#aahth ,,congress #b;d ,session ,s4 #bhh ,,an ,,act ,to prevent1 treat1 and cure tuberculosis globally4 #a4 ,short title ,this ,act may be cited as the ,end ,tuberculosis ,now ,act of #bjbd4 #b4 ,united ,states ,government assistance to combat tuberculosis ,section #ajd;,b of the ,foreign ,assistance ,act of #aifa 7#bb ,u4,s4,c4 #baea;b-#c7 is amended to read as follows3 #ajd;,b4 ,assistance to combat tuberculosis 7a7 ,findings ,congress makes the following findings3 7#a7 ,the international spread of tuberculosis 7referred to in this section as ,,tb7 and the deadly impact of ,,tb's continued existence constitutes a continuing challenge4 7#b7 ,additional tools and resources are required to effectively diagnose1 prevent1 and treat ,,tb4 7#c7 ,effectively resourced ,,tb programs can serve as a critical platform for preventing and responding to future infectious respiratory disease pandemics4 7b7 ,policy 7#a7 ,in general ,it is a major objective of the foreign assistance program of the ,united ,states to help end the ,,tb public health emergency through accelerated actions-- 7,a7 to support the diagnosis and treatment of all adults and children with all forms of ,,tb2 and 7,b7 to prevent new ,,tb infections from occurring4 7#b7 ,support for global plans and objectives ,in countries in which the ,united ,states ,government has established foreign assistance programs under this ,act1 particularly in countries with the highest burden of ,,tb and other countries with high rates of infection and transmission of ,,tb1 it is the policy of the ,united ,states-- 7,a7 to support the objectives of the ,world ,health ,organization ,end ,,tb ,strategy1 including its goals-- 7i7 to reduce ,,tb deaths by #ie percent by #bjce2 7ii7 to reduce the ,,tb incidence rate by #ij percent by #bjce2 and 7iii7 to reduce the number of families facing catastrophic health costs due to ,,tb by #ajj percent by #bjce2 7,b7 to support the ,stop ,,tb ,partnership's ,global ,plan to ,end ,,tb #bjbc-bjcj1 including by providing support for-- 7i7 developing and using innovative new technologies and therapies to increase active case finding and rapidly diagnose and treat children and adults with all forms of ,,tb1 alleviate suffering1 and ensure ,,tb treatment completion2 7ii7 expanding diagnosis and treatment in line with the goals established by the ,political ,declaration of the ,high-,level ,meeting of the ,general ,assembly on the ,fight ,against ,tuberculosis1 including-- 7,i7 successfully treating #dj1jjj1jjj people with active ,,tb by #bjbc1 including #c1ejj1jjj children1 and #a1ejj1jjj people with drug-resistant ,,tb2 and 7,,ii7 diagnosing and treating latent tuberculosis infection1 in support of the global goal of providing preventive therapy to at least #cj1jjj1jjj people by #bjbc1 including #d1jjj1jjj children younger than #e years of age1 #bj1jjj1jjj household contacts of people affected by ,,tb1 and #f1jjj1jjj people living with ,,hiv2 7iii7 ensuring high-quality ,,tb care by closing gaps in care cascades1 implementing continuous quality improvement at all levels of care1 and providing related patient support2 and 7iv7 sustainable procurements of ,,tb commodities to avoid interruptions in supply1 the procurement of commodities of unknown quality1 or payment of excessive commodity costs in countries impacted by ,,tb2 and 7,c7 to ensure1 to the greatest extent practicable1 that ,united ,states funding supports activities that simultaneously emphasize-- 7i7 the development of comprehensive person-centered programs1 including diagnosis1 treatment1 and prevention strategies to ensure that-- 7,i7 all people sick with ,,tb receive quality diagnosis and treatment through active case finding2 and 7,,ii7 people at high risk for ,,tb infection are found and treated with preventive therapies in a timely manner2 7ii7 robust ,,tb infection control practices are implemented in all congregate settings1 including hospitals and prisons2 7iii7 the deployment of diagnostic and treatment capacity-- 7,i7 in areas with the highest ,,tb burdens2 and 7,,ii7 for highly at-risk and impoverished populations1 including patient support services2 7iv7 program monitoring and evaluation