Obama administration proposes increased funding for antibiotic resistance, sustained investments for HIV

Members of the Infectious Diseases Society of America were “encouraged” by a $43 million increase in federal funding proposed by President Barack Obama to combat antibiotic resistance; however, members of the HIV Medicine Association were not as optimistic about the planned funding for HIV research.

The 2017 fiscal year budget proposed earlier this week includes an $877 million investment that would be allocated to several organizations for interventions that reduce the spread of antibiotic-resistant infections, according to the Department of Health and Human Services.

“We are encouraged to see the investment that came with this year’s budget for a variety of governmental initiatives in the area of antimicrobial resistance,” Helen W. Boucher, MD, of the division of infectious diseases at Tufts Medical Center and treasurer for IDSA, told Infectious Disease News. “It is a step in the right direction.”

Combating antimicrobial resistance

Crucial areas of research that require funds for antibiotic resistance include the surveillance of national resistance and antimicrobial stewardship programs implemented by the CDC, clinical trial networks coordinated by the NIH, new antibiotics investigated by the Biomedical Advanced Research and Development Authority, and the regulatory approval of new medicines by the FDA, Boucher said.

“Certainly as you look in each area, there is more that’s needed to adequately fund these initiatives, she added. “But we’re encouraged, especially in this economic time, to see money being dedicated to this area.”

Boucher also hopes that a portion of the budget will go toward a better understanding of antibiotic resistance in food-producing animals. According to a recent FDA report, sales and distribution of medically important antimicrobials for food-producing animals in the United States increased 23% from 2009 through 2014. Last year, sales increased 3% alone despite the FDA’s request for pharmaceutical companies to voluntarily remove FDA-approved indications for antibiotic use in food-producing animals on drug labels by December.

Of the FDA’s $5.1 billion budget proposed for 2017, more than $250 million would go toward implementing food safety systems, such as safety standards for produce farms, and improving the safety and quality of medical products through several approaches such as addressing concerns associated with antimicrobial drug use in animals, according to a press release.

Budget proposal for HIV research disappointing

Despite the increased funding for antibiotic resistance, investments in HIV remain at a standstill. Proposed funds in HIV research have been “flat funded” since 2015, and funds for the President’s Emergency Plan for AIDS Relief have not increased since 2010, according to Carlos del Rio, MD, FIDSA, chair of the HIVMA. In a recent statement, del Rio wrote that an increase in funds is “more critical than ever” to combat HIV, as only 40% of people living with HIV in the U.S. are receiving care, and 30% are virally suppressed.

Carlos del Rio

“At this time of pivotal promise and potential for game-changing HIV research discoveries, it is disappointing that the president abandoned his FY 2016 proposal of a $100 million increase for HIV research at the NIH despite an overall enacted increase of $2 billion in FY 2016,” he wrote. “Flat funding will slow progress toward the next breakthrough discoveries that hold promise for an HIV vaccine and a cure.”

On behalf of HIVMA, del Rio applauded the sustained funds for the Ryan White Program, which offers care and treatment for more than a half million people with HIV. The organization also supported the proposed $20 million investment for a CDC demonstration project designed to improve access to pre-exposure prophylaxis, as well as a $9 million project to expand access for hepatitis C virus screening and treatment. Finally, del Rio hailed the requested $1.1 billion over 2 years in federal funding to increase access to prevention and treatment of opioid abuse, which is “critical to improving health outcomes” for patients with HIV and substance use issues, he wrote.

Disclosure: Boucher reports serving on a data safety monitoring boards for Actelion, Cardaes Pharma and the adjudication committee for the NIH.