End Tuberculosis Now Act of 2026
- Sponsor
- Sen. Young, Todd [R-IN]
- Committees
- Foreign Relations Committee (primary)
- Last action
- Jun 11, 2026
Bottom line
This bill seeks to re-energize and strategically focus U.S. global health efforts to eradicate tuberculosis by 2030 through enhanced funding authorization, policy directives, and robust accountability measures.
What it actually does
This bill reauthorizes and significantly expands U.S. foreign assistance programs to combat tuberculosis (TB) globally. It amends the Foreign Assistance Act of 1961 to establish new policy objectives, authorize assistance, set ambitious goals for TB reduction, and mandate detailed annual reports on progress and research. The legislation aims to accelerate diagnosis, treatment, and prevention of all forms of TB, including drug-resistant strains, and integrate TB efforts into broader health systems.
Proponents argue
Supporters argue that TB remains a significant global health threat, exacerbated by the COVID-19 pandemic, and that sustained U.S. leadership and investment are crucial to achieving global eradication goals. They emphasize that well-resourced TB programs can also strengthen preparedness for future respiratory pandemics and that the bill's focus on innovative diagnostics, treatment, and prevention, coupled with robust reporting, will ensure effective use of resources and measurable impact.
Opponents contend
Potential opponents might raise concerns about the cost of expanding foreign assistance programs, especially given domestic economic priorities, or question the effectiveness of large-scale international health initiatives. Some might argue that the ambitious goals are unrealistic or that the U.S. should prioritize other global health challenges. However, given the bipartisan nature of global health initiatives, direct opposition to the *goal* of ending TB is less likely than concerns about *resource allocation* or *programmatic efficiency*.
The bill is moderately detailed but accessible, allowing an informed reader to understand its core provisions within a reasonable timeframe, especially given the critical nature of the public health issue it addresses.
Section 2(a), amending Sec. 104B(a) of the Foreign Assistance Act of 1961
Congressional Findings on Tuberculosis
This section establishes the legislative basis for the bill by outlining Congress's understanding of the global tuberculosis crisis, the necessity for new tools and resources, and the strategic importance of TB programs for future pandemic preparedness. It also notes alignment with the 'America First Global Health Strategy'. These findings underscore the urgency and strategic importance of combating TB, justifying increased U.S. investment and leadership in global health.
Supporters argue
Supporters argue these findings underscore the urgency and strategic importance of combating TB, justifying increased U.S. investment and leadership in global health.
Critics contend
No specific opposition to the findings themselves, but critics might question the emphasis on 'America First Global Health Strategy' if it implies a shift from broader humanitarian goals.
Tradeoffs
Balances humanitarian concerns with national security and strategic interests.
Section 2(a), amending Sec. 104B(b) of the Foreign Assistance Act of 1961
Major Objectives and Policies for Combating Tuberculosis
This section establishes the core policy framework for U.S. foreign assistance against TB. It mandates a comprehensive approach including supporting diagnosis and treatment for all forms of TB, preventing new infections, and implementing specific strategies like using innovative technologies, ensuring high-quality care, and coordinating with the private sector for research and development. It also emphasizes reducing cost barriers and integrating TB care into primary health systems, providing detailed policy directives that guide the allocation and use of authorized assistance.
Section 2(a), amending Sec. 104B(c) of the Foreign Assistance Act of 1961
Authorization and Priorities for TB Assistance
This provision grants the President the authority to provide foreign assistance specifically for TB prevention, treatment, control, and elimination. It outlines key priorities for this assistance, including strengthening TB programs, providing direct high-quality care, addressing drug-resistant TB (MDR-TB and XDR-TB), supporting research and development, integrating laboratory systems, and ensuring cost-effective procurement of diagnostics and treatments. It also explicitly links TB programs to broader respiratory pandemic response, establishing the legal basis for funding and directing the focus of U.S. foreign aid.