based on critical ,,tb indicators1 including indicators relating to infection control1 the numbers of patients accessing ,,tb treatment and patient support services1 and preventative therapy for those at risk1 including all close contacts1 and treatment outcomes for all forms of ,,tb2 7v7 training and engagement of health care workers on the use of new diagnostic tools and therapies as they become available1 and increased support for training frontline health care workers to support expanded ,,tb active case finding1 contact tracing1 and patient support services2 7vi7 coordination with domestic agencies and organizations to support an aggressive research agenda to develop vaccines as well as new tools to diagnose1 treat1 and prevent ,,tb globally2 7vii7 linkages with the private sector on-- 7,i7 research and development of a vaccine1 and on new tools for diagnosis and treatment of ,,tb2 7,,ii7 improving current tools for diagnosis and treatment of ,,tb1 including telehealth solutions for prevention and treatment2 and 7,,iii7 training healthcare professionals on use of the newest and most effective diagnostic and therapeutic tools2 7viii7 the reduction of barriers to care1 including stigma and treatment and diagnosis costs1 including through-- 7,i7 training health workers2 7,,ii7 sensitizing policy makers2 7,,iii7 requiring that all relevant grants and funding agreements include access and affordability provisions2 7,,iv7 supporting education and empowerment campaigns for ,,tb patients regarding local ,,tb services2 7,v7 monitoring barriers to accessing ,,tb services2 and 7,,vi7 increasing support for patient-led and community-led ,,tb outreach efforts2 7ix7 support for country-level1 sustainable accountability mechanisms and capacity to measure progress and ensure that commitments made by governments and relevant stakeholders are met2 and 7x7 support for the integration of ,,tb diagnosis1 treatment1 and prevention activities into primary health care1 as appropriate4 7c7 ,definitions ,in this section3 7#a7 ,appropriate congressional committees ,the term appropriate congressional committees means the ,committee on ,foreign ,relations of the ,senate and the ,committee on ,foreign ,affairs of the ,house of ,representatives4 7#b7 ,end ,,tb ,strategy ,the term ,end ,,tb ,strategy means the strategy to eliminate ,,tb that was approved by the ,world ,health ,assembly in ,may #bjad1 and is described in ,the ,end ,,tb ,strategy3 ,global ,strategy and ,targets for ,tuberculosis ,prevention1 ,care and ,control ,after #bjae4 7#c7 ,global alliance for tuberculosis drug development ,the term ,global ,alliance for ,tuberculosis ,drug ,development means the public-private partnership that bring together leaders in health1 science1 philanthropy1 and private industry to devise new approaches to ,,tb4 7#d7 ,global tuberculosis drug facility ,the term ,global ,tuberculosis ,drug ,facility means the initiative of the ,stop ,tuberculosis ,partnership to increase access to the most advanced1 affordable1 quality-assured ,,tb drugs and diagnostics4 7#e7 ,,mdr-,,tb ,the term ,,mdr-,,tb means multi-drug-resistant ,,tb4 7#f7 ,stop tuberculosis partnership ,the term ,stop ,tuberculosis ,partnership means the partnership of #a1fjj organizations 7including international and technical organizations1 government programs1 research and funding agencies1 foundations1 nongovernmental organizations1 civil society and community groups1 and the private sector71 donors1 including the ,united ,states1 high ,,tb burden countries1 multilateral agencies1 and nongovernmental and technical agencies1 which is governed by the ,stop ,,tb ,partnership ,coordinating ,board and hosted by a ,united ,nations entity1 committed to short- and long-term measures required to control and eventually eliminate ,,tb as a public health problem in the world4 7#g7 ,,xdr-,,tb ,the term ,,xdr-,,tb means extensively drug-resistant ,,tb4 7d7 ,authorization ,to carry out this section1 the ,president is authorized1 consistent with section #ajd7;c71 to furnish assistance1 on such terms and conditions as the ,president may determine1 for the prevention1 treatment1 control1 and elimination of ,,tb4 