[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5836 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 5836
To amend the Public Health Service Act with respect to making progress
toward the goal of eliminating tuberculosis, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 19, 2006
Mr. Brown of Ohio (for himself and Mrs. Wilson of New Mexico)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
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 2006''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
TITLE I--CENTERS FOR DISEASE CONTROL AND PREVENTION
Subtitle A--National Program for Elimination of Tuberculosis
Sec. 101. National program.
Subtitle B--Interagency Collaboration
Sec. 111. Advisory council for elimination of tuberculosis.
Subtitle C--New Tools for Tuberculosis Elimination
Sec. 121. New tools.
Subtitle D--Authorizations of Appropriations
Sec. 131. Authorizations of appropriations.
TITLE II--NATIONAL INSTITUTES OF HEALTH
Sec. 201. Activities of National Heart, Lung, and Blood Institute.
Sec. 202. Activities of National institute of Allergy and Infectious
Diseases.
Sec. 203. John E. Fogarty International Center for Advanced Study in
the Health Sciences.
Sec. 204. Loan repayment programs regarding research on tuberculosis.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Each year approximately 9 million people become ill
with active tuberculosis (``TB'') and 2 million of those people
die. This is a direct result of the disease having the ability
to develop resistance to treatments and to travel easily across
borders.
(2) In 2005, there were 14,093 cases of active TB reported
in the United States. However, the decline of 3.8 percent in
the national TB case rate from 2004 to 2005 was one of the
smallest declines in more than a decade.
(3) In addition to those with active TB, an estimated 10 to
15 million people in the United States have latent TB.
(4) The increasing occurrence of multidrug resistant TB,
including extensively drug-resistant TB--which is resistant to
at least two main first-line drugs and additionally to three or
more of the six classes of second-line drugs--raises concerns
of a future epidemic of virtually untreatable TB.
(5) New tools are needed to more effectively prevent,
diagnose, and treat TB. The standard method of diagnosing TB is
over 100 years old, and fails to adequately detect TB in
children and those coinfected with HIV/AIDS. The newest class
of anti-TB drug is 40 years old, while rates of multidrug
resistant TB are rising globally.
TITLE I--CENTERS FOR DISEASE CONTROL AND PREVENTION
Subtitle A--National Program for Elimination of Tuberculosis
SEC. 101. NATIONAL PROGRAM.
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 program for elimination of
tuberculosis''; and
(2) by amending subsection (b) to read as follows:
``(b) Research and Development; Demonstration Projects; Education
and Training.--With respect to the prevention, 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
development concerning--
``(A) clinical trials to evaluate the safety and
effectiveness of new drugs, diagnostics, and vaccines
for latent tuberculosis infection and active
tuberculosis;
``(B) epidemiological studies of populations at
risk of tuberculosis; and
``(C) field studies to evaluate the effectiveness
of new drugs, diagnostics, and vaccines, and evaluation
of efforts to eliminate the disease.
``(2) Demonstration projects for--
``(A) the development of regional capabilities to
prevent, control and eliminate tuberculosis;
``(B) the intensification of efforts to prevent,
detect, and treat tuberculosis among African Americans
and reduce or eliminate the racial disparity in the
incidence of tuberculosis in that population;
``(C) the intensification of efforts to control
tuberculosis along the United States-Mexico border and
among United States-Mexico binational populations;
``(D) the intensification of efforts to prevent,
detect, and treat tuberculosis among foreign-born
persons who are in the United States; and
``(E) collaboration with Immigration and Customs
Enforcement to identify and treat immigrants with
active or latent tuberculosis infection.
``(3) A public information and education program.
``(4) Education, training and clinical skills improvement
activities for health professionals, including allied health
personnel and emergency response employees.
``(5) Provide support for the Tuberculosis Trials
Consortium, the Tuberculosis Epidemiologic Studies Consortium,
and Regional Training and Medical Consultation Centers to carry
out activities under paragraphs (1) through (4).
``(6) Collaboration with international organizations and
foreign countries in carrying out such activities.''.
Subtitle B--Interagency Collaboration
SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBERCULOSIS.
(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
recommendations regarding the elimination of tuberculosis to
the Secretary, the Assistant Secretary for Health, and the
Director of the Centers for Disease Control and Prevention. In
addition, the Council shall, with respect to eliminating such
disease, provide to the Secretary and other appropriate Federal
officials advice on--
``(A) coordinating the activities of the Public
Health Service and other Federal agencies that relate
to the disease, including activities under subsection
(b); and
``(B) efficiently utilizing the Federal resources
involved.
``(3) National plan.--
``(A) In general.--In carrying out paragraph (2),
the Council shall make recommendations on the
development, revision, and implementation of a national
plan to eliminate tuberculosis in the United States.
