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End Tuberculosis Now Act of 2026

Introduced Jun 11, 2026 · Last action Jun 11, 2026 Read twice and referred to the Committee on Foreign Relations.

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Summary

This legislation is called the End Tuberculosis Now Act of 2026. It is being reviewed by a committee.

Full bill text

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4751 Introduced in Senate (IS)]

<DOC>

119th CONGRESS
  2d Session
                                S. 4751

           To prevent, treat, and cure tuberculosis globally.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             June 11, 2026

Mr. Young (for himself and Mrs. Shaheen) introduced the following bill;
which was read twice and referred to the Committee on Foreign Relations

_______________________________________________________________________

                                 A BILL

           To prevent, treat, and cure tuberculosis globally.

    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 ``End Tuberculosis Now Act of 2026''.

SEC. 2. ASSISTANCE TO COMBAT TUBERCULOSIS.

    (a) In General.--Section 104B of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b-3) is amended to read as follows:

``SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.

    ``(a) Findings.--Congress finds the following:
            ``(1) The international spread of tuberculosis (referred to
        in this section as `TB') and the deadly impact of TB's
        continued existence constitute a continuing challenge.
            ``(2) Additional tools and resources are required to
        effectively diagnose, prevent, and treat TB.
            ``(3) Effectively resourced TB programs can serve as a
        critical platform for preventing and responding to future
        infectious airborne and respiratory disease pandemics.
            ``(4) The America First Global Health Strategy sets out
        ambitious goals to address TB that are aligned with global
        goals to reduce incidences and mortality rates of TB.
    ``(b) Policy.--
            ``(1) Major objectives regarding tuberculosis.--It is a
        major objective of the foreign assistance program of the United
        States to help end the TB public health emergency through
        accelerated actions--
                    ``(A) to support the diagnosis and treatment of all
                adults and children with all forms of TB; and
                    ``(B) to prevent new TB infections from occurring.
            ``(2) Other policies regarding tuberculosis.--It is the
        policy of the United States, in countries in which the United
        States has established a foreign assistance program under this
        Act, particularly in countries with the highest rates of TB and
        other countries with high rates of infection and transmission
        of TB--
                    ``(A) to reduce mortality, incidence, and health
                costs caused by TB, including by providing support
                for--
                            ``(i) developing and using innovative new
                        technologies and therapies (including molecular
                        diagnostics) to increase active case finding
                        and rapidly diagnose and treat children and
                        adults with all forms of TB (including latent
                        TB), alleviate suffering, and ensure TB
                        treatment and preventative therapy completion;
                            ``(ii) expanding diagnosis and treatment
                        for individuals with all forms of TB (including
                        children) and expanding prophylaxis treatment
                        to at-risk individuals (including children),
                        household contacts, individuals with latent TB,
                        and individuals living with HIV;
                            ``(iii) ensuring high-quality TB care by
                        closing gaps in care cascades, implementing
                        continuous quality improvement at all levels of
                        care, and providing related patient support;
                            ``(iv) sustainable procurement of TB
                        commodities to avoid interruptions in supply;
                        and
                            ``(v) avoiding the procurement of TB
                        commodities of unknown quality and the payment
                        of excessive TB commodity costs; and
                    ``(B) to ensure, to the greatest extent
                practicable, that United States funding supports
                activities that simultaneously emphasize--
                            ``(i) the development of comprehensive
                        person-centered programs, including diagnosis,
                        treatment, and prevention strategies to ensure
                        that--
                                    ``(I) all individuals sick with TB
                                receive quality diagnosis and treatment
                                through active case finding; and
                                    ``(II) individuals at high risk for
                                TB infection are identified and treated
                                with prophylaxis treatment in a timely
                                manner;
                            ``(ii) robust TB infection control
                        practices are implemented in all congregate
                        settings, including hospitals and prisons;
                            ``(iii) the deployment of diagnostic and
                        treatment capacity--
                                    ``(I) in areas with the highest TB
                                burdens; and
                                    ``(II) for highly at-risk and
                                impoverished populations, including for
                                patient support;
                            ``(iv) program monitoring and evaluation
                        based on critical TB indicators, including
                        indicators relating to infection control, the
                        numbers of patients accessing TB treatment and
                        patient support, and prophylaxis treatment for
                        those at risk, including all close contacts,
                        and treatment outcomes for all forms of TB;
                            ``(v) training and engagement of health
                        care workers on the use of new diagnostic tools
                        and therapies as they become available, and
                        increased support for training frontline health
                        care workers to support expanded TB active case
                        finding, contact tracing, and patient support;
                            ``(vi) coordination with domestic agencies
                        and organizations to support an aggressive
                        research agenda to develop vaccines as well as
                        new tools to diagnose, treat, and prevent TB
                        globally;
