,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #ehce  ,,in ,,the ,,house ,,of  
,,representatives  ,december #aj1 #bjad 
,mr4 ,gene ,green of ,texas introduced  
the following bill2 which was referred  
to the ,committee on ,energy and        
,commerce  ,a ,,bill  ,to amend the     
,federal ,food1 ,drug1 and ,cosmetic    
,act and the ,public ,health ,service   
,act with respect to making progress    
toward the goal of eliminating          
tuberculosis1 and for other purposes4   
#a4 ,short title ,this ,act may be cited
 as the ,comprehensive ,,tb ,elimination
 ,act of #bjad4  #b4 ,findings ,the     
,congress finds as follows3  7#a7 ,each 
year approximately #i1jjj1jjj people    
become ill with active tuberculosis     
7,,tb71 an airborne infectious disease1 
and it is estimated that #a1ejj1jjj of  
those people die1 making ,,tb the second
 leading global infectious disease      
killer4  7#b7 ,there is a global        
underinvestment in quality ,,tb control1
 and in the research and development of 

new drugs1 diagnostics and a vaccine1 as
 well as in the relationship between    
,,tb and ,,hiv_/,,aids4  7#c7 ,the      
increasing occurrence of multi-drug     
resistant 7,,mdr7 ,,tb1 including       
extensively drug resistant 7,,xdr7 ,,tb 
which is resistant to at least two of   
the recommended first-line drugs and the
 recommended second-line medications1 is
 a serious and emerging global health   
problem4  7#d7 ,cases of ,,tb are       
reported annually in every ,state within
 the ,united ,states1 with a total of   
#i1ehb cases of active ,,tb reported in 
the ,united ,states in #bjac4  7#e7 ,in 
addition to those with active ,,tb1 an  
estimated #h1jjj1jjj to #aj1jjj1jjj     
people in the ,united ,states are       
infected with the ,,tb bacteria4  7#f7  
,drug-resistant ,,tb poses a particular 
challenge to domestic ,,tb control due  
to the high costs of treatment and      
intensive health care resources         
required4 ,treatment costs for ,,mdr    
,,tb range from #ajj1jjj to #cjj1jjj1   

which can cause a serious strain on     
,state public health budgets4  7#g7 ,in 
#bjac1 the ,united ,states experienced  
serious shortages of first- and         
second-line ,,tb drugs and biologics1   
including isoniazid1 the first-line ,,tb
 drug1 and tubersol1 the biologic used  
in ,,tb skin tests4  7#h7 ,new tools are
 urgently needed to more effectively    
prevent1 diagnose1 and treat ,,tb4      
,within the last #dj years1 only one new
 ,,tb drug has been developed and       
approved in the ,united ,states1 and the
 treatment regimen for ,,mdr ,,tb       
remains excessively lengthy1 toxic1 and 
difficult for patients to tolerate4 ,the
 existing vaccine1 which is not used in 
the ,united ,states1 confers no         
protection to adolescents and adults1   
protecting only against pulmonary ,,tb  
in infants and children4  7#i7 ,the     
expertise in identifying1 treating1 and 
preventing ,,tb is within the ,centers  
for ,disease ,control and ,prevention   
and the ,united ,states public health   

system4 ,the identification and         
preventive treatment of the millions of 
people in the ,united ,states with ,,tb 
infection1 representing the reservoir of
 future active ,,tb cases1 is a key     
component of the strategy to eliminate  
,,tb in the ,united ,states4  #c4 ,food 
and ,drug ,administration  ,clause 7i7  
of section #ejf;,d7a77#a77;,b7 of the   
,federal ,food1 ,drug1 and ,cosmetic    
,act 7#ba ,u4,s4,c4 #cef;d7a77#a77;,b77 
is amended to read as follows3  7i7     
plans for enhanced interagency and      
intra-agency coordination1              
communication1 and decisionmaking1      
including by ensuring coordination      
between the task force established under
 this section and the ,federal          
,tuberculosis ,task ,force under section
 #cag;,e7g7 of the ,public ,health      
,service ,act in the development and    
implementation of strategies and systems
 to prevent and mitigate shortages of   
drugs used in connection with           
tuberculosis2  4  #d4 ,centers for      

