- Countries with high rates of tuberculosis
- People worldwide who have or are at risk for tuberculosis
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Key Provisions
- The President must establish goals for United States tuberculosis programs for 2023-2030 that align with the World Health Organization's End TB Strategy, including reducing tuberculosis deaths by 95 percent by 2035, reducing infection rates by 90 percent by 2035, and eliminating catastrophic health costs from tuberculosis by 2035 (Sec. 2(e))
- The President must coordinate tuberculosis efforts with international organizations and ensure different United States agencies work together to avoid duplication and share information (Sec. 2(f))
- The President must submit annual reports to Congress until 2030 describing how many people were diagnosed, treated, trained in tuberculosis control, and other details about United States tuberculosis programs (Sec. 2(i))
- The President must submit annual reports until 2030 describing progress on developing new tuberculosis diagnostic tools, treatments, and vaccines (Sec. 2(j))
- The Government Accountability Office must evaluate the performance of tuberculosis programs supported by United States assistance within three years of this law passing and every five years after (Sec. 2(k))
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What Changes
If this becomes law, the United States government must make ending tuberculosis a major foreign assistance priority. The President must create specific targets for diagnosing and treating tuberculosis cases worldwide and coordinate more closely among federal agencies working on tuberculosis. The President must provide annual reports to Congress showing progress toward these goals.
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Important Definitions
- **End TB Strategy**: The tuberculosis elimination strategy approved by the World Health Assembly in May 2014
- **Stop TB Partnership**: An international partnership of 1,600 organizations (including governments, nonprofits, private companies, and research groups) committed to controlling and eliminating tuberculosis
- **MDR-TB**: Multi-drug-resistant tuberculosis (tuberculosis that does not respond to standard medicines)
- **XDR-TB**: Extensively drug-resistant tuberculosis (tuberculosis resistant to even more medicines than MDR-TB)
- **Appropriate congressional committees**: The Senate Committee on Foreign Relations and the House Committee on Foreign Affairs
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Effective Date
The law takes effect when signed by the President. However, the bill automatically ends on December 31, 2030 (Sec. 3).
118TH CONGRESS
2D SESSION
S. 288
AN ACT
To prevent, treat, and cure tuberculosis globally.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
2
† S 288 ES
SECTION 1. SHORT TITLE.
1
This Act may be cited as the ‘‘End Tuberculosis Now
2
Act of 2024’’.
3
SEC. 2. UNITED STATES GOVERNMENT ASSISTANCE TO
4
COMBAT TUBERCULOSIS.
5
Section 104B of the Foreign Assistance Act of 1961
6
(22 U.S.C. 2151b–3) is amended to read as follows:
7
‘‘SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.
8
‘‘(a) FINDINGS.—Congress makes the following find-
9
ings:
10
‘‘(1) The international spread of tuberculosis
11
(referred to in this section as ‘TB’) and the deadly
12
impact of TB’s continued existence constitutes a
13
continuing challenge.
14
‘‘(2) Additional tools and resources are required
15
to effectively diagnose, prevent, and treat TB.
16
‘‘(3) Effectively resourced TB programs can
17
serve as a critical platform for preventing and re-
18
sponding to future infectious respiratory disease
19
pandemics.
20
‘‘(b) POLICY.—
21
‘‘(1) IN GENERAL.—It is a major objective of
22
the foreign assistance program of the United States
23
to help end the TB public health emergency through
24
accelerated actions—
25
3
† S 288 ES
‘‘(A) to support the diagnosis and treat-
1
ment of all adults and children with all forms
2
of TB; and
3
‘‘(B) to prevent new TB infections from
4
occurring.
