[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1115 Reported in Senate (RS)]






                                                       Calendar No. 526
107th CONGRESS
  2d Session
                                S. 1115

                          [Report No. 107-227]

To amend the Public Health Service Act with respect to making progress 
  toward the goal of eliminating tuberculosis, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 27, 2001

Mr. Kennedy (for himself, Mr. Stevens, Mr. Inouye, Mrs. Hutchison,  Mr. 
 Corzine, Mr. Torricelli, Ms. Landrieu, Mr. Bingaman, and Mrs. Murray) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

                             July 26, 2002

               Reported by Mr. Kennedy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 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,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Comprehensive Tuberculosis 
Elimination Act of 2001''.</DELETED>

         <DELETED>TITLE I--PREVENTIVE HEALTH SERVICES</DELETED>

<DELETED>SEC. 101. ADVISORY COUNCIL FOR THE ELIMINATION OF 
              TUBERCULOSIS.</DELETED>

<DELETED>    Section 317E(f) of the Public Health Service Act (42 
U.S.C. 247b-6(f)) is amended--</DELETED>
        <DELETED>    (1) by redesignating paragraph (5) as paragraph 
        (6);</DELETED>
        <DELETED>    (2) by striking paragraphs (2) through (4), and 
        inserting the following:</DELETED>
        <DELETED>    ``(2) Duties.--For the purpose of making progress 
        toward the goal of eliminating tuberculosis, the Council shall 
        provide to the Secretary and other appropriate Federal 
        officials advice on coordinating the activities of the Public 
        Health Service and other Federal agencies that relate to such 
        disease and on efficiently utilizing the Federal resources 
        involved.</DELETED>
        <DELETED>    ``(3) National plan.--In carrying out paragraph 
        (2), the Council, in consultation with appropriate public and 
        private entities, shall make recommendations on the development 
        and implementation of a national plan to eliminate tuberculosis 
        in the United States. In carrying out this paragraph, the 
        Council shall--</DELETED>
                <DELETED>    ``(A) consider the recommendations of the 
                Institute of Medicine regarding the elimination of 
                tuberculosis;</DELETED>
                <DELETED>    ``(B) address the development and 
                application of new technologies; and</DELETED>
                <DELETED>    ``(C) review the extent to which progress 
                has been made toward eliminating 
                tuberculosis.</DELETED>
        <DELETED>    ``(4) Global activities.--In carrying out 
        paragraph (2), the Council, in consultation with appropriate 
        public and private entities, shall make recommendations for the 
        development and implementation of a plan to guide the 
        involvement of the United States in global tuberculosis-control 
        activities, including recommendations regarding policies, 
        strategies, objectives, and priorities. Such recommendations 
        for the plan shall have a focus on high incidence countries and 
        on access to a comprehensive package of tuberculosis control 
        measures, as defined by the World Health Organization directly 
        observed treatment, short course strategy (commonly known as 
        DOTS).</DELETED>
        <DELETED>    ``(5) Composition.--The Council shall be composed 
        of--</DELETED>
                <DELETED>    ``(A) representatives from the Centers for 
                Disease Control and Prevention, the National Institutes 
                of Health, the Agency for Healthcare Research and 
                Quality, the U.S.-Mexico Border Health Commission, and 
                other Federal departments and agencies that carry out 
                significant activities relating to tuberculosis; 
                and</DELETED>
                <DELETED>    ``(B) members appointed from among 
                individuals who are not officers or employees of the 
                Federal Government.''; and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
        <DELETED>    ``(7) Applicability of faca.--The Council shall be 
        subject to the Federal Advisory Committee Act (5 U.S.C. 
        App.).''.</DELETED>

<DELETED>TITLE II--CENTERS FOR DISEASE CONTROL AND PREVENTION</DELETED>

<DELETED>SEC. 201. NATIONAL PROGRAM FOR TUBERCULOSIS 
              ELIMINATION.</DELETED>

<DELETED>    Section 317E of the Public Health Service Act (42 U.S.C. 
247b-6) is amended--</DELETED>
        <DELETED>    (1) by striking the heading for the section and 
        inserting the following:</DELETED>

