,,ii #aai? ,,congress #b;d ,session ,s4 #dgea ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,june #aa1 #bjbf,mr4 ,"y 7= himself & ,mrs4 ,%ahe57 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,=eign ,relations ,a ,,bill ,to prev5t1 treat1 & cure tub]culosis globally4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,end ,tub]culosis ,n[ ,act ( #bjbf4 #b4 ,assi/ance to combat tub]culosis 7a7 ,9 g5]al ,section #ajd;,b ( ! ,=eign ,assi/ance ,act ( #aifa 7#bb ,u4,s4,c4 #baea;b-#c7 is am5d$ to read z foll[s3 #ajd;,b4 ,assi/ance to combat tub]culosis 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,! int]national spread ( tub]culosis 7ref]r$ to 9 ?is section z ,,tb7 & ! deadly impact ( ,,tb's cont9u$ exi/5ce con/itute a cont9u+ *all5ge4 7#b7 ,additional tools & res\rces are requir$ to effectively diagnose1 prev5t1 & treat ,,tb4 7#c7 ,effectively res\rc$ ,,tb programs c s]ve z a critical plat=m = prev5t+ & respond+ to future infecti\s airborne & respiratory disease p&emics4 7#d7 ,! ,am]ica ,fir/ ,global ,heal? ,/rategy sets out ambiti\s goals to address ,,tb t are align$ ) global goals to r$uce incid5ces & mortality rates ( ,,tb4 7b7 ,policy 7#a7 ,major objectives reg>d+ tub]culosis ,x is a major objective ( ! =eign assi/ance program ( ! ,unit$ ,/ates to help end ! ,,tb public heal? em]g5cy ?r\gh accel]at$ actions-- 7,a7 to support ! diagnosis & treatm5t ( all adults & *ildr5 ) all =ms ( ,,tb2 & 7,b7 to prev5t new ,,tb infections f occurr+4 7#b7 ,o!r policies reg>d+ tub]culosis ,x is ! policy ( ! ,unit$ ,/ates1 9 c\ntries 9 :i* ! ,unit$ ,/ates has e/abli%$ a =eign assi/ance program "u ?is ,act1 p>ticul>ly 9 c\ntries ) ! highe/ rates ( ,,tb & o!r c\ntries ) high rates ( infection & transmission ( ,,tb-- 7,a7 to r$uce mortality1 incid5ce1 & heal? co/s caus$ by ,,tb1 includ+ by provid+ support =-- 7i7 develop+ & us+ innovative new te*nologies & !rapies 7includ+ molecul> diagno/ics7 to increase active case f9d+ & rapidly diagnose & treat *ildr5 & adults ) all =ms ( ,,tb 7includ+ lat5t ,,tb71 alleviate suff]+1 & ensure ,,tb treatm5t & prev5tative !rapy completion2 7ii7 exp&+ diagnosis & treatm5t = individuals ) all =ms ( ,,tb 7includ+ *ildr57 & exp&+ prophylaxis treatm5t to at-risk individuals 7includ+ *ildr571 h\sehold contacts1 individuals ) lat5t ,,tb1 & individuals liv+ ) ,,hiv2 7iii7 ensur+ high-quality ,,tb c>e by clos+ gaps 9 c>e cascades1 implem5t+ cont9u\s quality improvem5t at all levels ( c>e1 & provid+ relat$ pati5t support2 7iv7 su/a9able procurem5t ( ,,tb commodities to avoid int]ruptions 9 supply2 & 7v7 avoid+ ! procurem5t ( ,,tb commodities ( unkn[n quality & ! paym5t ( excessive ,,tb commodity co/s2 & 7,b7 to ensure1 to ! greate/ ext5t practicable1 t ,unit$ ,/ates fund+ supports activities t simultane\sly emphasize-- 7i7 ! developm5t ( compreh5sive p]son-c5t]$ programs1 includ+ diagnosis1 treatm5t1 & prev5tion /rategies to ensure t-- 7,i7 all individuals sick ) ,,tb receive quality diagnosis & treatm5t ?r\gh active case f9d+2 & 7,,ii7 individuals at high risk = ,,tb infection are id5tifi$ & treat$ ) prophylaxis treatm5t 9 a timely mann]2 7ii7 robu/ ,,tb infection control practices are implem5t$ 9 all congregate sett+s1 includ+ hospitals & prisons2 7iii7 ! deploym5t ( diagno/ic & treatm5t capacity-- 7,i7 9 areas ) ! highe/ ,,tb burd5s2 & 7,,ii7 = highly at-risk & impov]i%$ populations1 includ+ = pati5t support2 7iv7 program monitor+ & evaluation bas$ on critical ,,tb indicators1 includ+ indicators relat+ to infection control1 ! numb]s ( pati5ts access+ ,,tb treatm5t & pati5t support1 & prophylaxis treatm5t = ^? at risk1 includ+ all close contacts1 & treatm5t outcomes = all =ms ( ,,tb2 7v7 tra9+ & engagem5t ( heal? c>e work]s on ! use ( new diagno/ic tools & !rapies z !y become available1 & increas$ support = tra9+ frontl9e heal? c>e work]s to support exp&$ ,,tb active case f9d+1 contact trac+1 & pati5t support2 7vi7 coord9ation ) dome/ic ag5cies & organizations to support an aggressive rese>* ag5da to develop vacc9es z well z new tools to diagnose1 treat1 & prev5t ,,tb globally2 7vii7 l9kages ) ! private sector on-- 7,i7 rese>* & developm5t ( a vacc9e1 & on new tools = diagnosis & treatm5t ( ,,tb2 7,,ii7 improv+ curr5t tools = diagnosis & treatm5t ( ,,tb1 includ+ teleheal? solutions = prev5tion & treatm5t2 7,,iii7 tra9+ heal?c>e pr(essionals on ! use ( ! newe/ & mo/ effective diagno/ic & !rapeutic tools2 & 7,,iv7 transp>5cy & acc\ntability2 7viii7 ! r$uction ( b>ri]s to treatm5t & diagnosis co/s1 includ+ ?r\gh-- 7,i7 tra9+ heal? work]s to ensure integration into c\ntry's wid] heal?c>e sy/em2 7,,ii7 requir+ t all relevant grants & fund+ agreem5ts include access & af=dability provisions2 7,,iii7 support+ campaigns = ,,tb pati5ts reg>d+ local ,,tb c>e = prev5tion1 diagnosis1 & treatm5t2 7,,iv7 monitor+ co/ b>ri]s to access+ ,,tb c>e = prev5tion1 diagnosis1 & treatm5t2 & 7,v7 increas+ support = pati5t-l$ & community-l$ ,,tb outrea* ef=ts2 7ix7 support = local & c\ntry-level1 su/a9able acc\ntability me*anisms to measure local progress & ensure commitm5ts made by gov]nm5ts & relevant /akehold]s are met2 & 7x7 support = ! inclusion ( ,,tb diagnosis1 treatm5t1 & prev5tion activities into prim>y heal? c>e1 z appropriate4 7c7 ,au?orization 7#a7 ,9 g5]al ,! ,presid5t is au?oriz$ to furni% assi/ance1 on su* t]ms & conditions z ! ,presid5t may det]m9e necess>y to c>ry out ?is section1 = ! prev5tion1 treatm5t1 control1 & elim9ation ( ,,tb4 7#b7 ,priority = assi/ance ,9 furni%+ assi/ance "u p>agraph 7#a71 ! ,presid5t %all prioritize-- 7,a7 build+ & /r5g!n+ ,,tb programs-- 7i7 to increase ! diagnosis & treatm5t ( individuals :o are sick ) ,,tb2 & 7ii7 to ensure