World is Challenged by U.S. to Fight Antibiotic Resistance

The United States is leading an ambitious global initiative to combat the growing threat of antibiotic resistance (AR or AMR). The new AMR Challenge, announced during Tuesday’s United Nations (UN) General Assembly in New York, is spearheaded by the U.S. Department of Health and Human Services (HHS) and the CDC.

Unprecedented in scale, the challenge charges pharmaceutical and health insurance companies, food animal producers and purchasers, medical professionals, government health officials, and other industry leaders from around the world to work together to address antibiotic resistance. The challenge is encouraging:

• Reduction of antibiotics and resistance in the environment, including water and soil;
• Improvement of antibiotic use, such as ensuring that people can access antibiotic medicines when they are needed;
• Development of new vaccines, drugs, and diagnostic tests;
• Improvement of infection prevention and control; and
• Enhancement of data sharing and data collection.

More than 100 organizations have already expressed intent to build on progress against one of the greatest global public health threats, according to the CDC.

“Untreatable infections are the reality for too many families around the world—and in the U.S.” said HHS Secretary Alex Azar, in a prepared statement. “We’ve had some success fighting antibiotic resistance but, if we don’t all act fast together, we will see global progress quickly unravel. Antibiotic resistance isn’t slowing down. Every country and industry has to step up.”

Among the first AMR Challenge commitments received include:

• As part of theAMR Industry Alliance,generic and research-based pharmaceutical companies have agreed on a framework that promotes responsible antibiotic manufacturing. Antibiotics and their residues can be released (or discharged) into the environment when these drugs are made and can potentially contribute to the emergence and spread of resistance.
• Walmart U.S.is working with its animal protein suppliers to report antibiotic use throughout its supply chain and will conduct blockchain projects (a ledger of transactions) to improve responsible antibiotic use in farm animals, affecting its more than 5,000 stores and clubs nationwide.
• NovaDigm Therapeuticsis developing a vaccine forCandida auris, an emerging resistant fungal threat that has caused serious illness and death worldwide, to prevent infections.
• CARB-Xwill invest $80 million globally by December 2019 to support more than 40 product developers as they pursue new drug classes to treat gram-negative bacteria, new diagnostics to identify new resistance and infections faster, and new treatment alternatives and vaccines. Each award agreement will include commitments to access and stewardship to ensure proper use of these live-saving innovations.
• Aetna,whose healthcare network includes 1.2 million health care professionals and more than 5,700 hospitals, commits to partnering with state health departments to provide feedback to providers about their antibiotic prescribing performance and promote vaccinations.
• Petcocommits to not allowing prophylactic use of antibiotics in its supply chain and supporting veterinary oversight for access to antibiotics in its 1,500 locations across the U.S. and online channels.
• Healthcare systems,which impact care at more than 20,000 healthcare facilities in the U.S. and abroad, are committed to reducing inappropriate antibiotic use—many between 20% and 45%—and hundreds have also committed to reducing infections.
• Professional clinical societies,representing more than 283,000 providers across U.S. healthcare settings, are committed to improving antibiotic use among their members.
• Patient representative organizations, representing individuals impacted by antibiotic resistance and sepsis, continue to provide education and awareness to patients and caregivers about this important threat.
• APHL, ASTHO, and CSTE(see acronyms below) are working with state and local health departments to develop more than 50 tailored commitments that align with each state’s AR threats and goals.

“We are seeing resistance to life-saving antibiotics, and scientists worldwide are uncovering new types of resistance. Our shared commitment to confront this threat is critical to all American communities and companies, protecting our progress in healthcare outcomes, food production and even life expectancy,” said CDC Director Robert Redfield, in a prepared statement.

According to the CDC, the U.S. Government remains a global leader in the fight against antibiotic resistance. Earlier in September, the agencypublishedThe Core Elements of Human Antibiotic Stewardship Programs in Resource-Limited Settings: National and Hospital Levelsto help improve antibiotic use in healthcare settings worldwide; and the FDAannounced its plans to combat antibiotic resistance through antibiotic innovation and antibiotic stewardship in human medicine and animal agriculture. CARB-X, launched in 2016 by ASPR and NIH, continues its investments of more than $500 million by 2021 in research and development of new antibiotics, vaccines, rapid diagnostics, and other life-saving products.

Antibiotic resistance has been found in all regions of the world. In the U.S. alone, at least 2 million people get resistant infections each year and at least 23,000 die.

“Modern travel of people, animals, and goods means antibiotic resistance can easily spread across borders and continents. Antibiotic resistance in one country means antibiotic resistance in every country,” said Azar. “Fighting this threat requires a collaborative global approach across sectors to detect, prevent, and respond to these threats when they occur. Every country, regardless of resources, can take steps to slow antibiotic resistance.”