7e7 ,goals ,in consultation with the appropriate congressional committees1 the ,president shall establish goals1 based on the policy and indicators described in subsection 7b71 for-- 7#a7 ,united ,states ,,tb programs to detect1 cure1 and prevent all forms of ,,tb globally for the period between #bjbc and #bjcj that are aligned with the ,end ,,tb ,strategy's #bjcj targets and the ,,usaid's ,global ,tuberculosis 7,,tb7 ,strategy #bjbc-bjcj2 and 7#b7 updating the ,national ,action ,plan for ,combating ,multidrug-,resistant ,tuberculosis4 7f7 ,coordination 7#a7 ,in general ,in carrying out this section1 the ,president shall coordinate with the ,world ,health ,organization1 the ,stop ,,tb ,partnership1 the ,global ,fund to ,fight ,,aids1 ,tuberculosis1 and ,malaria1 and other organizations with respect to the development and implementation of a comprehensive global ,,tb response program4 7#b7 ,bilateral assistance ,in providing bilateral assistance under this section1 the ,president1 acting through the ,administrator of the ,united ,states ,agency for ,international ,development1 shall-- 7,a7 catalyze support for research and development of new tools to prevent1 diagnose1 treat1 and control ,,tb worldwide1 particularly to reduce the incidence of1 and mortality from1 all forms of drug-resistant ,,tb2 7,b7 ensure ,united ,states programs and activities focus on finding individuals with active ,,tb disease and provide quality diagnosis and treatment1 including through digital health solutions1 and reaching those at high risk with preventive therapy2 and 7,c7 ensure coordination among relevant ,united ,states ,government agencies1 including the ,department of ,state1 the ,centers for ,disease ,control and ,prevention1 the ,national ,institutes of ,health1 the ,biomedical ,advanced ,research and ,development ,authority1 the ,food and ,drug ,administration1 the ,national ,science ,foundation1 the ,department of ,defense 7through its ,congressionally ,directed ,medical ,research ,programs71 and other relevant ,federal departments and agencies that engage in international ,,tb activities-- 7i7 to ensure accountability and transparency2 7ii7 to reduce duplication of efforts2 and 7iii7 to ensure appropriate integration and coordination of ,,tb services into other ,united ,states-supported health programs4 7g7 ,priority ,to ,end ,,tb strategy ,in furnishing assistance under subsection 7d71 the ,president shall prioritize-- 7#a7 building and strengthening ,,tb programs-- 7,a7 to increase the diagnosis and treatment of everyone who is sick with ,,tb2 and 7,b7 to ensure that such individuals have access to quality diagnosis and treatment2 7#b7 direct1 high-quality integrated services for all forms of ,,tb1 as described by the ,world ,health ,organization1 which call for the coordination of active case finding1 treatment of all forms of ,,tb disease and infection1 patient support1 and ,,tb prevention2 7#c7 treating individuals co-infected with ,,hiv and other co-morbidities1 and other individuals with ,,tb who may be at risk of stigma2 7#d7 strengthening the capacity of health systems to detect1 prevent1 and treat ,,tb1 including ,,mdr-,,tb and ,,xdr-,,tb1 as described in the latest international guidance related to ,,tb2 7#e7 researching and developing innovative diagnostics1 drug therapies1 and vaccines1 and program-based research2 7#f7 support for the ,stop ,tuberculosis ,partnership's ,global ,drug ,facility1 the ,global ,alliance for ,tuberculosis ,drug ,development1 and other organizations promoting the development of new products and drugs for ,,tb2 and 7#g7 ensuring that ,,tb programs can serve as key platforms for supporting national respiratory pandemic response against existing and new infectious respiratory disease4 7h7 ,assistance for the ,world ,health ,organization and the ,stop ,tuberculosis ,partnership ,in carrying out this section1 the ,president1 acting through the ,administrator of the ,united ,states ,agency for ,international ,development1 is authorized-- 7#a7 to provide resources to the ,world ,health ,organization and the ,stop ,tuberculosis ,partnership to improve the capacity of countries with high burdens or rates