t su* individuals h access to quality diagnosis & treatm5t2 7,b7 direct1 high-quality c>e = all =ms ( ,,tb1 includ+ diagnosis1 coord9ation ( active case f9d+1 treatm5t ( all =ms ( ,,tb disease & infection1 pati5t support1 & ,,tb prev5tion2 7,c7 treat+ individuals co-infect$ ) ,,hiv1 o!r immune compromis+ co-morbidities1 & o!r high-risk individuals ) ,,tb :o may be at risk ( /igma2 7,d7 /r5g!n+ ! capacity ( heal? sy/ems to detect1 prev5t1 & treat ,,tb1 includ+ ,,mdr-,,tb & ,,xdr-,,tb2 7,e7 rese>*+ & develop+ innovative diagno/ics1 drug !rapies1 & vacc9es1 & program-bas$ rese>*2 7,f7 ensure integration ( lab sy/ems = molecul> diagno/ic networks = monitor+ & response = productive use ( laboratory capacities & heal?c>e facilities2 7,g7 support+ ! procurem5t ( co/-effective & quality ,,tb diagno/ics & treatm5ts1 includ+ annual support = ! ,global ,drug ,facility1 & assi/+ local c\ntry capacity build+ & su/a9ability to control all =ms ( ,,tb2 & 7,h7 ensur+ ,,tb programs c s]ve z key plat=ms = support+ national respiratory p&emic response ) respect to exi/+ & new infecti\s respiratory diseases4 7d7 ,e/abli%m5t ( goals ,! ,presid5t1 9 consultation ) ! appropriate congressional committees & 9 pursuit ( ! policies describ$ 9 subsection 7a71 %all e/abli% goals to-- 7#a7 detect1 cure1 & prev5t all =ms ( ,,tb globally dur+ ! p]iod beg9n+ on ,janu>y #a1 #bjbg1 & end+ on ,decemb] #ca1 #bjcj1 specifically by work+ to-- 7,a7 r$uce1 by #bjcj-- 7i7 ! ,,tb incid5ce rate by #hj p]c5t 7f #bjae levels72 & 7ii7 ! ,,tb mortality rate by #ij 7f #bjae levels7 p]c5t2 7,b7 ensure t-- 7i7 #ij p]c5t ( incid5t ,,tb cases are diagnos$ & initiat$ on treatm5t2 7ii7 #ij p]c5t ( incid5t drug resi/ant-,,tb cases are diagnos$ & initiat$ on treatm5t2 & 7iii7 !re is #ij p]c5t treatm5t success rate = drug s5sitive-,,tb & drug resi/ant-,,tb2 & 7,c7 provide ,,tb prev5tive treatm5t to #cj1jjj1jjj individuals2 & 7#b7 update ! ,national ,action ,plan = ,combat+ ,multidrug-,resi/ant ,tub]culosis4 7e7 ,coord9ation 7#a7 ,9 g5]al ,! ,presid5t %all consult1 z appropriate1 ) p>tn] nations & relevant int]national organizations1 nongov]nm5tal organizations1 & ! private sector ) respect to ! developm5t & implem5tation ( a coord9at$ & complem5t>y ,unit$ ,/ates global ,,tb response program4 7#b7 ,bilat]al assi/ance ,9 provid+ bilat]al assi/ance "u ?is section1 ! ,presid5t1 act+ ?r\gh ! ,secret>y ( ,/ate1 %all-- 7,a7 catalyze support = rese>* & developm5t ( new tools to prev5t1 diagnose1 treat1 & control ,,tb worldwide1 p>ticul>ly to r$uce ! incid5ce (1 & mortality f1 all =ms ( drug-resi/ant ,,tb2 7,b7 consid] ! incid5ce ( ,,tb infections :5 det]m9+ assi/ance priorities to c\ntries & regions2 7,c7 ensure ,unit$ ,/ates programs & activities focus on f9d+ individuals ) active ,,tb & provide co/-effective & quality diagnosis & treatm5t1 includ+ ?r\gh