The US Department of Health and Human Services today unveiled an action plan, developed by an interdepartmental task force, that provides the United States with a comprehensive approach to combat antimicrobial resistance. The plan designates priorities, identifies responsible agencies and creates timelines.

The Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Food and Drug Administration (FDA) led a task force of 10 agencies and departments that included the Agency for Healthcare Research and Quality, the Health Care Financing Administration, and the Health Resources and Services Administration at HHS, as well as representatives from the Department of Agriculture, the Department of Defense, the Department of Veterans Affairs, and the Environmental Protection Agency. The task force, created in 1999, developed the plan, which provides a blueprint for specific, coordinated federal actions to address the emerging threat of antimicrobial resistance.

In the 1940s, the widespread availability of newly discovered antibiotics led to a dramatic reduction in illness and death from infectious diseases. However, bacteria and other disease-causing organisms are remarkably resilient and have been able to mutate and acquire resistant genes from other microbes, thereby developing resistance to existing antimicrobial drugs. Many scientists and public health specialists expect this resistance problem to worsen unless we act decisively. Additionally, the costs of treating antimicrobial resistant infections place a significant burden on society. For example, it has been estimated that the in-hospital cost of hospital-acquired infections caused by just six common kinds of resistant bacteria is at least $1.3 billion per year, in 1992 dollars.

The plan has four major components: surveillance, prevention and control, research, and product development. Within those four components are 84 action items, including 13 priority action steps considered essential to addressing antimicrobial resistance. Of these 13 initiatives, seven are already underway, and six are planned to begin within the next one to two years. CDC, FDA, and NIH, along with HHS, are leading the implementation of the action plan. Top priorities of the four major sections include:

Surveillance. CDC will work with state health departments and other task force members to design and implement a plan that will define national, regional, state and local antimicrobial resistance surveillance responsibilities so that these entities are coordinated and use similar methodology. Additionally, FDA, USDA and CDC plan to develop systems that can monitor patterns of antimicrobial drug use in human medicine, in agriculture and in consumer products.

Prevention and control. HHS and partners will launch a national public education campaign to reduce the overuse and misuse of antimicrobial drugs and to improve antibiotic use in health care systems. Along with professional societies and other stakeholders, CDC already has started to prepare clinical guidelines for health professionals on how best to use antimicrobials. Additionally, FDA has initiated consultations with stakeholders to refine its proposed framework for assessing the human health impact of antimicrobials that may be used in food-producing animals. CDC, too, has been supporting pilot projects to identify effective strategies to promote appropriate antimicrobial drug use and reduce infection rates in clinical practice.

Research. NIH will lead a team of agencies that will provide the research community with new information and technologies, including genetic blueprints for various microbes, to identify targets for desperately needed new diagnostics, treatments and vaccines that could assist in preventing the emergence and spread of resistant pathogens. NIH plans to develop clinical studies to test new antimicrobials and novel approaches to treating and preventing infections caused by resistant pathogens. NIH continues to encourage and facilitate new rapid diagnostic methods and will pursue their development and evaluate their ultimate impact in the context of antimicrobial resistance.

Product Development. To identify and publicize priority health needs for new products that prevent resistance or treat resistant infections, HHS plans to create an Interagency Antimicrobial Product Development Working Group. Once formed, this group also will consult with stakeholders and economic consultants to identify incentives that encourage this kind of product development.