5
‘‘(2) SUPPORT FOR GLOBAL PLANS AND OBJEC-
6
TIVES.—In countries in which the United States
7
Government has established foreign assistance pro-
8
grams under this Act, particularly in countries with
9
the highest burden of TB and other countries with
10
high rates of infection and transmission of TB, it is
11
the policy of the United States—
12
‘‘(A) to support the objectives of the World
13
Health Organization End TB Strategy, includ-
14
ing its goals—
15
‘‘(i) to reduce TB deaths by 95 per-
16
cent by 2035;
17
‘‘(ii) to reduce the TB incidence rate
18
by 90 percent by 2035; and
19
‘‘(iii) to reduce the number of families
20
facing catastrophic health costs due to TB
21
by 100 percent by 2035;
22
‘‘(B) to support the Stop TB Partnership’s
23
Global Plan to End TB 2023–2030, including
24
by providing support for—
25
4
† S 288 ES
‘‘(i) developing and using innovative
1
new technologies and therapies to increase
2
active case finding and rapidly diagnose
3
and treat children and adults with all
4
forms of TB, alleviate suffering, and en-
5
sure TB treatment completion;
6
‘‘(ii) expanding diagnosis and treat-
7
ment in line with the goals established by
8
the Political Declaration of the High-Level
9
Meeting of the General Assembly on the
10
Fight Against Tuberculosis, including—
11
‘‘(I)
successfully
treating
12
40,000,000 people with active TB by
13
2023, including 3,500,000 children,
14
and 1,500,000 people with drug-re-
15
sistant TB; and
16
‘‘(II) diagnosing and treating la-
17
tent tuberculosis infection, in support
18
of the global goal of providing preven-
19
tive therapy to at least 30,000,000
20
people by 2023, including 4,000,000
21
children younger than 5 years of age,
22
20,000,000 household contacts of peo-
23
ple affected by TB, and 6,000,000
24
people living with HIV;
25
5
† S 288 ES
‘‘(iii) ensuring high-quality TB care
1
by closing gaps in care cascades, imple-
2
menting continuous quality improvement
3
at all levels of care, and providing related
4
patient support; and
5
‘‘(iv) sustainable procurements of TB
6
commodities to avoid interruptions in sup-
7
ply, the procurement of commodities of un-
8
known quality, or payment of excessive
9
commodity costs in countries impacted by
10
TB; and
11
‘‘(C) to ensure, to the greatest extent prac-
12
ticable, that United States funding supports ac-
13
tivities that simultaneously emphasize—
14
‘‘(i) the development of comprehensive
15
person-centered programs, including diag-
16
nosis, treatment, and prevention strategies
17
to ensure that—
18
‘‘(I) all people sick with TB re-
19
ceive quality diagnosis and treatment
20
through active case finding; and
21
‘‘(II) people at high risk for TB
22
infection are found and treated with
23
preventive therapies in a timely man-
24
ner;
25
6
† S 288 ES
‘‘(ii) robust TB infection control prac-
1
tices are implemented in all congregate set-
2
tings, including hospitals and prisons;
3
‘‘(iii) the deployment of diagnostic
4
and treatment capacity—
5
‘‘(I) in areas with the highest TB
6
burdens; and
7
‘‘(II) for highly at-risk and im-
8
poverished populations, including pa-
9
tient support services;
10
‘‘(iv) program monitoring and evalua-
11
tion based on critical TB indicators, in-
12
cluding indicators relating to infection con-
13
trol, the numbers of patients accessing TB
14
treatment and patient support services,
15
and preventative therapy for those at risk,
16
including all close contacts, and treatment
17
outcomes for all forms of TB;
18
‘‘(v) training and engagement of
19
health care workers on the use of new di-
20
agnostic tools and therapies as they be-
21
come available, and increased support for
22
training frontline health care workers to
23
support expanded TB active case finding,
24
7
† S 288 ES
contact tracing, and patient support serv-
1
ices;
2
‘‘(vi) coordination with domestic agen-
3
cies and organizations to support an ag-
4
gressive research agenda to develop vac-
5
cines as well as new tools to diagnose,
6
treat, and prevent TB globally;
7
‘‘(vii) linkages with the private sector
8
on—
9
‘‘(I) research and development of
10
a vaccine, and on new tools for diag-
11
nosis and treatment of TB;
12
‘‘(II) improving current tools for
13
diagnosis and treatment of TB, in-
14
cluding telehealth solutions for pre-
15
vention and treatment; and
16
‘‘(III) training healthcare profes-
17
sionals on use of the newest and most
18
effective diagnostic and therapeutic
19
tools;
20
‘‘(viii) the reduction of barriers to
21
care, including stigma and treatment and
22
diagnosis costs, including through—
23
‘‘(I) training health workers;
24
‘‘(II) sensitizing policy makers;
25
8
† S 288 ES
‘‘(III) requiring that all relevant
1
grants and funding agreements in-
2
clude access and affordability provi-
3
sions;
4
‘‘(IV) supporting education and
5
empowerment campaigns for TB pa-
6
tients regarding local TB services;
7
‘‘(V) monitoring barriers to ac-
8
cessing TB services; and
9
‘‘(VI) increasing support for pa-
10
tient-led and community-led TB out-
11
reach efforts;
12
‘‘(ix) support for country-level, sus-
13
tainable accountability mechanisms and ca-
14
pacity to measure progress and ensure that
15
commitments made by governments and
16
relevant stakeholders are met; and
17
‘‘(x) support for the integration of TB
18
diagnosis, treatment, and prevention activi-
19
ties into primary health care, as appro-
20
priate.
