United States Takes Actions to Tackle Antibiotic Resistance

On September 18, 2014, the White House announced four different actions aimed to tackle antibiotic resistance: an Executive Orders signed by President Obama, a National Strategy, President’s Council of Advisors on Science and Technology (PCAST) report on Combating Antibiotic Resistance and $20 million prize for rapid point-of-care diagnostics.

Dr. Anthony So, director of the Program on Global Health and Technology Access, served as a member of the PCAST Antibiotic Resistance Working Group and provided advisory input to the PCAST report. The PCAST report includes recommendations to appoint a White House Director for National Antibiotic Resistance Policy, tasked with ensuring inter-agency collaboration and accountability among federal agencies, as well as establishment of the Interagency Task Force and Presidential Advisory Council.  Establishing such strong federal coordination and leadership is required to tackle the rising antibiotic resistance crisis.

It’s encouraging to see the Obama Administration taking action and showing leadership to address the global public health challenge of antibiotic resistance. We are especially pleased that the PCAST report calls for White House-level coordination and innovative approaches to financing new diagnostics and drugs, from prizes for diagnostics to delinkage mechanisms. Delinkage–which refers to approaches that divorce a drug company’s return on investment from volume-based sales of the antibiotic–might be particularly useful in helping to realign economic incentives.” said Dr. So.

The four actions are summarized below:

1. The Executive Order signed by the President Obama provides the following directives:

  • Establishment of a new Task Force for Combating Antibiotic-Resistant Bacteria charged with submitting a National Action Plan to the President by February 15, 2015 to implement the National Strategy and address the recommendations made by the PCAST.
  • Establishment of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria composed of leading non-governmental experts.

2. The National Strategy provides details on actions for five goals to be achieved by 2020 in collaboration with partners from academic, public and private sectors involved in healthcare, public health, veterinary medicine, agriculture and food safety. The broad-ranging goals are to prevent the spread of resistant bacteria, strengthen national surveillance, accelerate research and development of diagnostics, vaccines and therapeutics, and improve international collaboration.

3. The PCAST Report on ‘Combating Antibiotic Resistance’  was developed in consultation with a working group of public and private sector experts spanning the human and veterinary health sectors. The report outlines a broad ranging set of actions for the US government to bring the antibiotic-resistance crisis under control.

The Executive Order signed by President Obama has not yet implemented all of the recommendations made by PCAST such as:

  • Doubling annual funding by United States to tackle antibiotic resistance from $450 million to $900 million;
  • Establishing a position for White House Director for National Antibiotic Resistance Policy (DNARP) to ensure inter-agency cooperation and accountability;
  • Establishing a national capability for pathogen surveillance based on genome analysis; or
  • Creating an Antibiotic Incentive Fund that would allow the Biomedical Advanced Research and Development Authority (BARDA) to provide financial and technical support to industry for development of new antibiotics.

4. Prize for Rapid, Point-of-Care Diagnostic Tests: The White House also announced the launch of a $20 million prize for new rapid point-of-care diagnostics. The National Institutes of Health (NIH) and Biomedical Advanced Research and Development Authority (BARDA) will cosponsor the prize for development of diagnostics to identify highly resistant bacterial infections. HHS will host a public meeting to engage public and private sector stakeholders to layout the parameters of the competition. This prize fund established by the Obama administration is higher than the £10 million Longitude Prize for diagnostics announced by the British Government, but lower than the $25 million prize fund recommended by the PCAST.

 

The full Executive Action, National Strategy, and PCAST Report are attached:

Executive Order — Combating Antibiotic-Resistant Bacteria The White House

National Strategy for Combating Antibiotic Resistance Bacteria

PCAST Report on Combating Antibiotic Resistance