President Barack Obama signed an executive order Thursday that addresses the growing threat of antibiotic-resistant bacterial infections, which kill more than 20,000 Americans each year.
The order establishes the Task Force for Combating Antibiotic-Resistant Bacteria, consisting of representatives from numerous federal agencies. A presidential advisory council will closely examine how antibiotics are used the United States and what practices can lead to the spread of deadly bacteria in the healthcare setting and in the broader community.
The order came the same day the President’s Council of Advisors on Science and Technology (PCAST) issued a 78-page report on ways to combat antibiotic resistance in the United States.
'This Situation Threatens ... National Security'
The report highlights key areas that need immediate attention, including the “misuse and overuse” of antibiotics in human medicine, the “very serious concern” of antibiotic use in animal agriculture, the development of new antibiotics, and creating a more comprehensive surveillance system to track the use of antibiotics and the occurrence of drug-resistant infections.
“The evolution of antibiotic resistance is now occurring at an alarming rate and is outpacing the development of new countermeasures capable of thwarting infections in humans,” the report states. “This situation threatens patient care, economic growth, public health, agriculture, economic security, and national security.”
PCAST recommends the issue be tackled with strong federal leadership, a strong surveillance system, expanded research into antibiotic alternatives in agriculture, and greater support for clinical trials of urgently needed antibiotics.
“Success in combating antibiotic resistance will require elevating the issue to a national priority,” the report states. “The crisis in antibiotic resistance comes as no surprise: it has been brewing for decades, despite urgent calls from medical experts dating back as far as the 1940s and 1950s. Yet, the issue has only just begun to seize the public attention, due to increasing high rates of resistant pathogens in healthcare facilities.”
According to the latest estimate by the U.S. Centers for Disease Control and Prevention (CDC), drug-resistant “superbugs” kill 23,000 Americans and sicken another 2 million each year. Hospital acquired infections, including those from superbugs, cost U.S. hospitals an estimated $28.4 billion to $33.8 billion a year.
The CDC and the World Health Organization list antibiotic resistance as one of the greatest threats to human health worldwide.
Questioning the Use of Antibiotics in Livestock
One grave concern for public health advocates is the way antibiotics are used in livestock. Currently, 80 percent of all antibiotics used in the United States are fed to animals meant for human consumption.
The antibiotics help the animals gain weight and stay healthy in overcrowded conditions, but they also encourage antibiotic resistant bacteria to populate the animals, where they can easily spread to farmworkers and meat consumers. The U.S. Food and Drug Administration (FDA) has left the agriculture industry to voluntarily regulate its own antibiotic use.
Legislation to limit the use of antibiotics in livestock, such as the Preservation of Antibiotics for Medical Treatment Act (PAMTA), has been a tough political sell. Rep. Louise Slaughter (D-NY) has introduced the bill during each congressional session since 2007, but despite support from more than 500 medical groups, the bill has never been heard in its respective subcommittee.
“I appreciate PCAST’s recommendations for greater surveillance of antibiotic use in agriculture, and that the FDA and USDA work to collect more detailed data to show whether or not FDA's voluntary guidance will actually lead to a reduction in antibiotic use,” Rep. Slaughter said in a statement. “However, I maintain that voluntarily asking industry to change labels is not enough to protect human health.”
Environmental Group Calls for 'Much More Follow Through'
Earlier this year, a federal appeals court judge overturned a lower court’s ruling regarding the FDA’s response to antibiotic use in livestock. In 1977, the FDA acknowledged that using antibiotics in animals for growth promotion could pose a risk to human health, but it never addressed the issue outright. The lawsuit was brought by the Natural Resources Defense Council (NRDC) and other groups.
Mae Wu, a health attorney with the NRDC, said the new PCAST report “underscores the crisis” of antibiotic resistance.
“Unfortunately, much more follow through is needed from the administration,” Wu said. “Just as the administration is taking steps to deal with abuse of antibiotics in humans, it must take steps to curb the overuse of antibiotics in animals, which consume about 80 percent of the antibiotics sold in the United States. Shying away from taking these needed steps will not yield the ‘substantial changes’ that PCAST says are necessary.”
By Feb. 15, the new task force will give the president a document outlining a five-year strategy, including specific actions needed to preserve the effectiveness of current antibiotics while spurring the development of new ones.