Increased congressional funding supports antibiotic resistance effort, syringe service programs

An omnibus bill that included increased funding to reduce antibiotic resistance and support syringe service programs was passed on Friday by a 65-33 vote in the Senate and a 316-113 vote in the House.

The bill will provide $160 million in new funding to the CDC’s Antibiotic Resistance Solutions Initiative, which supports national outbreak detection, prevention strategies and improved antibiotic use, according to the CDC. An additional $3 million will go toward the CDC’s National Healthcare Safety Network for increased surveillance of antibiotic use and resistance patterns.

Moreover, the National Institute of Allergy and Infectious Diseases will receive a $100 million increase in funds for research activities, including the development of a clinical trial network to assess new antibiotics; the Biomedical Advanced Research and Development Authority (BARDA) will receive a $97 million increase for the development of new therapies and diagnostics; the Agency for Healthcare Research and Quality will receive a $10 million increase for antibiotic resistance activities; and the FDA will receive an $8.7 million increase to streamline the development of new antibiotics.

“It’s safe to say it’s been years in the making and we’re really excited about this new investment,” Amanda J. Jezek, vice president of public policy and government relations for the Infectious Diseases Society of America (IDSA), told Infectious Disease News. “IDSA has been talking for well over a decade about the crisis of antibiotic resistance and the need for a multipronged solution to address what is a very complex problem.”

According to the CDC, antibiotic resistance causes more than 2 million illnesses and 23,000 deaths in the United States each year.

National Action Plan

In 2014, the President’s Council of Advisors on Science and Technology advocated for more federal investments in the surveillance and prevention of antibiotic-resistant bacteria, as well as the development of newer therapies and diagnostic tests. The request was followed-up earlier this year with the launch of the National Action Plan for Combating Antibiotic-Resistant Bacteria, Jezek said.

“We were really excited about this action plan because not only did it say that these kinds of investments and federal activities to combating antibiotic resistance were necessary, but it set forth a very assertive 5-year plan with very specific goals and benchmarks for progress,” she said. “[However], we also recognized that in order to make the action plan a reality and to ensure that we were meeting the goals that were set forth, Congress would need to appropriate new funding.”

In January, the White House requested in its 2016 budget proposals that the NIH and BARDA collect more than $650 million, the CDC collect more than $280 million, and the FDA collect $47 million. Although not all funding appeals were met, Jezek said the IDSA is encouraged by the increase in funds.

“It’s not every dollar that the president requested, but it’s certainly a really strong down payment,” she said. “I think this is a really big win for patients and public health. We’re looking forward to working with the administration to make sure that these investments are well-spent and working with Congress again next year to ensure that these investments are continued and built upon. This is a really great step forward.”

Investments in HIV, hepatitis C

Other funds in the bill will support certain components of syringe service programs, which provide sterile injection equipment and link individuals to services such as HIV and hepatitis C virus testing, substance abuse treatment and overdose prevention, according to the CDC.

Jonathan Mermin

“Outbreaks in Indiana and elsewhere have been powerful reminders that people who inject drugs can be at very high risk for HIV and hepatitis C, and studies have shown that syringe services programs are cost-saving, and can reduce the risk of infection without increasing drug use,” Jonathan Mermin, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a press release. “CDC has historically recommended that states ensure people who inject drugs have access to integrated prevention services from a reliable source, including sterile injection equipment, opioid therapy, and HIV and hepatitis testing. Congress’ decision makes that job easier.”

Infection drug use accounts for nearly 8% of new HIV infections in the U.S. and contributed to a 150% increase in acute HCV infections, according to Mermin.

“Because these infections can spread from drug users to others, syringe services programs can help protect whole communities,” he said.

Among the most recent data is an analysis from Monica S. Ruiz, PhD, MPH, assistant research professor in the department of prevention and community health at George Washington University’s Milken Institute School of Public Health, and colleagues that examined the effectiveness of a needle exchange program implemented in Washington, D.C., in 2008. The researchers projected that the syringe exchange program prevented 120 new HIV infections in the span of 2 years and saved $44.3 million in health care costs.

“CDC is committed to helping communities use all effective tools to stop the spread of HIV and hepatitis,” Mermin said in the release. “Along with other tools proven to reduce the risk of infection and strategies to prevent and treat substance abuse itself, syringe services programs can be a valuable component of a comprehensive prevention strategy for people who inject drugs and their partners.” – by Stephanie Viguers

Reference:

Ruiz MS, et al. AIDS Behav. 2015;doi:10.1007/s10461-015-1143-6.

Disclosure: Jezek, Mermin and Ruiz report no relevant financial disclosures.