 <DELETED>``national program for tuberculosis elimination'';</DELETED>

        <DELETED>    (2) by amending subsection (b) to read as 
        follows:</DELETED>
<DELETED>    ``(b) Research, 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:</DELETED>
        <DELETED>    ``(1) Research, with priority given to research 
        concerning--</DELETED>
                <DELETED>    ``(A) diagnosis and treatment of latent 
                infection of tuberculosis;</DELETED>
                <DELETED>    ``(B) strains of tuberculosis resistant to 
                drugs;</DELETED>
                <DELETED>    ``(C) cases of tuberculosis that affect 
                certain populations; and</DELETED>
                <DELETED>    ``(D) clinical trials, including a 
                tuberculosis trials consortium.</DELETED>
        <DELETED>    ``(2) Demonstration projects, including for--
        </DELETED>
                <DELETED>    ``(A) the development of regional 
                capabilities for the prevention, control, and 
                elimination of tuberculosis; and</DELETED>
                <DELETED>    ``(B) collaboration with the Immigration 
                and Naturalization Service to identify and treat 
                immigrants with active or latent tuberculosis 
                infection.</DELETED>
        <DELETED>    ``(3) Public information and education 
        programs.</DELETED>
        <DELETED>    ``(4) Education, training and clinical skills 
        improvement activities for health professionals, including 
        allied health personnel.</DELETED>
        <DELETED>    ``(5) Support of model centers to carry out 
        activities under paragraphs (2) through (4).</DELETED>
        <DELETED>    ``(6) Collaboration with international 
        organizations and foreign countries in carrying out such 
        activities, including coordinating activities through the 
        Advisory Council for the Elimination of Tuberculosis.''; 
        and</DELETED>
        <DELETED>    (3) by striking subsection (g) and inserting the 
        following:</DELETED>
<DELETED>    ``(g) Reports.--The Secretary, acting through the Director 
of the Centers for Disease Control and Prevention and in consultation 
with the Advisory Council for the Elimination of Tuberculosis, shall 
biennially prepare and submit to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on Energy and 
Commerce of the House of Representatives, a report on the activities 
carried out under this section. Each report shall include the opinion 
of the Council on the extent to which the recommendations of the 
Institute of Medicine regarding tuberculosis have been implemented.''; 
and</DELETED>
<DELETED>    ``(h) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be appropriated 
$528,000,000 for fiscal year 2002, and such sums as may be necessary 
for each of the fiscal years 2003 through 2006.''.</DELETED>

      <DELETED>TITLE III--NATIONAL INSTITUTES OF HEALTH</DELETED>

<DELETED>SEC. 301. ACTIVITIES OF NATIONAL HEART, LUNG, AND BLOOD 
              INSTITUTE.</DELETED>

<DELETED>    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:</DELETED>

                   <DELETED>``tuberculosis</DELETED>

<DELETED>    ``Sec. 424C. (a) In General.--The Director of the 
Institute shall expand, intensify, and coordinate research and related 
activities of the Institute with respect to tuberculosis, including 
activities toward the goal of eliminating such disease.</DELETED>
<DELETED>    ``(b) Certain Activities.--Activities under subsection (a) 
shall include--</DELETED>
        <DELETED>    ``(1) enhancing basic and clinical research on 
        tuberculosis; and</DELETED>
        <DELETED>    ``(2) expanding research on the relationship 
        between such disease and the human immunodeficiency 
        virus.</DELETED>
<DELETED>    ``(c) Research Education.--</DELETED>
        <DELETED>    ``(1) Tuberculosis academic awards.--The Director 
        of the Institute may provide awards to faculty of schools of 
        medicine, nursing, or osteopathic medicine for information and 
        education programs, including the development of curricula, to 
        significantly increase the opportunities for students and for 
        practicing providers to learn the principles and practices of 
        preventing, managing, and controlling tuberculosis.</DELETED>
        <DELETED>    ``(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, including 
        tuberculosis, by providing for supervised study and 
        research.</DELETED>
        <DELETED>    ``(3) Authorization of appropriations.--</DELETED>
                <DELETED>    ``(A) Tuberculosis academic awards.--For 
                the purpose of carrying out paragraph (1), there are 
                authorized to be appropriated $5,000,000 for fiscal 
                year 2002, and such sums as may be necessary for each 
                of the fiscal years 2003 through 2006.</DELETED>
                <DELETED>    ``(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 2002, and such sums as may be necessary for 
                each of the fiscal years 2003 through 
                2006.''.</DELETED>

