The Office on Pandemics and Emerging Threats:

Antimicrobial Resistance

Larry Kerr, PhD Director Office of Global Affairs

Office of the Secretary The U.S. Department of Health and Human Services

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Working Together is Essential

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Overview: The Office on Pandemics and Emerging Threats (PET)

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Issues we work on: • Antimicrobial resistance (AMR) • Emerging infectious diseases • Season and Pandemic Influenza • Global Health Security Alliance (GHSA) • Biothreat Prevention

Antibiotic Resistance (AR) • Health Impacts

– At least 2 million illnesses each year that are resistant to antibiotics

– 23,000 deaths due to antibiotic resistant bacteria

– > 250,000 illnesses and ~ 15,000 deaths due to clostridium difficile infections each year

• Health Costs

– Estimated $20-35 billion annually

• As bacteria develop new ways to resist antibiotics, we lose the ability to treat and prevent both common and serious infections

– Antibiotics are among the most commonly prescribed drugs

– Up to 50% of the time antibiotics are not optimally prescribed, often done so when not needed, or at an incorrect dose or duration

– In recent years we have seen the emergence of a number of resistant organisms and a reduction in the utility of a number of antimicrobial

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Antimicrobial Resistance (AMR)

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The Federal Government Response

• HHS is engaged in a comprehensive, Administration-wide effort under the CARB National Action Plan that aims to: 1. Slow the Emergence of Resistant Bacteria and Prevent the

Spread of Resistant Infections 2. Strengthen National One-Health Surveillance Efforts to

Combat Resistance 3. Advance Development and Use of Rapid and Innovative

Diagnostic Tests for Identification and Characterization of Resistant Bacteria

4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines

5. Improve International Collaboration and Capacities for Antibiotic-resistance Prevention, Surveillance, Control, and Antibiotic Research and Development

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Federal CARB Task Force

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Overview of CARB

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● PCAST Report on Combating Antibiotic Resistance (2014)

● National Strategy on Combating Antibiotic-Resistant Bacteria (2014)

● Executive Order (2014)

● National Action Plan on Combating Antibiotic-Resistant Bacteria (2015)

● National Action Plan for Combating MultiDrug-Resistant Tuberculosis (2015)

OGA Coordination

• By executive order, the Assistant Secretary for Global Affairs leads the implementation of objective five of the National Action for Combating Antibiotic-Resistance (CARB)

• Objective Five calls for “Improving International Collaboration and Capacities to Address AMR and Develop New Antibiotics”

• National Action Plan outlines steps for implementing the National Strategy and recommendations of PCAST

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HHS Efforts

• HHS activities focus on the following: – Tracking the problem and identify emerging

threats

– Preventing infections and preventing the spread of resistance

– Improving antibiotic prescribing and stewardship

– Developing new diagnostics and medical treatments (including basic, translation, and clinical research to inform new development)

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• Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (Advisory Council) PACCARB

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Mission & Members

• Provides advice, information, and recommendations on a range of issues related to antibiotic resistance affecting both human and animal health.

• The Advisory Council consists of:

– 15 voting members, including the Chair and Vice Chair,

– 5 non-voting liaison representative members, and

– 10 non-voting ex-officio members.

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Advisory Council Activities

• Held 7 public meetings and a series of working group meetings on specific topics.

• Wrote initial assessment of the USG performance in addressing antibiotic resistance and identified impact opportunities: – The One Health approach must be an organizing

principle.

– We need a lead champion in the USG.

– Economic incentives to ensure the development and deployment of new therapies, preventatives, and diagnostics are critical.

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Future Activities

• As a follow up to the need for economic incentives, the Advisory Council will propose ideas for incentivizing the development of therapeutics/anti-infectives, diagnostics, and vaccines.

• The final report will be deliberated and voted on by the full Advisory Council in September 2017.

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Conclusions

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• Implementation of the CARB and MDR-TB National Action Plans will require the sustained, coordinated, and complementary efforts of individuals and groups around the world, including public and private sector partners, healthcare providers, healthcare leaders, veterinarians, agriculture industry leaders, manufacturers, policymakers, and patients.

• Efforts carried out as part of the National Action Plans will help the Federal government curb the rise of antibiotic-resistant bacteria with the goal of saving lives.

Thank you for your attention!

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