Comprehensive TB Elimination Act of 2021
This bill reauthorizes for FY2022-FY2027 and revises the tuberculosis (TB) prevention and treatment grant program administered by the Centers for Disease Control and Prevention. The Health Resources and Services Administration may also award grants to state, tribal, territorial, and local governments and specified health care providers (e.g., Native Hawaiian health organizations and federally qualified health centers) for TB prevention and treatment efforts.
Additionally, the Government Accountability Office must report on (1) national TB prevention and treatment efforts, and (2) matters concerning TB drug shortages and costs.
To amend the Public Health Service Act to enhance the national strategy 
  for combating and 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 TB Elimination Act of 
2021''.

SEC. 2. NATIONAL STRATEGY FOR COMBATING AND ELIMINATING TUBERCULOSIS.

    (a) In General.--Section 317E of the Public Health Service Act (42 
U.S.C. 247b-6) is amended--
            (1) in subsection (a)--
                    (A) by striking ``The Secretary'' and inserting the 
                following:
            ``(1) Grants.--The Secretary''; and
                    (B) by adding at the end the following:
            ``(2) Priority.--In making grants under this subsection, 
        the Secretary may give priority to State health departments 
        proposing to focus on the prevention, control, and elimination 
        of tuberculosis in high-risk populations, including foreign-
        born, homeless, incarcerated, HIV-tuberculosis co-infected, and 
        medically underserved populations.'';
            (2) in subsection (b)--
                    (A) in paragraph (3)--
                            (i) in subparagraph (C), by redesignating 
                        clauses (i) and (ii) as subclauses (I) and 
                        (II), respectively, and adjusting the margins 
                        accordingly; and
                            (ii) by redesignating subparagraphs (A) 
                        through (F) as clauses (i) through (vi), 
                        respectively, and adjusting the margins 
                        accordingly;
                    (B) by redesignating paragraphs (1) through (8) as 
                subparagraphs (A) through (H), respectively, and 
                adjusting the margins accordingly;
                    (C) in the matter preceding subparagraph (A), as so 
                redesignated, by striking ``With respect to'' and 
                inserting the following:
            ``(1) In general.--With respect to'';
                    (D) by striking subparagraph (B), as so 
                redesignated, and inserting the following:
                    ``(B) Research, investigations, experiments, 
                demonstrations, and studies in the health sciences that 
                are related to--
                            ``(i) the development of new tools, 
                        including vaccines and antimicrobial drugs, to 
                        prevent and treat tuberculosis;
                            ``(ii) novel therapeutics for special 
                        populations, including pediatric populations, 
                        immunosuppressed individuals, and pregnant 
                        women;
                            ``(iii) the development or testing of 
                        medical diagnostics to detect tuberculosis;
                            ``(iv) research to address the 
                        epidemiology, mechanisms, and pathogenesis of 
                        tuberculosis;
                            ``(v) public health interventions to 
                        address the prevention, treatment, and control 
                        of tuberculosis, such as directly observed 
                        therapy and non-pharmaceutical intervention;
                            ``(vi) methods to enhance detection and 
                        response to outbreaks of tuberculosis, 
                        including multidrug resistant tuberculosis; and
                            ``(vii) other relevant research areas.'';
                    (E) in subparagraph (C), as so redesignated--
                            (i) by redesignating clause (vi), as so 
                        redesignated, as clause (vii);
                            (ii) in clause (v), as so redesignated, by 
                        striking ``; and'' and inserting ``;''; and
                            (iii) by inserting after clause (v), as so 
                        redesignated, the following:
                            ``(vi) the intensification of efforts to 
                        prevent, detect, and treat latent tuberculosis; 
                        and'';
                    (F) in subparagraph (D), as so redesignated, by 
                inserting before the period the following: ``, 
                including public awareness campaigns and development of 
                educational, risk, and media communications, using 
                materials in languages appropriate to target 
                audiences.'';
                    (G) in subparagraph (F), as so redesignated, by 
                striking ``paragraphs (1) through (4)'' and inserting 
                ``subparagraphs (A) through (D)''; and
                    (H) by adding at the end the following:
            ``(2) Selection.--In carrying out the activities described 
        in paragraph (1), the Secretary--
                    ``(A) is encouraged to give priority to 
                programmatically relevant research so that new tools 
                can be utilized in public health practice; and
                    ``(B) may seek input from the Biomedical Advanced 
                Research and Development Authority in identifying novel 
                candidates to utilize in the efforts under this 
                subsection to prevent, diagnose, and control 
                tuberculosis.'';
            (3) by redesignating subsections (c) through (h) as 
        subsections (d) through (i), respectively;
            (4) by inserting after subsection (b) the following--
    ``(c) Grants for Coordination of Programs and Services for 
Prevention, Diagnosis, and Treatment.--
            ``(1) Grants.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, may award grants to State and local 
        governments, territories, Indian Tribes, Tribal organization, 
        urban Indian health organizations, health service providers to 
        Indian Tribes, Native Hawaiian health organizations, community 
        health centers, and Federally qualified health centers for 
        coordinating the programs and services of such entities to 
        ensure timely and appropriate prevention, risk-based screening, 
        diagnosis, and treatment of latent and active tuberculosis.
            ``(2) Definition.--In this subsection, the term `Federally 
        qualified health center' has the meaning given to such term in 
        section 1861(aa) of the Social Security Act.'';
            (5) in subsections (d), (e), and (f), as so redesignated, 
        by striking ``(a) or (b)'' each place it appears and inserting 
        ``(a), (b), or (c)'';
            (6) in subsection (g)(4), as so redesignated, by adding at 
        the end the following:
                    ``(C) Report to congress.--The Secretary is 
                encouraged to make the reports under subparagraph (A), 
                or other publications relevant to domestic tuberculosis 
                surveillance, publicly available on the internet 
                website of the Centers for Disease Control and 
                Prevention and to disseminate such information to 
                stakeholders.'';
            (7) in subsection (h), as so redesignated--
                    (A) in paragraph (1)--
                            (i) by striking ``research into new tools 
                        under subsection (b)(2)'' and inserting ``the 
                        research, investigations, experiments, 
                        demonstrations, and studies in health science 
                        under subsection (b)(1)(B)''; and
                            (ii) by inserting ``ensuring access to the 
                        products developed as a result of such 
                        research, investigations, experiments, 
                        demonstrations, and studies and'' after 
                        ``advice regarding''; and
                    (B) in paragraph (3)--
                            (i) by redesignating subparagraphs (D) and 
                        (E) as subparagraphs (E) and (F), respectively; 
                        and
                            (ii) by inserting after subparagraph (C) 
                        the following:
                    ``(D) members of the Biomedical Advanced Research 
                and Development Authority;''; and
            (8) in subsection (i)(1)(A), as so redesignated, by 
        striking ``$200,000,000'' and all that follows through the 
        period and inserting ``$142,200,000 for fiscal year 2022, 
        $195,700,000 for fiscal year 2023, $225,000,000 for fiscal year 
        2024, $236,250,000 for fiscal year 2025, $248,062,500 for 
        fiscal year 2026, and $260,465,625 for fiscal year 2027.''.
    (b) NIH Tuberculosis Activities.--Section 424C(b) of the Public 
Health Service Act (42 U.S.C. 285b-7c(b)) is amended by striking 
paragraph (1) and inserting the following:
            ``(1) enhancing basic, clinical, and operational research 
        on tuberculosis, including with respect to--
                    ``(A) drug-resistant tuberculosis;
                    ``(B) infection with tuberculosis and latency and 
                progression of tuberculosis; and
                    ``(C) pediatric tuberculosis;''.