of ,,tb and other affected countries to implement the ,end ,,tb ,strategy1 the ,stop ,,tb ,global ,plan to ,end ,,tb1 their own national strategies and plans1 other global efforts to control ,,mdr-,,tb and ,,xdr-,,tb2 and 7#b7 to leverage the contributions of other donors for the activities described in paragraph 7#a74 7i7 ,annual report on ,,tb activities ,not later than ,december #ae of each year until the earlier of the date on which the goals specified in subsection 7b77#b77;,a7 are met or the last day of #bjcj1 the ,president shall submit an annual report to the appropriate congressional committees that describes ,united ,states foreign assistance to control ,,tb and the impact of such efforts1 including-- 7#a7 the number of individuals with active ,,tb disease that were diagnosed and treated1 including the rate of treatment completion and the number receiving patient support2 7#b7 the number of persons with ,,mdr-,,tb and ,,xdr-,,tb that were diagnosed and treated1 including the rate of completion1 in countries receiving ,united ,states bilateral foreign assistance for ,,tb control programs2 7#c7 the number of people trained by the ,united ,states ,government in ,,tb surveillance and control2 7#d7 the number of individuals with active ,,tb disease identified as a result of engagement with the private sector and other nongovernmental partners in countries receiving ,united ,states bilateral foreign assistance for ,,tb control programs2 7#e7 a description of the collaboration and coordination of ,united ,states anti-,,tb efforts with the ,world ,health ,organization1 the ,stop ,,tb ,partnership1 the ,global ,fund to ,fight ,,aids1 ,tuberculosis and ,malaria1 and other major public and private entities2 7#f7 a description of the collaboration and coordination among the ,united ,states ,agency for ,international ,development and other ,united ,states departments and agencies1 including the ,centers for ,disease ,control and ,prevention and the ,office of the ,global ,,aids ,coordinator1 for the purposes of combating ,,tb and1 as appropriate1 its integration into primary care2 7#g7 the constraints on implementation of programs posed by health workforce shortages1 health system limitations1 barriers to digital health implementation1 other challenges to successful implementation1 and strategies to address such constraints2 7#h7 a breakdown of expenditures for patient services supporting ,,tb diagnosis1 treatment1 and prevention1 including procurement of drugs and other commodities1 drug management1 training in diagnosis and treatment1 health systems strengthening that directly impacts the provision of ,,tb services1 and research2 and 7#i7 for each country1 and when practicable1 each project site receiving bilateral ,united ,states assistance for the purpose of ,,tb prevention1 treatment1 and control-- 7,a7 a description of progress toward the adoption and implementation of the most recent ,world ,health ,organization guidelines to improve diagnosis1 treatment1 and prevention of ,,tb for adults and children1 disaggregated by sex1 including the proportion of health facilities that have adopted the latest ,world ,health ,organization guidelines on strengthening monitoring systems and preventative1 diagnostic1 and therapeutic methods1 including the use of rapid diagnostic tests and orally administered ,,tb treatment regimens2 7,b7 the number of individuals screened for ,,tb disease and the number evaluated for ,,tb infection using active case finding outside of health facilities2 7,c7 the number of individuals with active ,,tb disease that were diagnosed and treated1 including the rate of treatment completion and the number receiving patient support2 7,d7 the number of adults and children1 including people with ,,hiv and close contacts1 who are evaluated for ,,tb infection1 the number of adults and children started on treatment for ,,tb infection1 and the number of adults and children completing such treatment1 disaggregated by sex and1 as possible1 income or wealth quintile2 7,e7 the establishment of effective ,,tb infection control in all relevant congregant settings1 including hospitals1 clinics1 and prisons2 7,f7 a description