[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1532 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 1532

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

                             March 15, 2007

 Mr. Gene Green of Texas (for himself, Mrs. Wilson of New Mexico, and 
 Ms. Baldwin) 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 2007''.
    (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. 205. Authorization of appropriations.

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 
        (``MDR'') TB, including extensively drug resistant (``XDR'') 
        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) The Centers for Disease Control and Prevention is 
        increasingly relied upon globally for its expertise and 
        technical assistance in global tuberculosis preparedness and 
        outbreak response capacity to identify and investigate 
        outbreaks of multidrug resistant and extensively drug resistant 
        TB.
            (6) 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 co-infected 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--
                            ``(i) to prevent, detect, and treat 
                        tuberculosis among African Americans and other 
                        United States-born populations with documented 
                        health disparities; and
                            ``(ii) to reduce or eliminate racial 
                        disparities in the incidence of tuberculosis in 
                        these populations;
                    ``(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, 
                laboratorians, 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, 
        vaccines, and public health interventions.--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, vaccines, and public health 
        interventions.
            ``(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), 
                including 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 2008, and such sums as may be necessary for each 
                of the fiscal years 2009 through 2012.
                    ``(B) Reservation for emergency grants.--Of the 
                amounts appropriated under subparagraph (A) for a 
                fiscal year, the Secretary may reserve not more than 25 
                percent for emergency grants under subsection (a) for 
                any geographic area in which there is, relative to 
                other areas, a substantial number of cases of 
                tuberculosis, multidrug resistant tuberculosis, or 
                extensively resistant tuberculosis or a substantial 
                rate of increase in such cases.
                    ``(C) Priority.--In allocating amounts appropriated 
                under subparagraph (A) and not reserved under 
                subparagraph (B), the Secretary shall give priority to 
                allocating such amounts for grants under subsection 
                (a).
                    ``(D) Allocation of funds.--
                            ``(i) Requirement of formula.--Of the 
                        amounts appropriated under subparagraph (A), 
                        not reserved under subparagraph (B), and 
                        allocated by the Secretary for grants under 
                        subsection (a), the Secretary shall distribute 
                        such amounts to grantees under subsection (a) 
                        on the basis of a formula.
                            ``(ii) Relevant factors.--The formula 
                        developed by the Secretary under clause (i) 
                        shall take into account the level of 
                        tuberculosis morbidity in the respective 
                        geographic area and may consider other factors 
                        relevant to tuberculosis in such area.
                            ``(iii) No change to formula required.--
                        This subparagraph does not require the 
                        Secretary to modify the formula that was used 
                        by the Secretary to distribute funds to 
                        grantees under subsection (a) for fiscal year 
                        2007.
            ``(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 2008, and such sums as may 
                be necessary for each of the fiscal years 2009 through 
                2012.
                    ``(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 2007.''.

                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.''.

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 striking ``In carrying out section 446'' and 
        inserting ``(a) In carrying out section 446''; and
            (2) by inserting at the end the following:
    ``(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.''.

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 2008 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.''.

SEC. 205. AUTHORIZATION OF APPROPRIATIONS.

    For the purpose of carrying out this title and the amendments made 
by this title, there are authorized to be appropriated such sums as may 
be necessary. Such authorization of appropriations shall be in addition 
to the authorization of appropriations established by section 402A(a) 
of the Public Health Service Act and any other authorization of 
appropriations available for such purpose.
                                 <all>