SEC. 3. GAO STUDIES.

    (a) Tuberculosis Prevention and Elimination Study.--Not later than 
2 years after the date of enactment of this Act, the Comptroller 
General of the United States shall issue a report on the coordination 
of efforts in the United States to--
            (1) prevent, control, and eliminate tuberculosis; and
            (2) implement the activities under section 317E of the 
        Public Health Service Act (42 U.S.C. 247b-6), as amended by 
        this Act, and the National Action Plan for Combating Multidrug-
        Resistant Tuberculosis, issued in December 2015.
    (b) Study on Tuberculosis Activities.--Not later than 6 months 
after the date of enactment of this Act, the Comptroller General of the 
United States shall issue to the Committee on Energy and Commerce of 
the House of Representatives and the Committee on Health, Education, 
Labor, and Pensions of the Senate a report on the coordination of 
activities between the Food and Drug Administration and the Centers for 
Disease Control and Prevention with respect to--
            (1) shortages of critical tuberculosis drugs in the United 
        States;
            (2) efforts to increase the availability of pediatric 
        tuberculosis drug formulations in the United States;
            (3) mitigating the cost of tuberculosis drugs for States, 
        including efforts to ensure States have timely access to 
        treatments for individuals with tuberculosis; and
            (4) consideration for the introduction in the United States 
        of pediatric tuberculosis drug formulations that are available 
        in foreign countries.
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Comprehensive TB Elimination Act of 2021
To amend the Public Health Service Act to enhance the national strategy for combating and eliminating tuberculosis, and for other purposes.
Comprehensive TB Elimination Act of 2021
Rep. Bera, Ami