21
‘‘(c) DEFINITIONS.—In this section:
22
‘‘(1) APPROPRIATE
CONGRESSIONAL
COMMIT-
23
TEES.—The term ‘appropriate congressional com-
24
mittees’ means the Committee on Foreign Relations
25
9
† S 288 ES
of the Senate and the Committee on Foreign Affairs
1
of the House of Representatives.
2
‘‘(2) END TB STRATEGY.—The term ‘End TB
3
Strategy’ means the strategy to eliminate TB that
4
was approved by the World Health Assembly in May
5
2014, and is described in ‘The End TB Strategy:
6
Global Strategy and Targets for Tuberculosis Pre-
7
vention, Care and Control After 2015’.
8
‘‘(3) GLOBAL
ALLIANCE
FOR
TUBERCULOSIS
9
DRUG
DEVELOPMENT.—The term ‘Global Alliance
10
for Tuberculosis Drug Development’ means the pub-
11
lic-private partnership that bring together leaders in
12
health, science, philanthropy, and private industry to
13
devise new approaches to TB.
14
‘‘(4) GLOBAL
TUBERCULOSIS
DRUG
FACIL-
15
ITY.—The term ‘Global Tuberculosis Drug Facility’
16
means the initiative of the Stop Tuberculosis Part-
17
nership to increase access to the most advanced, af-
18
fordable, quality-assured TB drugs and diagnostics.
19
‘‘(5) MDR–TB.—The term ‘MDR–TB’ means
20
multi-drug-resistant TB.
21
‘‘(6) STOP TUBERCULOSIS PARTNERSHIP.—The
22
term ‘Stop Tuberculosis Partnership’ means the
23
partnership of 1,600 organizations (including inter-
24
national and technical organizations, government
25
10
† S 288 ES
programs, research and funding agencies, founda-
1
tions, nongovernmental organizations, civil society
2
and community groups, and the private sector), do-
3
nors, including the United States, high TB burden
4
countries, multilateral agencies, and nongovern-
5
mental and technical agencies, which is governed by
6
the Stop TB Partnership Coordinating Board and
7
hosted by a United Nations entity, committed to
8
short- and long-term measures required to control
9
and eventually eliminate TB as a public health prob-
10
lem in the world.
11
‘‘(7) XDR–TB.—The term ‘XDR–TB’ means
12
extensively drug-resistant TB.
13
‘‘(d) AUTHORIZATION.—To carry out this section, the
14
President is authorized, consistent with section 104(c), to
15
furnish assistance, on such terms and conditions as the
16
President may determine, for the prevention, treatment,
17
control, and elimination of TB.
18
‘‘(e) GOALS.—In consultation with the appropriate
19
congressional committees, the President shall establish
20
goals, based on the policy and indicators described in sub-
21
section (b), for—
22
‘‘(1) United States TB programs to detect,
23
cure, and prevent all forms of TB globally for the
24
period between 2023 and 2030 that are aligned with
25
11
† S 288 ES
the End TB Strategy’s 2030 targets and the
1
USAID’s Global Tuberculosis (TB) Strategy 2023–
2
2030; and
3
‘‘(2) updating the National Action Plan for
4
Combating Multidrug-Resistant Tuberculosis.
5
‘‘(f) COORDINATION.—
6
‘‘(1) IN GENERAL.—In carrying out this sec-
7
tion, the President shall coordinate with the World
8
Health Organization, the Stop TB Partnership, the
9
Global Fund to Fight AIDS, Tuberculosis, and Ma-
10
laria, and other organizations with respect to the de-
11
velopment and implementation of a comprehensive
12
global TB response program.