Section 2(a), amending Sec. 104B(d) of the Foreign Assistance Act of 1961
Ambitious Global TB Reduction Goals
This section mandates the President to establish specific, ambitious goals for global TB reduction between 2027 and 2030. These targets include significant reductions in TB incidence and mortality rates, high rates of diagnosis and successful treatment for both drug-sensitive and drug-resistant TB, and providing preventive treatment to 30 million individuals. It also requires an update to the National Action Plan for Combating Multidrug-Resistant Tuberculosis, providing clear, measurable targets for U.S. global TB efforts.
Section 2(a), amending Sec. 104B(e) of the Foreign Assistance Act of 1961
Enhanced Coordination of TB Response
This provision emphasizes the need for robust coordination in the U.S. global TB response. It requires the President to consult with partner nations, international organizations, NGOs, and the private sector. For bilateral assistance, it mandates catalyzing research and development, prioritizing aid based on TB incidence, focusing on active case finding and preventive treatment, and ensuring seamless coordination among relevant U.S. Federal departments and agencies to prevent duplication and integrate TB efforts into broader health programs, aiming to improve the efficiency and effectiveness of global TB efforts.
Section 2(a), amending Sec. 104B(f) of the Foreign Assistance Act of 1961
Support for Global TB Partnerships
This section authorizes the President, through the Secretary of State, to provide resources for various TB partnership activities. These include monitoring and disseminating epidemiological information about all forms of TB, directly supporting high-TB countries to build local capacity and implement national strategies, leveraging contributions from other donors, and utilizing existing U.S. partnerships to address TB both domestically and internationally. This strengthens global and local capacity to respond to TB through direct aid, information sharing, and collaborative efforts.
Section 2(a), amending Sec. 104B(g) of the Foreign Assistance Act of 1961
Comprehensive Annual Reporting and Evaluation
This provision establishes extensive reporting requirements for U.S. global TB efforts. It mandates annual reports until 2032 detailing the impact of U.S. foreign assistance, including specific metrics on diagnosis, treatment completion rates, training, private sector involvement, funding allocations, and coordination with other entities. It also requires an annual report on TB research and development progress and challenges, and a comprehensive evaluation report by the Comptroller General of the United States four years after enactment to assess program performance and impact, thereby increasing transparency and accountability.
Section 2(b)
Sunset of TB Assistance Authority
This provision establishes a sunset date of January 1, 2033, for the amendments made by this Act to the Foreign Assistance Act of 1961. This means that the specific authorities and directives established by the 'End Tuberculosis Now Act of 2026' will expire on that date unless further legislative action is taken. This creates a finite lifespan for the bill's provisions, necessitating future legislative review and reauthorization to continue the programs.
The amendments made by this Act, which establish the new framework for U.S. assistance to combat tuberculosis, will cease to have effect on January 1, 2033.
Section 2(b)
Why it matters:Sunset clauses are common legislative practice to ensure periodic review and reauthorization of programs, rather than an attempt to hide the provision.
Case for: Ensures Congress will revisit the program's effectiveness and adapt it to future global health landscapes, preventing indefinite continuation of potentially outdated policies.
Case against: Creates uncertainty for long-term program planning and funding, which can be detrimental to sustained efforts against a persistent global health challenge like TB.
Estimated impact: Affects the long-term continuity and stability of U.S. global TB programs beyond 2032.
For each country receiving U.S. bilateral assistance for TB prevention, treatment, and control, the U.S. will track the country government's co-investment in these efforts.
Section 2(a), amending Sec. 104B(g)(1)(xiv) of the Foreign Assistance Act of 1961
Why it matters:This is a technical accountability measure, often placed within reporting sections as standard legislative drafting, not necessarily to hide it.
Case for: Promotes shared responsibility and sustainability by encouraging recipient countries to invest their own resources, ensuring that U.S. aid supplements rather than replaces local funding.
Case against: Some might argue that requiring co-investment tracking could be burdensome for countries with limited administrative capacity or that it might inadvertently penalize countries facing severe economic hardship.
Estimated impact: Enhances accountability and promotes sustainability of TB programs in recipient countries by encouraging local financial commitment.