President Obama has issued an executive order to establish a Task Force for Combating Antibiotic-Resistant Bacteria.
The task force will be co-chaired by the Secretaries of Defense, Agriculture and HHS and seeks to implement the strategies and recommendations offered by the President's Council of Advisors on Science and Technology, which developed a report offering actionable recommendations to help keep antibiotic resistance under control.
The executive order calls for the task force to submit a five-year National Action Plan by Feb. 15, 2015 outlining future specific actions to be taken to implement the strategy.
The recommendations of PCAST's report can be grouped into three main categories: Improving surveillance of the rise of antibiotic-resistant bacteria, increasing the longevity of current antibiotics and quickening the rate at which new antibiotics and interventions are developed.
Here are PCAST's six recommendations to achieve better surveillance, stewardship and development of antibiotics.
1. Ensure strong federal leadership. PCAST suggests heightening federal coordination and oversight of efforts to combat antibiotic resistance, such as devoting a professional staff to ensure accountability and annual reporting. Additionally, PCAST recommends forming an interagency task force to be co-chaired by representatives of the Department of Agriculture, Defense and HHS to develop a national action plan.
2. Increase and improve surveillance and response for antibiotic resistance. This two part recommendation includes increasing funding to state and local public health departments to enhance antibiotic resistance detection, outbreak response and prevention activities. Secondly, the report suggest establishing a "national capability" for pathogen surveillance using genome analysis.
3. Expand research. PCAST suggests dedicating $150 million per year over seven years to dedicated research on understanding and overcoming antibiotic resistance, as well as an evaluation of its effectiveness at the end of the period.
4. Support clinical trials. PCAST recommends developing a clinical trials infrastructure dedicated to new antibiotics as well as creating new regulatory pathways to evaluate urgently needed antibiotics. In the report, PCAST suggest the government supports passing legislation authorizing the U.S. Food and Drug Administration to establish a full Special Medical Use pathway for antibiotics.
5. Increase economic incentives for developing urgently needed antibiotics. Private investment in developing ne antibiotics could help bring more antibiotics to market more quickly. PCAST estimates incentives of $800 million by the government in partnership with the industry could yield approximately one new FDA-approved antibiotic every year.
6. Drive antibiotic stewardship efforts. PCAST offers four key ways to help incentivize and push antibiotic stewardship efforts. First, they suggest CMS use reimbursement incentives to encourage providers to develop and implement antibiotic stewardship programs in both inpatient and outpatient settings and gather data on antibiotic use and resistance. Secondly, the federal government could require implementing stewardship programs as a condition for receiving federal grants. The government should also lead by example and implement such programs in its own facilities. Finally, the report suggests HHS creates prizes for developing rapid, inexpensive and effective diagnostics.
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