su/a9able digital heal? solutions1 & rea*+ individuals at high risk ) prophylaxis treatm5t2 & 7,d7 ensure coord9ation among relevant ,f$]al dep>tm5ts & ag5cies t engage 9 int]national activities relat+ to ,,tb-- 7i7 to ensure acc\ntability & transp>5cy2 7ii7 to r$uce duplication ( ef=ts2 & 7iii7 to ensure appropriate incorporation & coord9ation ( ,,tb prev5tion1 diagnosis1 & treatm5t into o!r ,unit$ ,/ates-support$ heal? programs4 7f7 ,assi/ance = tub]culosis p>tn]%ips ,! ,presid5t1 act+ ?r\gh ! ,secret>y ( ,/ate1 is au?oriz$-- 7#a7 to provide res\rces to monitor & dissem9ate epidemiological in=mation ab\t tub]culosis1 drug resi/ant ,,tb1 ,,mdr-,,tb1 & ,,xdr-,,tb2 7#b7 to provide res\rces directly to c\ntries ) high rates ( ,,tb-- 7,a7 to directly improve ! capacity ( su* c\ntries to prev5t1 diagnose1 & treat ,,tb on a local level2 & 7,b7 to develop & implem5t ! national /rategies & plans ( su* c\ntries to control ,,tb & elim9ate ,,mdr-,,tb & ,,xdr-,,tb us+ ! goals describ$ 9 subsection 7d77#a72 7#c7 to lev]age ! contributions ( donors to facilitate ! activities describ$ 9 p>agraphs 7#a7 & 7#b7 :ile increas+ ! capacity ( ! ,unit$ ,/ates to monitor & dissem9ate relevant in=mation2 & 7#d7 to utilize long/&+ ,unit$ ,/ates p>tn]%ips & res\rces to address ,,tb dome/ically & int]nationally4 7g7 ,reports 7#a7 ,annual report on activities reg>d+ tub]culosis ,n lat] ?an ,decemb] #ae ( ea* ye> until ! e>li] ( ! date on :i* ! goals specifi$ 9 subsection 7d77#a7 are met or ,decemb] #ca1 #bjcb1 ! ,presid5t %all submit a report to ! appropriate congressional committees t describes ,unit$ ,/ates =eign assi/ance to control ,,tb & ! impact ( su* assi/ance1 includ+-- 7,a7 ! numb] ( individuals ) active ,,tb t 7 diagnos$ & treat$1 includ+ ! rate ( treatm5t completion & ! numb] ( individuals receiv+ pati5t support2 7,b7 ! numb] ( individuals ) ,,mdr-,,tb & ,,xdr-,,tb t 7 diagnos$ & treat$1 includ+ ! rate ( treatm5t completion1 9 c\ntries receiv+ bilat]al =eign assi/ance f ! ,unit$ ,/ates = programs to control ,,tb2 7,c7 ! numb] ( individuals tra9$ by ! ,unit$ ,/ates ,gov]nm5t 9 ,,tb surveillance & control2 7,d7 ! numb] ( individuals ) active ,,tb id5tifi$ z a result ( engagem5t ) ! private sector & o!r nongov]nm5tal p>tn]s 9 c\ntries receiv+ ,unit$ ,/ates bilat]al =eign assi/ance = ,,tb control programs2 7,e7 a description ( ! am\nt ( funds provid$1 activities c>ri$ out1 & any collaboration & coord9ation ( ,unit$ ,/ates anti-,,tb ef=ts ) p>tn] nations & relevant int]national organizations1 nongov]nm5tal organizations1 & ! private sector1 includ+ ! am\nt ( fund+ provid$ to su* entities2 7,f7 a description ( ! collaboration & coord9ation betwe5 ! relevant ,f$]al dep>tm5ts & ag5cies1 includ+ ! ,c5t]s = ,disease ,control & ,prev5tion & ! ,(fice ( ! ,global ,,aids ,coord9ator1 to combat ,,tb &1 z appropriate1 