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

August 1 (legislative day, JULY 21), 2003

Mr. KENNEDY (for himself, Mrs. HUTCHISON, Mr. INOUYE, 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

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.

This Act may be cited as the `Comprehensive Tuberculosis Elimination Act of 2003'.

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 section heading and inserting the following:

`NATIONAL PROGRAM FOR TUBERCULOSIS ELIMINATION';

(2) by striking subsection (b) and inserting the following:

`(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.

`(h) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out this section, there are authorized to be appropriated $235,000,000 for fiscal year 2004, and such sums as may be necessary for each of the fiscal years 2005 through 2008.'.

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 2004, and such sums as may be necessary for each of the fiscal years 2005 through 2008.'.

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:

`(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 2004, $162,000,000 for fiscal year 2005, and such sums as may be necessary for each of the fiscal years 2006 through 2008'.

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.

END