<DELETED>SEC. 302. ACTIVITIES OF NATIONAL INSTITUTE OF ALLERGY AND 
              INFECTIOUS DISEASES.</DELETED>

<DELETED>    Section 447A of the Public Health Service Act (42 U.S.C. 
285f-2) is amended--</DELETED>
        <DELETED>    (1) by redesignating subsection (b) as subsection 
        (c);</DELETED>
        <DELETED>    (2) by inserting after subsection (a) the 
        following subsection:</DELETED>
<DELETED>    ``(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</DELETED>
        <DELETED>    (3) in subsection (c) (as so redesignated), in the 
        first sentence--</DELETED>
                <DELETED>    (A) by striking ``and'' after ``1994,''; 
                and</DELETED>
                <DELETED>    (B) by inserting before the period the 
                following: ``, $240,000,000 for fiscal year 2002, and 
                such sums as may be necessary for each of the fiscal 
                years 2003 through 2006''.</DELETED>

<DELETED>SEC. 303. JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED 
              STUDY IN THE HEALTH SCIENCES.</DELETED>

<DELETED>    Section 482 of the Public Health Service Act (42 U.S.C. 
287b) is amended--</DELETED>
        <DELETED>    (1) by inserting ``(a) In General.--'' before 
        ``The general purpose'';</DELETED>
        <DELETED>    (2) in subsection (a) (as so designated), by 
        inserting after ``Health Sciences'' the following: ``(in this 
        subpart referred to as the `Center')''; and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
<DELETED>    ``(b) Tuberculosis.--</DELETED>
        <DELETED>    ``(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. In particular, the Center 
        shall expand its activities to include support for clinical, 
        operational, and health services research and 
        training.</DELETED>
        <DELETED>    ``(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.''.</DELETED>

<DELETED>SEC. 304. LOAN REPAYMENT PROGRAMS REGARDING RESEARCH ON 
              TUBERCULOSIS.</DELETED>

<DELETED>    Part G of title IV of the Public Health Service Act (42 
U.S.C. 288 et seq.) is amended--</DELETED>
        <DELETED>    (1) by redesignating the second section 487F as 
        section 487G; and</DELETED>
        <DELETED>    (2) by inserting after section 487G (as so 
        redesignated) the following section:</DELETED>

<DELETED>``loan repayments regarding research on tuberculosis</DELETED>

<DELETED>    ``Sec. 487H. In carrying out sections 487C, 487E, and 
487F, the Secretary shall seek to ensure that, for fiscal year 2002 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.''.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Comprehensive Tuberculosis 
Elimination Act of 2002''.

                  TITLE I--PREVENTIVE HEALTH SERVICES

SEC. 101. ADVISORY COUNCIL FOR THE ELIMINATION OF TUBERCULOSIS.

    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.--For the purpose of making progress toward 
        the goal of eliminating tuberculosis from the United States, 
        the Council shall provide to the Secretary and other 
        appropriate Federal officials advice on coordinating the 
        activities of the Public Health Service and other Federal 
        agencies that relate to such disease and on efficiently 
        utilizing the Federal resources involved.
            ``(3) National plan.--In carrying out paragraph (2), the 
        Council, in consultation with appropriate public and private 
        entities, shall make recommendations on the development, 
        revision, and implementation of a national plan to eliminate 
        tuberculosis in the United States. In carrying out this 
        paragraph, the Council shall--
                    ``(A) consider the recommendations of the Institute 
                of Medicine regarding the elimination of tuberculosis;
                    ``(B) address the development and application of 
                new technologies; and
                    ``(C) review the extent to which progress has been 
                made toward eliminating tuberculosis.
            ``(4) Global activities.--In carrying out paragraph (2), 
        the Council, in consultation with appropriate public and 
        private entities, shall make recommendations for the 
        development and implementation of a plan to guide the 
        involvement of the United States in global and cross border 
        tuberculosis-control activities, including recommendations 
        regarding policies, strategies, objectives, and priorities. 
        Such recommendations for the plan shall have a focus on 
        countries where a high incidence of tuberculosis directly 
        affects the United States, such as Mexico, and on access to a 
        comprehensive package of tuberculosis control measures, as 
        defined by the World Health Organization directly observed 
        treatment, short course strategy (commonly known as DOTS).
            ``(5) Composition.--The Council shall be composed of--
                    ``(A) representatives from the Centers for Disease 
                Control and Prevention, the National Institutes of 
                Health, the Agency for Healthcare Research and Quality, 
                the Health Resources and Services Administration, the 
                U.S.-Mexico Border Health Commission, and other Federal 
                departments and agencies that carry out significant 
                activities relating to tuberculosis; and
                    ``(B) members appointed from among individuals who 
                are not officers or employees of the Federal 
                Government.''.

          TITLE II--CENTERS FOR DISEASE CONTROL AND PREVENTION

SEC. 201. NATIONAL PROGRAM FOR TUBERCULOSIS ELIMINATION.