include treatm5t ( ,,tb 9 prim>y c>e2 7,g7 ! con/ra9ts on implem5tation ( programs pos$ by heal? work=ce %ortages1 heal? sy/em limitations1 b>ri]s to digital heal? implem5tation1 o!r *all5ges to successful implem5tation1 & /rategies to address su* con/ra9ts1 includ+ local commitm5ts to su/a9 ,,tb control ef=ts2 7,h7 a breakd[n ( exp5ditures = pati5t c>e support+ ,,tb diagnosis1 treatm5t1 & prev5tion1 includ+ procurem5t ( drugs & o!r ,,tb commodities1 drug managem5t1 tra9+ 9 diagnosis & treatm5t1 heal? sy/ems /r5g!n+ t directly impacts ! provision ( ,,tb prev5tion1 diagnosis1 treatm5t1 & rese>*2 & 7,i7 = ea* c\ntry & ea* project site receiv+ bilat]al ,unit$ ,/ates assi/ance = ! purpose ( ,,tb prev5tion1 treatm5t1 & control-- 7i7 ! numb] ( individuals scre5$ = ,,tb disease 7includ+ scre5+s utiliz+ quality new rapid diagno/ic te/s7 & ! numb] evaluat$ = ,,tb infection us+ active case f9d+ outside ( heal? facilities2 7ii7 ! numb] ( individuals ) active ,,tb disease t 7 diagnos$ 7includ+ diagnoses made ?r\gh us+ quality new rapid diagno/ic te/s7 & treat$ ) safe & effective oral regim5s1 includ+ ! rate ( treatm5t completion & ! numb] receiv+ pati5t support2 7iii7 ! numb] ( adults & *ildr51 includ+ individuals ) ,,hiv & close contacts1 :o are evaluat$ = ,,tb infection1 ! numb] ( adults & *ildr5 />t$ on treatm5t = ,,tb infection1 & ! numb] ( adults & *ildr5 complet+ su* treatm5t1 disaggregat$ by sex &1 if possible1 income or weal? qu9tile2 7iv7 ! e/abli%m5t ( effective ,,tb infection control 9 all relevant congregant sett+s1 includ+ hospitals1 cl9ics1 & prisons2 7v7 a description ( progress 9 implem5t+ measures to r$uce ,,tb incid5ce1 includ+ actions-- 7,i7 to exp& active case f9d+ & contact trac+ to rea* vuln]able gr\ps2 & 7,,ii7 to exp& ,,tb prophylaxis treatm5t1 engagem5t ( ! private sector1 & diagno/ic capacity2 7vi7 a description ( progress to exp& diagnosis1 prev5tion1 & treatm5t = all =ms ( ,,tb1 includ+ 9 pregnant wom51 *ildr51 & individuals & gr\ps at great] risk ( ,,tb1 includ+ migrants1 prison]s1 m9]s1 & individuals expos$ to silica1 disaggregat$ by sex2 7vii7 ! rate ( successful completion ( ,,tb treatm5t = adults & *ildr51 disaggregat$ by sex1 & ! numb] ( individuals receiv+ support = treatm5t completion2 7viii7 ! numb] ( individuals1 disaggregat$ by sex1 receiv+ treatm5t = ,,mdr-,,tb1 includ+ ! proportion ( ^? individuals :o are be+ treat$ ) saf] & m effective oral regim5s1 & any factors imp$+ ! scale up ( treatm5t1 & a description ( progress to exp& community-bas$ ,,mdr-,,tb c>e2 7ix7 a description ( ,,tb commodity procurem5t *all5ges1 includ+ %ortages1 /ock\ts1 or fail$ t5d]s = ,,tb drugs or o!r ,,tb commodities2 7x7 ! proportion ( heal? facilities ) specim5 ref]ral l9kages to quality diagno/ic networks1 includ+ e/abli%$ te/+ sites & ref]5ce labs1 to ensure maximum access & ref]ral = second-l9e drug resi/ance te/+1 & a description ( ! turn>\nd "t = te/ results2 7xi7 ! numb] ( individuals tra9$ by ! ,unit$ ,/ates ,gov]nm5t & its implem5t+ p>tn]s to deliv] high-quality ,,tb diagno/ic1 prev5tative1 monitor+1 treatm5t1 & c>e2 7xii7 a description ( h[ support$ activities are coord9at$ )-- 7,i7 c\ntry national ,,tb plans & /rategies2 & 7,,ii7 ,,tb control ef=ts support$ by ! ,global ,fund to ,fight ,,aids1 ,tub]culosis1 & ,mal>ia1 & o!r int]national assi/ance programs & funds1 includ+ 9 ! areas ( program developm5t & implem5tation2 7xiii7 = ! fir/ #c ye>s ( ! report requir$ "u ?is p>agraph1 a description ( ! progress 9 recov]+ f ! negative impact ( ,,covid-#ai on ,,tb1 includ+-- 7,i7 :e!r !re has be5 ! developm5t & implem5tation ( a compreh5sive plan to recov] ,,tb activities f div]sion ( res\rces2 7,,ii7 ! cont9u$ use ( bidirectional ,,tb-,,covid te/+2 & 7,,iii7 progress on increas$ diagnosis & treatm5t ( active ,,tb2 & 7xiv7 = ea* c\ntry receiv+ ,unit$ ,/ates bilat]al assi/ance = ! purpose ( ,,tb prev5tion1 treatm5t1 & control1 ! ,unit$ ,/ates w track c\ntry gov]nm5t co-inve/m5t 9 ,,tb prev5tion1 treatm5t1 & control4 7#b7 ,annual report on tub]culosis rese>* & developm5t ,! ,presid5t1 act+ ?r\gh ! ,secret>y ( ,/ate1 & 9 coord9ation ) ! heads ( o!r relevant ,f$]al dep>tm5ts & ag5cies1 %all1 n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ! ,end ,tub]culosis ,n[ ,act ( #bjbf1 & annually !reaft] until ,decemb] #ca1 #bjcb1 submit a report to ! appropriate congressional committees t-- 7,a7 describes ! curr5t progress & *all5ges to ! developm5t ( new tools = ,,tb prev5tion1 treatm5t1 & control2 7,b7 id5tifies critical gaps & em]g+ priorities = rese>* & developm5t1 includ+ rapid & po9t-(-c>e diagno/ics1 %ort5$ treatm5ts & prev5tion me?ods1 teleheal? solutions = prev5tion & treatm5t1 & vacc9es2 & 7,c7 describes rese>* inve/m5ts by type1 fund$ entities1 & level ( inve/m5t4 7#c7 ,evaluation report ,n lat] ?an #d ye>s aft] ! date ( ! enactm5t ( ! ,end ,tub]culosis ,n[ ,act ( #bjbf1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit a report to ! appropriate congressional committees t evaluates ! p]=mance & impact ( programs support$ by ,unit$ ,/ates bilat]al assi/ance fund+ on ! prev5tion1 diagnosis1 treatm5t1 & c>e ( ,,tb1 includ+ recomm5dations = improv+ su* programs4 7h7 ,def9itions ,9 ?is section3 7#a7 ,appropriate congressional committees ,! t]m appropriate congressional committees means-- 7,a7 ! ,committee on ,=eign ,relations ( ! ,s5ate2 & 7,b7 ! ,committee on ,=eign ,affairs ( ! ,h\se ( ,repres5tatives4 7#b7 ,,mdr-,,tb ,! t]m ,,mdr-,,tb means multi-drug-resi/ant tub]culosis4 7#c7 ,,xdr-,,tb ,! t]m ,,xdr-,,tb means ext5sively drug-resi/ant tub]culosis4 4 7b7 ,sunset ,! am5dm5t made by subsection 7a7 %all cease to h any =ce or effect beg9n+ on ,janu>y #a1 #bjcc4