; and (2) not less than every 2 years thereafter, update such strategy. (b) Contents The strategy under subsection (a) shall include— (1) proposed budgetary requirements; (2) an assessment of all federally funded programs and activities related to surveillance, diagnosis, treatment, education, or prevention with respect to Lyme disease or other tick-borne disease, an evaluation of progress and performance based on mission and purpose, and a description of significant challenges or barriers to performance, including an assessment of Federal grants awarded; (3) a strategy for improving diagnosis, treatment, and prevention, including increasing the impact of grants awarded by the National Institutes of Health, the Centers for Disease Control and Prevention, and other agencies and offices of the Department of Health and Human Services; (4) a strategy for improving outcomes of individuals with Lyme disease or another tick-borne disease or disorder, including progress related to chronic or persistent symptoms and chronic or persistent infection and coinfections, including plans for evaluating the potential value of and supporting the conduct of observational studies, comparative effectiveness research, patient-centered outcomes research, or other real world evidence; (5) the appropriate benchmarks to measure progress in achieving the improvements described in paragraphs (3) and (4); (6) a strategy for improving interactions, coordination, and partnerships with other Federal agencies, State and local governments, and global entities