    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 tuberculosis elimination'';

            (2) by amending subsection (b) to read as follows:
    ``(b) Research, 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 
        concerning--
                    ``(A) diagnosis and treatment of latent infection 
                of tuberculosis;
                    ``(B) strains of tuberculosis resistant to drugs;
                    ``(C) cases of tuberculosis that affect certain 
                high-risk populations; and
                    ``(D) clinical trials, including those conducted 
                through the Tuberculosis Trials Consortium.
            ``(2) Demonstration projects, including for--
                    ``(A) the development of regional capabilities for 
                the prevention, control, and elimination of 
                tuberculosis particularly in low-incidence regions; and
                    ``(B) collaboration with the Immigration and 
                Naturalization Service to identify and treat immigrants 
                with active or latent tuberculosis infection.
            ``(3) Public information and education programs.
            ``(4) Education, training and clinical skills improvement 
        activities for health professionals, including allied health 
        personnel.
            ``(5) Support of model centers to carry out activities 
        under paragraphs (2) through (4).
            ``(6) Collaboration with international organizations and 
        foreign countries, including Mexico, in coordination with the 
        United States Agency for International Development, in carrying 
        out such activities, including coordinating activities through 
        the Advisory Council for the Elimination of Tuberculosis.''; 
        and
            (3) by striking subsection (g) and inserting the following:
    ``(g) Reports.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention and in consultation with the 
Advisory Council for the Elimination of Tuberculosis, shall biennially 
prepare and submit to the Committee on Health, Education, Labor, and 
Pensions of the Senate and the Committee on Energy and Commerce of the 
House of Representatives, a report on the activities carried out under 
this section. Each report shall include the opinion of the Council on 
the extent to which its recommendations under section 317E(f)(3) 
regarding tuberculosis have been implemented.''; and
    ``(h) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $235,000,000 
for fiscal year 2003, and such sums as may be necessary for each of the 
fiscal years 2004 through 2007.''.

                TITLE III--NATIONAL INSTITUTES OF HEALTH

SEC. 301. 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:

                             ``tuberculosis

    ``Sec. 424C. (a) In General.--The Director of the Institute shall 
expand, intensify, and coordinate research and related activities of 
the Institute with respect to the treatment, diagnosis, and prevention 
of tuberculosis, including--
            ``(1) basic and clinical research on tuberculosis; and
            ``(2) research on the relationship between tuberculosis and 
        the human immunodeficiency virus.
    ``(b) Research Education.--
            ``(1) Tuberculosis academic awards.--The Director of the 
        Institute may award grants to institutions for the development 
        and support of programs of core curricula for training clinical 
        investigators, including medical, nursing, or osteopathic 
        students, in the principles and practices of preventing, 
        managing, and controlling tuberculosis in patients.
            ``(2) Tuberculosis/pulmonary infection awards.--The 
        Director of the Institute may provide awards to support the 
        research of trained professionals into the basic biological 
        processes and mechanisms involved in tuberculosis, as well as 
        research into the development of new diagnostic techniques and 
        treatments.
            ``(3) Authorization of appropriations.--For the purpose of 
        carrying out this subsection, there are authorized to be 
        appropriated $10,000,000 for fiscal year 2003, and such sums as 
        may be necessary for each of the fiscal years 2004 through 
        2007.''.

SEC. 302. 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) may include activities to 
develop a tuberculosis vaccine. The recommendations contained within 
the Blueprint for Tuberculosis Vaccine Development, described in the 
report prepared pursuant to the workshop convened in March 1998 by the 
Director of the Institute, shall be taken into consideration.''; 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: 
                ``, $136,000,000 for fiscal year 2003, $162,000,000 for 
                fiscal year 2004, and such sums as may be necessary for 
                each of the fiscal years 2005 through 2007''.

SEC. 303. JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN 
              THE HEALTH SCIENCES.

    (a) In General.--With respect to tuberculosis, the John E. Fogarty 
International Center for Advanced Study in the Health Sciences shall 
expand, intensify, and coordinate international activities of the 
Center for research and training. In particular, the Center shall 
expand its activities to include support for clinical, operational, and 
health services research and training.
    (b) International Training Program.--In carrying out subsection 
(a), 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.




                                                       Calendar No. 526

107th CONGRESS

  2d Session

                                S. 1115

                          [Report No. 107-227]

_______________________________________________________________________

                                 A BILL

To amend the Public Health Service Act with respect to making progress 
  toward the goal of eliminating tuberculosis, and for other purposes.

_______________________________________________________________________

                             July 26, 2002

                       Reported with an amendment