13
‘‘(2) BILATERAL ASSISTANCE.—In providing bi-
14
lateral assistance under this section, the President,
15
acting through the Administrator of the United
16
States
Agency
for
International
Development,
17
shall—
18
‘‘(A) catalyze support for research and de-
19
velopment of new tools to prevent, diagnose,
20
treat, and control TB worldwide, particularly to
21
reduce the incidence of, and mortality from, all
22
forms of drug-resistant TB;
23
‘‘(B) ensure United States programs and
24
activities focus on finding individuals with ac-
25
12
† S 288 ES
tive TB disease and provide quality diagnosis
1
and treatment, including through digital health
2
solutions, and reaching those at high risk with
3
preventive therapy; and
4
‘‘(C) ensure coordination among relevant
5
United States Government agencies, including
6
the Department of State, the Centers for Dis-
7
ease Control and Prevention, the National In-
8
stitutes of Health, the Biomedical Advanced
9
Research and Development Authority, the Food
10
and Drug Administration, the National Science
11
Foundation,
the
Department
of
Defense
12
(through its Congressionally Directed Medical
13
Research Programs), and other relevant Fed-
14
eral departments and agencies that engage in
15
international TB activities—
16
‘‘(i) to ensure accountability and
17
transparency;
18
‘‘(ii) to reduce duplication of efforts;
19
and
20
‘‘(iii) to ensure appropriate integra-
21
tion and coordination of TB services into
22
other United States-supported health pro-
23
grams.
24
13
† S 288 ES
‘‘(g) PRIORITY TO END TB STRATEGY.—In fur-
1
nishing assistance under subsection (d), the President
2
shall prioritize—
3
‘‘(1) building and strengthening TB pro-
4
grams—
5
‘‘(A) to increase the diagnosis and treat-
6
ment of everyone who is sick with TB; and
7
‘‘(B) to ensure that such individuals have
8
access to quality diagnosis and treatment;
9
‘‘(2) direct, high-quality integrated services for
10
all forms of TB, as described by the World Health
11
Organization, which call for the coordination of ac-
12
tive case finding, treatment of all forms of TB dis-
13
ease and infection, patient support, and TB preven-
14
tion;
15
‘‘(3) treating individuals co-infected with HIV
16
and other co-morbidities, and other individuals with
17
TB who may be at risk of stigma;
18
‘‘(4) strengthening the capacity of health sys-
19
tems to detect, prevent, and treat TB, including
20
MDR–TB and XDR–TB, as described in the latest
21
international guidance related to TB;
22
‘‘(5) researching and developing innovative
23
diagnostics, drug therapies, and vaccines, and pro-
24
gram-based research;
25
14
† S 288 ES
‘‘(6) support for the Stop Tuberculosis Partner-
1
ship’s Global Drug Facility, the Global Alliance for
2
Tuberculosis Drug Development, and other organiza-
3
tions promoting the development of new products
4
and drugs for TB; and
5
‘‘(7) ensuring that TB programs can serve as
6
key platforms for supporting national respiratory
7
pandemic response against existing and new infec-
8
tious respiratory disease.
9
‘‘(h) ASSISTANCE FOR THE WORLD HEALTH ORGA-
10
NIZATION
AND
THE STOP TUBERCULOSIS PARTNER-
11
SHIP.—In carrying out this section, the President, acting
12
through the Administrator of the United States Agency
13
for International Development, is authorized—
14
‘‘(1) to provide resources to the World Health
15
Organization and the Stop Tuberculosis Partnership
16
to improve the capacity of countries with high bur-
17
dens or rates of TB and other affected countries to
18
implement the End TB Strategy, the Stop TB Glob-
19
al Plan to End TB, their own national strategies
20
and plans, other global efforts to control MDR–TB
21
and XDR–TB; and
22
‘‘(2) to leverage the contributions of other do-
23
nors for the activities described in paragraph (1).
24
15
† S 288 ES
‘‘(i) ANNUAL REPORT ON TB ACTIVITIES.—Not later
1
than December 15 of each year until the earlier of the
2
date on which the goals specified in subsection (b)(2)(A)
3
are met or the last day of 2030, the President shall submit
4
an annual report to the appropriate congressional commit-
5
tees that describes United States foreign assistance to
6
control TB and the impact of such efforts, including—
7
‘‘(1) the number of individuals with active TB
8
disease that were diagnosed and treated, including
9
the rate of treatment completion and the number re-
10
ceiving patient support;
11
‘‘(2) the number of persons with MDR–TB and
12
XDR–TB that were diagnosed and treated, includ-
13
ing the rate of completion, in countries receiving
14
United States bilateral foreign assistance for TB
15
control programs;
1
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