End Tuberculosis Now Act of 2026
- Sponsor
- Rep. Bera, Ami [D-CA-6]
- Committees
- Foreign Affairs Committee (primary)
- Last action
- Sep 2, 2026
Bottom line
The End Tuberculosis Now Act of 2026 aims to significantly enhance U.S. foreign assistance to eradicate TB worldwide by setting aggressive targets and outlining comprehensive strategies for prevention, diagnosis, and treatment.
What it actually does
This bill amends the Foreign Assistance Act of 1961 to update and expand U.S. policy and assistance for combating tuberculosis (TB) globally. It establishes ambitious goals to reduce TB incidence and mortality rates by 2030, prioritizes comprehensive diagnosis, treatment, and prevention strategies, and mandates detailed reporting on U.S. efforts and research progress. The bill also includes a sunset clause, terminating the amendment's effect on January 1, 2033.
Proponents argue
Proponents argue that the bill is a critical step towards ending the global TB public health emergency, which poses a continuing challenge to international health security. They emphasize that effectively resourced TB programs can serve as vital platforms for preventing and responding to future infectious airborne pandemics, aligning with the 'America First Global Health Strategy.' Supporters highlight the bill's focus on innovative technologies, person-centered care, and robust coordination as essential for achieving ambitious global health goals.
Opponents contend
While the bill enjoys broad bipartisan support, potential critics might raise concerns about the overall cost of expanded foreign assistance, particularly without specific appropriation amounts detailed in the bill. Some may question the feasibility of achieving the ambitious targets by 2030, given the complexities of global health challenges and varying capacities of recipient countries. Others might argue for a greater focus on domestic health priorities over international ones, or scrutinize the effectiveness and accountability mechanisms for such large-scale global health initiatives.
The bill is relatively concise and clearly structured, making it accessible for an informed reader to understand its core provisions and implications within a reasonable timeframe.
Section 2(a), amending Section 104B(a) of the Foreign Assistance Act of 1961
Congressional Findings on Tuberculosis
This provision updates the Congressional findings, recognizing the international spread and deadly impact of TB as a continuing challenge. It emphasizes the need for additional tools and resources for diagnosis, prevention, and treatment, and highlights that effective TB programs can serve as platforms for future pandemic response. It also notes alignment with the 'America First Global Health Strategy' goals.
Supporters argue
Supporters argue these findings are crucial for establishing the urgency and strategic importance of combating TB, linking it to broader U.S. national security and global health interests, including pandemic preparedness.
Critics contend
No specific opposition is typically raised against congressional findings, as they serve to establish legislative intent and context rather than enacting direct policy changes.
Tradeoffs
The findings aim to balance humanitarian concerns with strategic national interests, framing TB control as both a moral imperative and a component of global health security.
Section 2(a), amending Section 104B(b) of the Foreign Assistance Act of 1961
U.S. Policy Objectives for Combating Tuberculosis
This section establishes the major objective of U.S. foreign assistance to end the TB public health emergency by supporting diagnosis and treatment for all forms of TB and preventing new infections. It outlines specific policies, including developing innovative technologies, expanding diagnosis and treatment for at-risk individuals, ensuring high-quality care, sustainable procurement, and integrating TB activities into primary health care.
Section 2(a), amending Section 104B(c) of the Foreign Assistance Act of 1961
Authorization and Priorities for TB Assistance
This provision authorizes the President to furnish assistance for TB prevention, treatment, control, and elimination. It mandates prioritization for building and strengthening TB programs, providing direct, high-quality care for all forms of TB, treating co-infected and high-risk individuals, strengthening health systems, supporting research and development, fostering public-private partnerships, integrating lab systems, and ensuring TB programs serve as platforms for respiratory pandemic response.
Section 2(a), amending Section 104B(d) of the Foreign Assistance Act of 1961
Establishment of Global TB Goals
This provision mandates the President, in consultation with Congress, to establish specific, measurable goals for global TB control during 2027-2030. These goals include reducing TB incidence by 80% and mortality by 90% from 2015 levels, achieving 90% diagnosis and treatment initiation for all TB and drug-resistant TB cases, ensuring 90% treatment success rates, and providing preventive treatment to 30 million individuals. It also requires updating the National Action Plan for Combating Multidrug-Resistant Tuberculosis.
Section 2(a), amending Section 104B(g) of the Foreign Assistance Act of 1961
Annual Reporting and Evaluation Requirements
This provision mandates annual reports to Congress until December 31, 2032, detailing U.S. foreign assistance for TB control and its impact. Reports must include metrics on diagnosis, treatment completion, training, private sector engagement, funding, interagency coordination, implementation constraints, and expenditures. It also requires an annual report on TB research and development progress and challenges, and a Comptroller General evaluation report within four years of enactment.
Section 2(b)
Sunset Clause for TB Assistance Amendment
This provision stipulates that the amendment made by subsection (a) (which updates Section 104B of the Foreign Assistance Act of 1961) shall cease to have any force or effect beginning on January 1, 2033. This means the enhanced policies, authorizations, goals, and reporting requirements for combating TB globally will expire on that date unless renewed by Congress.
Requires that all relevant grants and funding agreements for TB programs include access and affordability provisions.
Section 2(a), amending Section 104B(b)(2)(B)(viii)(II) of the Foreign Assistance Act of 1961
Why it matters:This is standard legislative practice for detailing implementation requirements within broader policy directives. It's a technical detail that ensures the policy's intent regarding affordability is carried out at the programmatic level.
Case for: Supporters would argue that this provision is crucial for ensuring that U.S.-funded TB interventions are genuinely accessible to the populations most in need, preventing financial barriers from hindering diagnosis, treatment, and prevention efforts. It operationalizes the commitment to equity.
Case against: No specific opposition is typically raised against requiring access and affordability provisions, as it aligns with humanitarian goals. However, some implementing partners might face practical challenges in consistently enforcing these provisions across diverse contexts with varying healthcare systems and economic conditions.
Estimated impact: Potentially significant, as it could influence the pricing and distribution strategies of TB commodities and services funded by the U.S., making them more affordable for patients in recipient countries.
The amendment made by subsection (a) (which updates Section 104B of the Foreign Assistance Act of 1961) shall cease to have any force or effect beginning on January 1, 2033.
Section 2(b)
Why it matters:Sunset clauses are often placed at the end of bills as a standard legislative mechanism to ensure programs are reviewed periodically. While not intentionally evasive, its placement can lead to it being overlooked by a casual reader focused on the main body of the amendment.
Case for: Proponents of sunset clauses argue that they ensure programs are regularly evaluated for effectiveness and relevance, preventing indefinite continuation of policies that may become outdated or inefficient. It provides an opportunity for Congress to reassess and potentially refine the U.S. approach to global TB control based on progress and new challenges.
Case against: Critics argue that a hard sunset date for a critical global health initiative like TB control can create significant uncertainty for long-term planning, program sustainability, and partner commitments. They contend that it could disrupt ongoing efforts and necessitate a potentially contentious reauthorization process, rather than allowing for continuous, adaptive policy.
Estimated impact: High, as it dictates the lifespan of the entire legislative framework for U.S. global TB assistance, potentially leading to a cessation or significant restructuring of programs after 2032.