of progress in implementing measures to reduce ,,tb incidence1 including actions-- 7i7 to expand active case finding and contact tracing to reach vulnerable groups2 and 7ii7 to expand ,,tb preventive therapy1 engagement of the private sector1 and diagnostic capacity2 7,g7 a description of progress to expand diagnosis1 prevention1 and treatment for all forms of ,,tb1 including in pregnant women1 children1 and individuals and groups at greater risk of ,,tb1 including migrants1 prisoners1 miners1 people exposed to silica1 and people living with ,,hiv_/,,aids1 disaggregated by sex2 7,h7 the rate of successful completion of ,,tb treatment for adults and children1 disaggregated by sex1 and the number of individuals receiving support for treatment completion2 7,i7 the number of people1 disaggregated by sex1 receiving treatment for ,,mdr-,,tb1 the proportion of those treated with the latest regimens endorsed by the ,world ,health ,organization1 factors impeding scale up of such treatment1 and a description of progress to expand community-based ,,mdr-,,tb care2 7,j7 a description of ,,tb commodity procurement challenges1 including shortages1 stockouts1 or failed tenders for ,,tb drugs or other commodities2 7,k7 the proportion of health facilities with specimen referral linkages to quality diagnostic networks1 including established testing sites and reference labs1 to ensure maximum access and referral for second line drug resistance testing1 and a description of the turnaround time for test results2 7,l7 the number of people trained by the ,united ,states ,government to deliver high-quality ,,tb diagnostic1 preventative1 monitoring1 treatment1 and care services2 7,m7 a description of how supported activities are coordinated with-- 7i7 country national ,,tb plans and strategies2 and 7ii7 ,,tb control efforts supported by the ,global ,fund to ,fight ,,aids1 ,tuberculosis1 and ,malaria1 and other international assistance programs and funds1 including in the areas of program development and implementation2 and 7,n7 for the first #c years of the report required under this subsection1 a description of the progress in recovering from the negative impact of ,,covid-#ai on ,,tb1 including-- 7i7 whether there has been the development and implementation of a comprehensive plan to recover ,,tb activities from diversion of resources2 7ii7 the continued use of bidirectional ,,tb-,,covid testing2 and 7iii7 progress on increased diagnosis and treatment of active ,,tb4 7j7 ,annual report on ,,tb research and development ,the ,president1 acting through the ,administrator of the ,united ,states ,agency for ,international ,development1 and in coordination with the ,national ,institutes of ,health1 the ,centers for ,disease ,control and ,prevention1 the ,biomedical ,advanced ,research and ,development ,authority1 the ,food and ,drug ,administration1 the ,national ,science ,foundation1 and the ,office of the ,global ,,aids ,coordinator1 shall submit to the appropriate congressional committees until #bjcj an annual report that-- 7#a7 describes the current progress and challenges to the development of new tools for the purpose of ,,tb prevention1 treatment1 and control2 7#b7 identifies critical gaps and emerging priorities for research and development1 including for rapid and point-of-care diagnostics1 shortened treatments and prevention methods1 telehealth solutions for prevention and treatment1 and vaccines2 and 7#c7 describes research investments by type1 funded entities1 and level of investment4 7k7 ,evaluation report ,not later than #c years after the date of the enactment of the ,end ,tuberculosis ,now ,act of #bjbd1 and #e years thereafter1 the ,comptroller ,general of the ,united ,states shall submit a report to the appropriate congressional committees that evaluates the performance and impact on ,,tb prevention1 diagnosis1 treatment1 and care efforts that are supported by ,united ,states bilateral assistance funding1 including recommendations for improving such programs4 4 #c4 ,sunset ,the amendment made by section #b shall cease to have any force or effect beginning on ,december #ca1 #bjcj4 ,passed the ,senate ,september #ai1 #bjbd4,secretary