By Tuesday, commitments were made by the following 106 organizations:

1. AdvaMedDx
2. Aetna
3. American Academy of Orthopedic Surgeons
4. American Association of Avian Pathologists
5. American Cancer Society
6. American College of Physicians
7. American Hospital Association
8. American Society for Microbiology
9. American Society of Health-System Pharmacists
10. American Veterinary Medical Association
11. AMR Industry Alliance
12. Antibiotic Resistance Action Center
13. Ascension
14. Asolva, Inc.
15. Association for Professionals in Infection Control and Epidemiology (APIC)
16. Association of Public Health Laboratories (APHL)
17. Association of State and Territorial Health Officials (ASTHO)
18. Atrium Health
19. BD
20. Bill & Melinda Gates Foundation
21. bioMérieux
22. Biotia
23. Bugworks Research, Inc.
24. C Diff Foundation
25. CARB-X
26. CDC Foundation
27. Cepheid
28. Chicago Area Patient-Centered Outcomes Research Network
29. Chicago Prevention and Intervention Epicenter
30. Conduent
31. Council of State and Territorial Epidemiologists (CSTE)
32. CVS Health
33. Doctor on Demand, Inc.
34. Duke University and the Duke Center for Antimicrobial Stewardship and Infection Prevention
35. Ecolab, Inc.
36. Elanco
37. Emory Antibiotic Resistance Center
38. Emory University
39. Express Scripts
40. Global Health Alliance Melbourne
41. Global Health Technologies Coalition
42. GoHealth Urgent Care
43. Government of Finland
44. Government of India — Department of Biotechnology, Ministry of Science and Technology
45. Government of India — Indian Council of Medical Research, Ministry of Health and Family Welfare
46. Government of Japan
47. Government of Nigeria
48. Government of Pakistan
49. HCA Healthcare
50. Henry Ford Health System
51. HP, Inc.
52. Infectious Disease Society of America (IDSA)
53. Intermountain Healthcare
54. International Livestock Research Institute
55. Kaiser Permanente
56. Making a Difference in Infectious Diseases
57. Max Healthcare
58. Merck
59. Milken Institute
60. Mountaire Farms, Inc.
61. National Institute for Antimicrobial Resistance Research and Education
62. National Milk Producers Federation
63. National Pork Board
64. National Pork Producers Council
65. North American Meat Institute
66. Northwest Antimicrobial Resistance Coalition
67. NovaDigm
68. PATH
69. Pediatric Infectious Disease Society (PIDS)
70. Pet Industry Joint Advisory Council (PIJAC)
71. Petco
72. Pew Charitable Trusts
73. Premier, Inc.
74. Roche Diagnostics
75. Rush University Medical Center
76. Sackler Institute for Nutrition Science
77. SCYNEXIS, Inc.
78. Society for Healthcare Epidemiology of America (SHEA)
79. Society of Infectious Disease Pharmacists (SIDP)
80. The Children’s Hospital of Philadelphia (CHOP)
81. The Joint Commission
82. The Perelman School of Medicine of the University of Pennsylvania
83. Trinity Health
84. U.S. Agency for Healthcare Research and Quality (AHRQ)
85. U.S. Biomedical Advanced Research and Development Authority (BARDA)
86. U.S. Centers for Disease Control and Prevention (CDC)
87. U.S. Centers for Medicare and Medicaid Services (CMS)
88. U.S. Department of Agriculture (USDA)
89. U.S. Department of Defense (DoD)
90. U.S. Department of Health and Human Services Office of Global Affairs (HHS/OGA)
91. U.S. Department of State (DOS)
92. U.S. Department of Veterans Affairs (VA)
93. U.S. Food and Drug Administration (FDA)
94. U.S. National Institutes of Health (NIH)
95. U.S.-India Strategic Partnership Forum
96. United Nations Foundation
97. University of Illinois at Chicago
98. University of Illinois Hospital and Health Sciences System
99. University of Illinois, College of Medicine, Chicago
100. University of Iowa
101. University of Maryland
102. University of Utah
103. Urgent Care Association of America
104. Vermont Oxford Network
105. Walmart
106. Wellcome Trust

Read the commitments received to date atCDC.gov.

Reference

U.S. Challenges World to Intensify Global Fight Against Antibiotic Resistance [news release]. Atlanta, GA; September 25, 2018: CDC website. https://www.cdc.gov/media/releases/2018/p0925-global-antibiotic-resistance.html. Accessed September 25, 2018.