``(B) Consultation.--In carrying out subparagraph
(A), the Council shall consult with public and private
entities, including--
``(i) individuals who are scientists,
physicians, and other health professionals, who
are not officers or employees of the Federal
Government and who represent the disciplines
relevant to tuberculosis elimination;
``(ii) members of public-private
partnerships established to address the
elimination of tuberculosis ;
``(iii) members of national and
international nongovernmental organizations
established to address tuberculosis
elimination; and
``(iv) members from the general public who
are knowledgeable with respect to tuberculosis
elimination including individuals who have or
have had tuberculosis.
``(C) Certain components of plan.--In carrying out
subparagraph (A), the Council shall--
``(i) consider the recommendations of the
Institute of Medicine regarding the elimination
of tuberculosis;
``(ii) 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 such as Mexico; and
``(iii) review the extent to which progress
has been made toward eliminating tuberculosis.
``(4) Annual report.--The Council shall annually submit to
Congress and the Secretary a report on the activities carried
under this section, other than subsection (g). 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--
``(A) activities under subsection (b); and
``(B) the national plan referred to in paragraph
(3).
``(5) Composition.--The Council shall be composed of--
``(A) representatives from the Centers for Disease
Control and Prevention, the National Institutes of
Health, the United States Agency for International
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 and officials;
``(C) individuals who are scientists, physicians,
laboritorians, and other health professionals who
represent disciplines relevant to tuberculosis
elimination;
``(D) members of national and international
nongovernmental organizations established to address
the elimination of tuberculosis; and
``(E) members from the general public who are
knowledgeable with respect to the elimination of
tuberculosis, including individuals who have or have
had tuberculosis.''.
(b) Rule of Construction Regarding Current Membership.--With
respect to the advisory council under section 317E(f) of the Public
Health Service Act, the amendments made by subsection (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.
Subtitle C--New Tools for Tuberculosis Elimination
SEC. 121. NEW TOOLS.
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) New Tools for Elimination of Tuberculosis.--
``(1) Research and development on drugs, diagnostics, and
vaccines .--The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall expand,
intensify, and coordinate research and development and related
activities of such Centers to develop new tools for the
elimination of tuberculosis, including drugs, diagnostics, and
vaccines.
``(2) Federal tuberculosis task force.--
``(A) Duties.--The Federal Tuberculosis Task Force
(established in December 2001 as part of the Centers
for Disease Control and Prevention) (in this subsection
referred to as the `Task Force') shall provide to the
Secretary and other appropriate Federal officials
advice on the implementation of paragraph (1), include
advice regarding the efficient utilization of the
Federal resources involved.
``(B) National plan for new tools development.--In
carrying out paragraph (1), the Task Force shall make
recommendations on the development of a national plan
for the development of new tools for the elimination of
tuberculosis, including drugs, diagnostics, and
vaccines.
``(C) Consultation.--In developing the national
plan under paragraph (1), the Task Force shall consult
with--
``(i) scientists, physicians, and other
health professionals and who represent the
specialties and disciplines relevant to the
research under consideration;
``(ii) members from public-private
partnerships or foundations (or both) engaged
in research relevant to research under
consideration;
``(iii) members of national and
international nongovernmental organizations
established to address tuberculosis
elimination;
``(iv) members from the general public who
are knowledgeable with respect to tuberculosis,
including individuals who have or have had
tuberculosis; and
``(v) scientists, physicians, 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.
``(3) Grants and contracts.--The Secretary shall carry out
paragraph (1) directly and through awards of grants,
cooperative agreements, and contracts to public and private
entities, including--
``(A) public-private partnerships;
``(B) academic institutions, including institutions
of higher education;
``(C) research institutions; and
``(D) the Tuberculosis Trials Consortium and the
Tuberculosis Epidemiologic Studies Consortium.''.
Subtitle D--Authorizations of Appropriations
SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS.
Section 317E of the Public Health Service Act, as amended by
section 121(1) of this Act, is amended by amending subsection (h) to
read as follows:
``(h) Authorization of Appropriations.--
``(1) General program.--
``(A) In general.--For the purpose of carrying out
this section, other than subsection (g), there are
authorized to be appropriated $528,000,000 for fiscal
year 2007, and such sums as may be necessary for each
of the fiscal years 2008 through 2011.
``(B) Priority in expenditure of funds.--In
expending amounts appropriated under subparagraph (A),
the Secretary shall give priority to making grants
under subsection (a) to States, which Core grants to
States and local tuberculosis programs shall be
distributed on the basis of a formula developed by the
Secretary that takes into account the level of
tuberculosis morbidity in each State, and other
relevant factors in each State regarding the disease.
The preceding sentence does not require the Secretary
to modify the formula that was used by the Secretary
for such grants for fiscal year 2006.
