Photo credit: U.S. Centers for Disease Control and Prevention
On Sept. 18, the White House announced a comprehensive strategy to combat antibiotic resistance and released several related policy documents. These included a presidential executive order, a report from the President’s Council of Advisors on Science and Technology and a National Strategy for Combating Antibiotic-Resistant Bacteria. The administration also launched a $20 million prize for the development of a test to rapidly diagnose resistant infections in the clinic. The administration’s announcement follows similar reports from the CDC and the WHO released in September 2013 and April 2014, respectively.
Overall, the Obama administration measures emphasize the need for:
- Better surveillance of resistant organisms to facilitate an effective response and limit their spread;
- Improved use of existing drugs in human and animal healthcare to maintain their efficacy and slow emergence of new resistance;
- New diagnostic and treatment strategies to prevent, treat and respond to resistant infections.
While the PCAST report and National Strategy outline recommendations and goals, the executive order is the muscle, declaring antibiotic resistance a national security priority and directing federal agencies to take action. The order also creates a task force whose mission is to construct a five-year plan for implementing the strategy and an advisory council to advise the secretary of the U.S. Department of Health and Human Services.
Effects on researchers. The policies outlined in the aforementioned documents will likely not affect most scientists. Besides the $20 million prize, no additional funds have been devoted to antimicrobial resistance research. The PCAST report, and presumably the forthcoming action plan, recommends additional appropriations for fundamental research in this area, but executing this would require congressional action. Directives from the executive order require federal agencies to institute parts of the PCAST report, but these are mostly public health-related and will not significantly affect basic biomedical research.
In addition to the executive order, there are multiple bills (S. 2236, H.R. 2285, H.R. 4187, S. 1256, S. 895, H.R. 1150 and H.R. 820) in Congress addressing antimicrobial resistance. However, neither Chamber has passed any, nor does it seem likely any will pass before the new Congress is sworn in.
The executive and legislative actions described above are promising developments. However, it remains important that legislators understand the importance of antimicrobial resistance and the dire consequences of inaction, and scientists should engage with them at every opportunity. Public education is also critical, and scientists have a role to play in that arena as well. Some key points to begin this conversation are below. If you are interested in antimicrobial resistance policy and have ideas about how to best engage legislators and the public on these issues, please detail your thoughts in the comments section.
The Centers for Disease Control and Prevention estimate that each year more than 23,000 Americans die from antibiotic-resistant infections and more than 2 million are sickened; these infections cost the U.S. $20 billion to $35 billion in excess healthcare costs and result in $35 billion in lost productivity each year. “Very high rates of [drug] resistance” are also found outside the U.S., according to the World Health Organization. Many scientists and organizations have warned that the spread of drug-resistant organisms combined with the lack of new treatment strategies may soon bring us back to the pre-antibiotic era.
Other publications of interest:
- If you are interested in learning more about current research strategies to address antibacterial resistance, NIAID’s antibacterial resistance program is a good place to start.
- Use of antimicrobial drugs in livestock is a contentious topic in the U.S. This paper compares the U.S. and E.U. approaches, which are vastly different.
- Louise Slaughter (D-N.Y.) is the only microbiologist in Congress. She recently published an article on Buzzfeed.
- There are many other great articles on antimicrobial resistance and related topics. Please leave recommendations for interested readers in the comments section.