                            ``(vii) linkages with the private sector
                        on--
                                    ``(I) research and development of a
                                vaccine, and on new tools for diagnosis
                                and treatment of TB;
                                    ``(II) improving current tools for
                                diagnosis and treatment of TB,
                                including telehealth solutions for
                                prevention and treatment;
                                    ``(III) training healthcare
                                professionals on the use of the newest
                                and most effective diagnostic and
                                therapeutic tools; and
                                    ``(IV) transparency and
                                accountability;
                            ``(viii) the reduction of barriers to
                        treatment and diagnosis costs, including
                        through--
                                    ``(I) training health workers to
                                ensure integration into country's wider
                                healthcare system;
                                    ``(II) requiring that all relevant
                                grants and funding agreements include
                                access and affordability provisions;
                                    ``(III) supporting campaigns for TB
                                patients regarding local TB care for
                                prevention, diagnosis, and treatment;
                                    ``(IV) monitoring cost barriers to
                                accessing TB care for prevention,
                                diagnosis, and treatment; and
                                    ``(V) increasing support for
                                patient-led and community-led TB
                                outreach efforts;
                            ``(ix) support for local and country-level,
                        sustainable accountability mechanisms to
                        measure local progress and ensure commitments
                        made by governments and relevant stakeholders
                        are met; and
                            ``(x) support for the inclusion of TB
                        diagnosis, treatment, and prevention activities
                        into primary health care, as appropriate.
    ``(c) Authorization.--
            ``(1) In general.--The President is authorized to furnish
        assistance, on such terms and conditions as the President may
        determine necessary to carry out this section, for the
        prevention, treatment, control, and elimination of TB.
            ``(2) Priority for assistance.--In furnishing assistance
        under paragraph (1), the President shall prioritize--
                    ``(A) building and strengthening TB programs--
                            ``(i) to increase the diagnosis and
                        treatment of individuals who are sick with TB;
                        and
                            ``(ii) to ensure that such individuals have
                        access to quality diagnosis and treatment;
                    ``(B) direct, high-quality care for all forms of
                TB, including diagnosis, coordination of active case
                finding, treatment of all forms of TB disease and
                infection, patient support, and TB prevention;
                    ``(C) treating individuals co-infected with HIV,
                other immune compromising co-morbidities, and other
                high-risk individuals with TB who may be at risk of
                stigma;
                    ``(D) strengthening the capacity of health systems
                to detect, prevent, and treat TB, including MDR-TB and
                XDR-TB;
                    ``(E) researching and developing innovative
                diagnostics, drug therapies, and vaccines, and program-
                based research;
                    ``(F) ensure integration of lab systems for
                molecular diagnostic networks for monitoring and
                response for productive use of laboratory capacities
                and healthcare facilities;
                    ``(G) supporting the procurement of cost-effective
                and quality TB diagnostics and treatments, including
                annual support for the Global Drug Facility, and
                assisting local country capacity building and
                sustainability to control all forms of TB; and
                    ``(H) ensuring TB programs can serve as key
                platforms for supporting national respiratory pandemic
                response with respect to existing and new infectious
                respiratory diseases.
    ``(d) Establishment of Goals.--The President, in consultation with
the appropriate congressional committees and in pursuit of the policies
described in subsection (a), shall establish goals to--
            ``(1) detect, cure, and prevent all forms of TB globally
        during the period beginning on January 1, 2027, and ending on
        December 31, 2030, specifically by working to--
                    ``(A) reduce, by 2030--
                            ``(i) the TB incidence rate by 80 percent
                        (from 2015 levels); and
                            ``(ii) the TB mortality rate by 90 (from
                        2015 levels) percent;
                    ``(B) ensure that--
                            ``(i) 90 percent of incident TB cases are
                        diagnosed and initiated on treatment;
                            ``(ii) 90 percent of incident drug
                        resistant-TB cases are diagnosed and initiated
                        on treatment; and
                            ``(iii) there is 90 percent treatment
                        success rate for drug sensitive-TB and drug
                        resistant-TB; and
                    ``(C) provide TB preventive treatment to 30,000,000
                individuals; and
            ``(2) update the National Action Plan for Combating
        Multidrug-Resistant Tuberculosis.
    ``(e) Coordination.--
            ``(1) In general.--The President shall consult, as
        appropriate, with partner nations and relevant international
        organizations, nongovernmental organizations, and the private
        sector with respect to the development and implementation of a
        coordinated and complementary United States global TB response
        program.
            ``(2) Bilateral assistance.--In providing bilateral
        assistance under this section, the President, acting through
        the Secretary of State, shall--
                    ``(A) catalyze support for research and development
                of new tools to prevent, diagnose, treat, and control
                TB worldwide, particularly to reduce the incidence of,
                and mortality from, all forms of drug-resistant TB;
                    ``(B) consider the incidence of TB infections when
