The Obama administration released their 62-page plan the curb antibiotic resistance titled, National Strategy on Combating Antibiotic-Resistant Bacteria, and the detailed plan received mixed reviews from several organizations with a direct interest in the topic.
In a blog post by Sylvia Mathews Burwell, Secretary of the Department of Health and Human Services; Tom Vilsack, Secretary of the Department of Agriculture and Ash Carter, Secretary of the Department of Defense they write:
Antibiotics save millions of lives every year. Today, however, the emergence of drug resistance in bacteria is undermining the effectiveness of current antibiotics and our ability to treat and prevent disease. The Centers for Disease Control and Prevention (CDC) estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the United States alone. Antibiotic resistance also limits our ability to perform a range of modern medical procedures, such as chemotherapy, surgery, and organ transplants. That’s why fighting antibiotic resistance is a national priority.
Over the past year, the Administration has taken important steps to address the threat of antibiotic resistance. In September 2014, the President issued Executive Order (EO) 13676: Combating Antibiotic-Resistant Bacteria, which outlines steps for implementing the National Strategy on Combating Antibiotic-Resistant Bacteria and addressing the policy recommendations of the President’s Council of Advisors on Science and Technology (PCAST)’s report on Combating Antibiotic Resistance. Furthermore, the President’s FY 2016 Budget released earlier this year proposed nearly doubling the amount of Federal funding for combating and preventing antibiotic resistance to more than $1.2 billion.
Combating and preventing antibiotic resistance, however, will be a long-term effort. That’s why, today, the Administration is releasing the National Action Plan for Combating Antibiotic Resistant Bacteria (NAP). The NAP outlines a whole-of-government approach over the next five years targeted at addressing this threat:
1. Slow the emergence of resistant bacteria and prevent the spread of resistant infections
The judicious use of antibiotics in health care and agriculture settings is essential to combating the rise in antibiotic resistance. We can help slow the emergence of resistant bacteria by being smarter about prescribing practices across all human and animal health care settings, and by continuing to eliminate the use of medically-important antibiotics for growth promotion in animals.
2. Strengthen national “One-Health” surveillance efforts
A “One-Health” approach to disease surveillance will improve detection and control of antibiotic resistance by integrating data from multiple monitoring networks, and by providing high-quality information, such as detailed genomic data, necessary to tracking resistant bacteria in diverse settings in a timely fashion.
3. Advance development and use of rapid and innovative diagnostic tests
The development of rapid “point-of-need” diagnostic tests could significantly reduce unnecessary antibiotic use by allowing health care providers to distinguish between viral and bacterial infections, and identify bacterial drug susceptibilities during a single health care visit making it easier for providers to recommend appropriate, targeted treatment.
4. Accelerate basic and applied research and development
New antibiotics and alternative treatments for both humans and animals are critical to maintaining our capacity to treat and prevent disease. This involves supporting and streamlining the drug development process, as well as increasing the number of candidate drugs at all stages of the development pipeline. Additionally, boosting basic research to better understand the ecology of antibiotic resistance will help us develop effective mitigation strategies.
5. Improve international collaboration and capacities
Antibiotic resistance is a global problem that requires global solutions. The United States will engage with foreign ministries and institutions to strengthen national and international capacities to detect, monitor, analyze, and report antibiotic resistance; provide resources and incentives to spur the development of therapeutics and diagnostics for use in humans and animals; and strengthen regional networks and global partnerships that help prevent and control the emergence and spread of resistance.
The NAP is a comprehensive effort that will require the coordinated and complementary efforts of individuals and groups around the world, including public- and private-sector partners, health care providers, health care leaders, veterinarians, agriculture industry leaders, manufacturers, policymakers, and patients. Working together, we can turn the tide against the rise in antibiotic resistance and make the world a healthier and safer place for the next generation.
The stamp of approval was given by the the Infectious Diseases Society of America (IDSA) and the Association for Professionals in Infection Control and Epidemiology (APIC) today.
The IDSA said they welcome the release of the National Action Plan for Combating Antibiotic Resistant Bacteria (CARB). IDSA has worked tirelessly to address this public health crisis for over a decade, beginning with our 2004 Bad Bugs, No Drugs report. We are encouraged to see the President and other high level government leaders commit to implementing multipronged policy solutions to protect patients and public health from the dangers of antibiotic resistant infections. We greatly appreciate that many federal leaders as well as Congress have already taken important steps in the last several years to address resistance, and we look forward to building upon those efforts. This action plan marks the beginning of an important new phase of well-coordinated federal activity in this area, and now significant work must be undertaken and new investments must be made.
APIC says they applaud the Administration for this interagency plan which appropriately focuses on the demand and supply sides of the antibiotic resistance problem and addresses overuse in the human and agricultural sections. The National Action Plan outlines Federal activities over the next five years to enhance domestic and international capacity to prevent and contain outbreaks of antibiotic-resistant infections; maintain the efficacy of current and new antibiotics; and develop and deploy next-generation diagnostics, antibiotics, vaccines, and other therapeutics.
However, not everybody was so happy with the plan.
Mae Wu, health attorney at the Natural Resources Defense Council (NRDC), issued the following statement:
“More than ever before, the White House is acknowledging the dangerous public health threat posed by the misuse of antibiotics in both human medicine and the livestock industry,” said Wu.
“But the Obama Administration needs to do more to reduce antibiotic use in animals that are not sick. The plan continues to allow the routine feeding of antibiotics to animals that live in the crowded conditions endemic to industrial farms.
“Our government should be taking steps to reduce antibiotics to protect our health, rather than protecting poor industry practices.”
In addition, fellow Democrat and the only microbiologist in Congress, Congresswoman Louise M. Slaughter (D-NY) said the following:
“Once again, the administration has fallen woefully short of taking meaningful action to curb the overuse of antibiotics in healthy food animals. With 80 percent of the antibiotics produced in the United States being used in agriculture mostly for prevention, any meaningful solution to the looming antibiotic resistance crisis must begin with limits on the farm – and trusting a voluntary policy that lets industry police itself will not bring about real change. Antibiotics were never meant for prevention of disease – they were meant for treatment of disease. Using them at sub-therapeutic levels for prevention has just made bacteria stronger and is rendering antibiotics ineffective. The U.S. is already a decade behind European nations in combating antibiotic resistance, and it will become a major trade issue when our foreign counterparts stop accepting U.S. meat raised with medically-important antibiotics. When the World Health Organization says that routine infections like strep throat may be fatal in ten years, it’s long past time to start taking decisive action. I encourage the public to support my bill to save eight classes of antibiotics from being routinely and unnecessarily fed to healthy farm animals, and to demand better from their leaders than a head-in-the-sand approach.”