Obama unveils strategy to combat antibiotic resistance

President Barack Obama has signed an executive order directing key federal departments and agencies to take action against the rise in antibiotic-resistant bacteria, and his administration also has released a national strategy to combat the threat.

In addition, the President’s Council of Advisors on Science and Technology (PCAST) released a report, requested by the president last year, outlining steps that the federal government can take to combat antibiotic-resistant bacteria.

“The president and his administration recognize that the rise of antibiotic-resistant bacteria represents a serious domestic and international challenge to human and animal health, national security and the economy,” John P. Holdren, PhD, director of the White House Office of Science and Technology Policy and assistant to the president for science and technology, said during a White House press conference.

The national strategy outlines a 5-year plan to enhance domestic and international capacity to prevent and contain outbreaks of resistant infections, maintain efficacy of current and new antibiotics and develop next-generation diagnostics, antibiotics, vaccines and other therapeutics. It includes a $20 million prize, co-sponsored by the NIH and the Biomedical Advanced Research and Development Authority, to develop a rapid, point-of-care diagnostic test for clinicians to use to identify resistant infections.

The executive order directs federal departments and agencies to implement the new national strategy and respond to the PCAST report. It also establishes an interagency task force led by the secretary of Health and Human Services in consultation with the secretaries of Defense and Agriculture, as well as a presidential advisory council consisting of nongovernmental experts, to provide advice and recommendations on policies for combating antibiotic-resistant bacteria.

The task force will be required to submit a national action plan to the president that outlines specific federal actions to implement the national strategy and address the recommendations made in the PCAST report.

“The report provides actionable, specific recommendations made by PCAST, in consult with experts from the public and private sectors,” Eric Lander, PhD, co-chair of PCAST, said during the press conference. “The report includes eight recommendations directed to three key components: surveillance of antibiotic resistance, development of new antibiotics and stewardship of current antibiotics.”

The recommendations include: steps to take the strongest possible federal leadership; strengthen the surveillance and response to resistance; promote fundamental research on antibiotics; accelerate clinical trials of new antibiotics; significantly increase economic incentives for developing urgently needed antibiotics; improving stewardship of existing antibiotics; and limiting the use of antibiotics in animal agriculture.

Lander said the eighth recommendation is to ensure effective international cooperation.

“Combating antibiotic resistance is not something that can be done solely within United States borders,” he said.

Thomas Frieden

CDC Director Thomas Frieden, MD, MPH, said antibiotic resistance is a worldwide problem and new forms of resistance can cross international boundaries and spread between continents easily. According to Frieden, antibiotic-resistant infections are associated with at least 23,000 deaths and 2 million illnesses each year, and these numbers are conservative estimates. In addition, the annual effect of resistant infections on the US economy is $20 billion in direct health care costs, and more in lost productivity from hospitalizations and sick days.

“The use of antibiotics is the single most important factor in antibiotic resistance around the world,” Frieden said during the press conference. “Up to half of all antibiotics prescribed are either not needed or not optimally effective as prescribed. The United States and the global community recognize that this is an urgent health threat and a threat to our economic stability.”