``(2) New tools.--
``(A) In general.--For the purpose of carrying out
subsection (g), there are authorized to be appropriated
$100,000,000 for fiscal year 2007, and such sums as may
be necessary for each of the fiscal years 2008 through
2011.
``(B) Limitation.--The authorization of
appropriations established in subparagraph (A) for a
fiscal year is effective only if the amount
appropriated under paragraph (1) for such year equals
or exceeds the amount appropriated to carry out this
section for fiscal year 2006.''.
TITLE II--NATIONAL INSTITUTES OF HEALTH
SEC. 201. ACTIVITIES OF NATIONAL HEART, LUNG, AND BLOOD INSTITUTE.
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 Institute shall expand,
intensify, and coordinate research and development and related
activities of the Institute with respect to tuberculosis, including
activities toward the goal of eliminating such disease.
``(b) Certain Activities.--Activities under subsection (a) shall
include--
``(1) enhancing basic and clinical research on
tuberculosis; and
``(2) expanding research on the relationship between such
disease and the human immunodeficiency virus.
``(c) Research Education.--
``(1) Tuberculosis academic awards.--The Director of the
Institute may provide awards to faculty of schools of medicine
or osteopathic medicine to assist such faculty in developing
high quality curricula in such schools designed to
significantly increase the opportunities for interested
individuals, including students of the school and practicing
physicians and nurses, to learn the principles and practices of
preventing, managing, and controlling tuberculosis.
``(2) Tuberculosis/pulmonary infection awards.--The
Director of the Institute may provide awards to support the
career development of clinically trained professionals who are
committed to research regarding pulmonary infections and
tuberculosis by providing for supervised study and research.
``(3) Authorization of appropriations.--
``(A) Tuberculosis academic awards.--For the
purpose of carrying out paragraph (1), there are
authorized to be appropriated $5,000,000 for fiscal
year 2007, and such sums as may be necessary for each
of the fiscal years 2008 through 2011.
``(B) Tuberculosis/pulmonary infection awards.--For
the purpose of carrying out paragraph (2), there are
authorized to be appropriated $5,000,000 for fiscal
year 2007, and such sums as may be necessary for each
of the fiscal years 2008 through 2011.''.
SEC. 202. ACTIVITIES OF NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS
DISEASES.
Section 447A of the Public Health Service Act (42 U.S.C. 285f-2) is
amended--
(1) by redesignating subsection (b) as subsection (c);
(2) by inserting after subsection (a) the following
subsection:
``(b) Activities under subsection (a) shall include activities to
develop a tuberculosis vaccine. Such activities shall be carried out in
accordance with the blueprint for tuberculosis vaccine development
described in the report prepared pursuant to the workshop convened in
March 1998 by the Advisory Council for Elimination of Tuberculosis, the
Director of the National Vaccine Program, and the Director of the
Institute.''; and
(3) in subsection (c) (as so redesignated), in the first
sentence--
(A) by striking ``and'' after ``1994,''; and
(B) by inserting before the period the following:
``, $240,000,000 for fiscal year 2007, and such sums as
may be necessary for each of the fiscal years 2008
through 2011''.
SEC. 203. JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN
THE HEALTH SCIENCES.
Section 482 of the Public Health Service Act (42 U.S.C. 287b) is
amended--
(1) by inserting ``(a) in general.--'' before ``The general
purpose'';
(2) in subsection (a) (as so designated), by inserting
after ``Health Sciences'' the following: ``(in this subpart
referred to as the `Center')''; and
(3) by adding at the end the following subsection:
``(b) Tuberculosis.--
``(1) In general.--In carrying out subsection (a) with
respect to tuberculosis, the Center shall expand, intensify,
and coordinate international activities of the Center for
research and training.
``(2) International training program.--In carrying out
paragraph (1), the Center shall carry out an international
training program regarding tuberculosis. Such program shall be
modeled after the international training program carried out by
the Center with respect to the human immunodeficiency virus.''.
SEC. 204. LOAN REPAYMENT PROGRAMS REGARDING RESEARCH ON TUBERCULOSIS.
Part G of title IV of the Public Health Service Act (42 U.S.C. 288
et seq.) is amended--
(1) by redesignating the second section 487F as section
487G; and
(2) by inserting after section 487G (as so redesignated)
the following section:
``loan repayments regarding research on tuberculosis
``Sec. 487H. In carrying out sections 487C, 487E, and 487F, the
Secretary shall seek to ensure that, for fiscal year 2007 and
subsequent fiscal years, a portion of amounts appropriated to carry out
such sections is reserved for the purpose of entering into contracts
under which (in accordance with the section involved) individuals will
conduct research on tuberculosis.''.
<all>