                determining assistance priorities to countries and
                regions;
                    ``(C) ensure United States programs and activities
                focus on finding individuals with active TB and provide
                cost-effective and quality diagnosis and treatment,
                including through sustainable digital health solutions,
                and reaching individuals at high risk with prophylaxis
                treatment; and
                    ``(D) ensure coordination among relevant Federal
                departments and agencies that engage in international
                activities relating to TB--
                            ``(i) to ensure accountability and
                        transparency;
                            ``(ii) to reduce duplication of efforts;
                        and
                            ``(iii) to ensure appropriate incorporation
                        and coordination of TB prevention, diagnosis,
                        and treatment into other United States-
                        supported health programs.
    ``(f) Assistance for Tuberculosis Partnerships.--The President,
acting through the Secretary of State, is authorized--
            ``(1) to provide resources to monitor and disseminate
        epidemiological information about tuberculosis, drug resistant
        TB, MDR-TB, and XDR-TB;
            ``(2) to provide resources directly to countries with high
        rates of TB--
                    ``(A) to directly improve the capacity of such
                countries to prevent, diagnose, and treat TB on a local
                level; and
                    ``(B) to develop and implement the national
                strategies and plans of such countries to control TB
                and eliminate MDR-TB and XDR-TB using the goals
                described in subsection (d)(1);
            ``(3) to leverage the contributions of donors to facilitate
        the activities described in paragraphs (1) and (2) while
        increasing the capacity of the United States to monitor and
        disseminate relevant information; and
            ``(4) to utilize longstanding United States partnerships
        and resources to address TB domestically and internationally.
    ``(g) Reports.--
            ``(1) Annual report on activities regarding tuberculosis.--
        Not later than December 15 of each year until the earlier of
        the date on which the goals specified in subsection (d)(1) are
        met or December 31, 2032, the President shall submit a report
        to the appropriate congressional committees that describes
        United States foreign assistance to control TB and the impact
        of such assistance, including--
                    ``(A) the number of individuals with active TB that
                were diagnosed and treated, including the rate of
                treatment completion and the number of individuals
                receiving patient support;
                    ``(B) the number of individuals with MDR-TB and
                XDR-TB that were diagnosed and treated, including the
                rate of treatment completion, in countries receiving
                bilateral foreign assistance from the United States for
                programs to control TB;
                    ``(C) the number of individuals trained by the
                United States Government in TB surveillance and
                control;
                    ``(D) the number of individuals with active TB
                identified as a result of engagement with the private
                sector and other nongovernmental partners in countries
                receiving United States bilateral foreign assistance
                for TB control programs;
                    ``(E) a description of the amount of funds
                provided, activities carried out, and any collaboration
                and coordination of United States anti-TB efforts with
                partner nations and relevant international
                organizations, nongovernmental organizations, and the
                private sector, including the amount of funding
                provided to such entities;
                    ``(F) a description of the collaboration and
                coordination between the relevant Federal departments
                and agencies, including the Centers for Disease Control
                and Prevention and the Office of the Global AIDS
                Coordinator, to combat TB and, as appropriate, include
                treatment of TB in primary care;
                    ``(G) the constraints on implementation of programs
                posed by health workforce shortages, health system
                limitations, barriers to digital health implementation,
                other challenges to successful implementation, and
                strategies to address such constraints, including local
                commitments to sustain TB control efforts;
                    ``(H) a breakdown of expenditures for patient care
                supporting TB diagnosis, treatment, and prevention,
                including procurement of drugs and other TB
                commodities, drug management, training in diagnosis and
                treatment, health systems strengthening that directly
                impacts the provision of TB prevention, diagnosis,
                treatment, and research; and
                    ``(I) for each country and each project site
                receiving bilateral United States assistance for the
                purpose of TB prevention, treatment, and control--
                            ``(i) the number of individuals screened
                        for TB disease (including screenings utilizing
                        quality new rapid diagnostic tests) and the
                        number evaluated for TB infection using active
                        case finding outside of health facilities;
                            ``(ii) the number of individuals with
                        active TB disease that were diagnosed
                        (including diagnoses made through using quality
                        new rapid diagnostic tests) and treated with
                        safe and effective oral regimens, including the
                        rate of treatment completion and the number
                        receiving patient support;
                            ``(iii) the number of adults and children,
                        including individuals with HIV and close
                        contacts, who are evaluated for TB infection,
                        the number of adults and children started on
                        treatment for TB infection, and the number of
                        adults and children completing such treatment,
                        disaggregated by sex and, if possible, income
                        or wealth quintile;
                            ``(iv) the establishment of effective TB
                        infection control in all relevant congregant
                        settings, including hospitals, clinics, and
                        prisons;
                            ``(v) a description of progress in
