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.
A Public Health Action Plan to Combat Antimicrobial Resistance is available
in today's Vidyya.