The evolution of pathogens to resist the drugs used to treat infections is an ongoing threat to public health, animal health, food production, and national security. Globally, a recent analysis estimated that 1.2 million deaths were caused by antibiotic-resistant (AR) bacteria in 2019, making this threat a leading cause of death for people of all ages worldwide. Domestically, the Centers for Disease Control and Prevention (CDC) estimates that more than 2.8 million Americans suffer from AR infections each year and that more than 35,000 die. While significant progress to address AR has been made in recent years, CDC found surges in antibiotic use and resistant infections in U.S. hospitals during the first year of the COVID-19 pandemic, including an alarming 15 percent increase in both resistant hospital-onset infections and deaths.
To coordinate and enhance the public health response to the AR threat, the U.S. Government is currently pursuing the National Action Plan for CARB, 2020-2025 (2020 Plan), which takes a global One Health approach recognizing that AR arising in humans, animals, or the environment may spread from one to the other, and from one country to another. The 2020 Plan follows on the original National Action Plan for CARB, 2015-2020, and describes continuing and new actions considered to be the highest priority for reducing antibiotic resistance. These Plans have provided a roadmap to guide the Nation in reducing the prevalence of antibiotic-resistant bacteria through infection prevention and control, surveillance, diagnostic testing, therapeutic and other product innovation, and global coordination.
The FY22 Report summarizes progress toward the 2020 Plan and includes highlights related to pandemic preparedness, equity, and other challenges; new and updated targets; common challenges and barriers; and progress toward all targets in FY22. The report includes a spotlight on surveillance, describing the collaboration between the Food and Drug Administration (FDA), CDC, and USDA to support the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS), which tracks changes in the antimicrobial susceptibility of enteric (intestinal) bacteria in the United States. Other achievements include:
- CDC’s efforts to develop evidence and incorporate health equity-driven efforts into its antibiotic stewardship program and research activities;
- The National Institutes for Health’s (NIH's) efforts to store, manage, analyze, and disseminate submitted sequence data and expand the data collection of antimicrobial resistant organisms and genes;
- The Agency for Healthcare Research and Quality’s (AHRQ’s) continued expansion of the Safety Program for Improving Antibiotic Use with positive results in long-term and ambulatory care, including completing the suite of three healthcare setting-specific toolkits based on the Four Moments of Antibiotic Decision Making;
- FDA’s multiple advances to foster stewardship of medically important antibiotics in animals, including the development of a targeted multi-media stakeholder outreach campaign director to farmers and ranchers in preparation for label changes associated with GFI #263.
- The Administration for Strategic Preparedness and Response/Biomedical Advanced Research and Development Authority’s (ASPR/BARDA’s) renewal of CARB-X with options to provide a total of up to $300 million over the next 10 years to support preclinical development of therapeutics, preventatives, and diagnostic candidates to combat AR infections; and
- USDA’s virtual public meeting to recognize 10 years of progress since the first USDA Antibiotic Resistance workshop held in 2012.
The primary challenge to implementing the 2020 Plan has been the COVID-19 pandemic, which led to increased numbers of hospitalized patients, increased lengths of stay and severity of illness for many patients, staffing shortages, changes in antibiotic use, and departures from standard infection prevention and control practices. The CARB Task Force continues to monitor, evaluate, and adapt to the impact of the COVID-19 pandemic on AR and ongoing efforts to address its threat.
For more information, please contact carbplan@hhs.gov.
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