                        implementing measures to reduce TB incidence,
                        including actions--
                                    ``(I) to expand active case finding
                                and contact tracing to reach vulnerable
                                groups; and
                                    ``(II) to expand TB prophylaxis
                                treatment, engagement of the private
                                sector, and diagnostic capacity;
                            ``(vi) a description of progress to expand
                        diagnosis, prevention, and treatment for all
                        forms of TB, including in pregnant women,
                        children, and individuals and groups at greater
                        risk of TB, including migrants, prisoners,
                        miners, and individuals exposed to silica,
                        disaggregated by sex;
                            ``(vii) the rate of successful completion
                        of TB treatment for adults and children,
                        disaggregated by sex, and the number of
                        individuals receiving support for treatment
                        completion;
                            ``(viii) the number of individuals,
                        disaggregated by sex, receiving treatment for
                        MDR-TB, including the proportion of those
                        individuals who are being treated with safer
                        and more effective oral regimens, and any
                        factors impeding the scale up of treatment, and
                        a description of progress to expand community-
                        based MDR-TB care;
                            ``(ix) a description of TB commodity
                        procurement challenges, including shortages,
                        stockouts, or failed tenders for TB drugs or
                        other TB commodities;
                            ``(x) the proportion of health facilities
                        with specimen referral linkages to quality
                        diagnostic networks, including established
                        testing sites and reference labs, to ensure
                        maximum access and referral for second-line
                        drug resistance testing, and a description of
                        the turnaround time for test results;
                            ``(xi) the number of individuals trained by
                        the United States Government and its
                        implementing partners to deliver high-quality
                        TB diagnostic, preventative, monitoring,
                        treatment, and care;
                            ``(xii) a description of how supported
                        activities are coordinated with--
                                    ``(I) country national TB plans and
                                strategies; and
                                    ``(II) TB control efforts supported
                                by the Global Fund to Fight AIDS,
                                Tuberculosis, and Malaria, and other
                                international assistance programs and
                                funds, including in the areas of
                                program development and implementation;
                            ``(xiii) for the first 3 years of the
                        report required under this paragraph, a
                        description of the progress in recovering from
                        the negative impact of COVID-19 on TB,
                        including--
                                    ``(I) whether there has been the
                                development and implementation of a
                                comprehensive plan to recover TB
                                activities from diversion of resources;
                                    ``(II) the continued use of
                                bidirectional TB-COVID testing; and
                                    ``(III) progress on increased
                                diagnosis and treatment of active TB;
                                and
                            ``(xiv) for each country receiving United
                        States bilateral assistance for the purpose of
                        TB prevention, treatment, and control, the
                        United States will track country government co-
                        investment in TB prevention, treatment, and
                        control.
            ``(2) Annual report on tuberculosis research and
        development.--The President, acting through the Secretary of
        State, and in coordination with the heads of other relevant
        Federal departments and agencies, shall, not later than 1 year
        after the date of the enactment of the End Tuberculosis Now Act
        of 2026, and annually thereafter until December 31, 2032,
        submit a report to the appropriate congressional committees
        that--
                    ``(A) describes the current progress and challenges
                to the development of new tools for TB prevention,
                treatment, and control;
                    ``(B) identifies critical gaps and emerging
                priorities for research and development, including
                rapid and point-of-care diagnostics, shortened
                treatments and prevention methods, telehealth solutions
                for prevention and treatment, and vaccines; and
                    ``(C) describes research investments by type,
                funded entities, and level of investment.
            ``(3) Evaluation report.--Not later than 4 years after the
        date of the enactment of the End Tuberculosis Now Act of 2026,
        the Comptroller General of the United States shall submit a
        report to the appropriate congressional committees that
        evaluates the performance and impact of programs supported by
        United States bilateral assistance funding on the prevention,
        diagnosis, treatment, and care of TB, including recommendations
        for improving such programs.
    ``(h) Definitions.--In this section:
            ``(1) Appropriate congressional committees.--The term
        `appropriate congressional committees' means--
                    ``(A) the Committee on Foreign Relations of the
                Senate; and
                    ``(B) the Committee on Foreign Affairs of the House
                of Representatives.
            ``(2) MDR-TB.--The term `MDR-TB' means multi-drug-resistant
        tuberculosis.
            ``(3) XDR-TB.--The term `XDR-TB' means extensively drug-
        resistant tuberculosis.''.
    (b) Sunset.--The amendment made by subsection (a) shall cease to
have any force or effect beginning on January 1, 2033.
                                 <all>

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Status

In Committee

  1. 1Introduced
  2. 2Committee
  3. 3Floor
  4. 4Passed
  5. 5Signed

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