,disease ,control and ,prevention2      
,health ,resources and ,services        
,administration  7a7 ,prioritizing      
programs for high-,risk populations1    
including foreign-,born1 homeless1 and  
uninsured populations ,subsection 7a7 of
 section #cag;,e of the ,public ,health 
,service ,act 7#db ,u4,s4,c4 #bdg;b-#f7 
is amended--  7#a7 by striking ,the     
,secretary and inserting the following3 
7#a7 ,grants ,the ,secretary  2 and     
7#b7 by adding at the end the following3
  7#b7 ,priority ,in making grants under
 this subsection1 the ,secretary shall  
give priority to awarding grants to     
,state health departments proposing to  
focus on the prevention1 control1 and   
elimination of tuberculosis in high-risk
 populations1 including foreign-born1   
homeless1 and uninsured populations4  4 
7b7 ,grants for coordination of programs
 and services for prevention1 diagnosis1
 and treatment  7#a7 ,grants ,section   
#cag;,e of the ,public ,health ,service 
,act 7#db ,u4,s4,c4 #bdg;b-#f7 is       

amended--  7,a7 by redesignating        
subsections 7c7 through 7h7 as          
subsections 7d7 through 7i71            
respectively2 and  7,b7 by inserting    
after subsection 7b7 the following3  7c7
 ,grants for coordination of programs   
and services for prevention1 diagnosis1 
and treatment  7#a7 ,grants ,the        
,secretary1 acting through the          
,administrator of the ,health ,resources
 and ,services ,administration1 may     
award grants to ,state and local        
governments and ,federally qualified    
health centers for coordinating the     
programs and services of such           
governments and centers to ensure timely
 and appropriate prevention1 diagnosis1 
and treatment of tuberculosis4  7#b7    
,definition ,in this subsection1 the    
term ,federally qualified health center 
has the meaning given to such term in   
section #ahfa7;aa7 of the ,social       
,security ,act4  4  7#b7 ,conforming    
changes ,section #cag;,e of the ,public 
,health ,service ,act 7#db ,u4,s4,c4    

#bdg;b-#f7 is amended--  7,a7 in        
subsections 7d71 7e77#a71 7e77#c77;,a71 
and 7f77#a71 as redesignated1 by        
striking subsection 7a7 or 7b7 each     
place it appears and inserting          
subsection 7a71 7b71 or 7c72 and  7,b7  
in subsection 7e77#c77;,a71 as          
redesignated1 by inserting 7subject to  
subsection 7a77#b77 after highest       
priority4  7c7 ,federal ,tuberculosis   
,task ,force ,paragraph 7#a7 of section 
#cag;,e7h7 of the ,public ,health       
,service ,act 7#db ,u4,s4,c4            
#bdg;b-#f7;g771 as redesignated1 is     
amended to read as follows3  7#a7       
,duties ,the ,federal ,tuberculosis     
,task ,force 7in this subsection        
referred to as the ,task ,force7 shall  
provide to the ,secretary and other     
appropriate ,federal officials advice   
on--  7,a7 research into new tools under
 subsection 7b77#b7 and ensuring access 
to such new tools2 and  7,b7 the        
development and implementation of       
strategies and systems to prevent and   

mitigate shortages of drugs used in     
connection with tuberculosis4  4  7d7   
,reauthorization of national strategy   
for combating and eliminating           
tuberculosis ,section                   
#cag;,e7i77#a77;,a7 of the ,public      
,health ,service ,act 7#db ,u4,s4,c4    
#bdg;b-#f7;h77#a77;,a77 is amended by   
striking #bdc1aja1bej for fiscal year   
#bjac and inserting #bdc1aja1bej for    
each of fiscal years #bjac through      
#bjai4  #e4 ,national ,institutes of    
,health  ,paragraph 7#a7 of section     
#dbd;,c7b7 of the ,public ,health       
,service ,act 7#db ,u4,s4,c4            
#bhe;b-#g;c7b77 is amended to read as   
follows3  7#a7 enhancing basic1         
clinical1 and operational research on   
tuberculosis1 including with respect    
to--  7,a7 drug resistant tuberculosis2 
7,b7 infection with1 and the progression
 of1 tuberculosis2 and  7,c7 pediatric  
tuberculosis2  4