The White House’s plan to tackle antibiotic resistance doesn’t go far enough

1. The White House has released its first-ever plan to combat antibiotic-resistant bacteria.
2. Observers are calling it "the boldest move against antibiotic resistance by any US administration, ever."
3. The plan is a response to growing evidence that drug-resistant — or "superbug" — infections could undo many of the advances of modern medicine and agriculture.
4. Critics of the plan worry it doesn't do enough to tackle the problem of antibiotic overuse in animals, which is where the overwhelming majority of the drugs are used.
5. The plan could have troubled getting funded, since Republicans in Congress need to approve Obama's budget that would pay for it.
   

The White House wants to tackle antibiotic resistance

Antibiotic resistance — when bacteria outsmart the drugs we have to combat them — is a massive problem facing the modern world. While resistance to drugs is a natural evolutionary process, it's been sped up by our overuse of antibiotics, spurring on more "superbug" infections, killing thousands of people every year, and rendering the drugs we have useless.

In recent years, experts have warned that we are at the "dawn of a post-antibiotic era" that amounts to a health "nightmare" and "catastrophic threat" on par with terrorism.

That's what makes this new report so important: for the first time ever, the White House has outlined a solution, in a national action plan for combating antibiotic resistance.

The report came after President Obama requested a doubling of the 2016 budget (to $1.2 billion) for preventing and combating antibiotic resistance, and issued an executive order to create a task force to draw up the plan comprising representatives from at least a dozen federal agencies. 

In order for the plan to be implemented, however, Congress needs to back the budget that pays for its measures.

The White House wants to see smarter prescribing, better surveillance, and new antibiotics

Dates of discovery of distinct classes of antibacterial drugs. You can see we've hit a "discovery void" in recent years. (WHO)

The basic idea behind the plan is to limit our overuse of antibiotics, better track and understand superbug infections, and create new antibiotics, all with the aim of staving off the threat posed by drug-resistant bacteria.

The plan, designed to be fully implemented by 2020, tackles this in a few ways. It focuses on slowing the emergence of resistant bacteria and strengthening surveillance efforts of resistant infections. It also calls for rewarding the development of rapid diagnostic tests that can help differentiate bacterial infections that need the drugs from viral ones that don't, as well as advancing research for developing new drugs.

Among other, more specific targets, the plan aims to reduce inappropriate antibiotic use by 50 percent in outpatient settings and by 20 percent in inpatient settings, and to establish antibiotic stewardship programs, including requiring hospitals to track how they're prescribing.

Money would also flow to states to establish and strengthen programs that monitor drug-resistant infections, and new DNA databanks to trace their sources. All these efforts would help reduce the incidence of superbugs, the administration said, including Clostridium difficile, hospital-acquired Carbapenem-resistant Enterobacteriaceae infections, and methicillin-resistant Staphylococcus aureus infections.

"It is the boldest move against antibiotic resistance by any US administration, ever," said Kevin Outterson, of Boston University School of Law.

Read more: 7 scary facts about antibiotic-resistant superbugs

The plan is soft on agriculture

Buyenlarge/Getty Images

Chickens at a hatchery in Alabama. (Buyenlarge/Getty)

One thing the plan does not do: set specific targets for reducing the use of antibiotics in animals, even though some 80 percent of antibiotics are currently used in agriculture.

On a call with White House officials today, they emphasized the need for better data before specific targets are set and said they were engaging with the industry through stakeholder meetings.

Still, some legislators weren't totally pleased with the current efforts.

"The administration has fallen woefully short of taking meaningful action to curb the overuse of antibiotics in healthy food animals," Rep. Louise Slaughter (D-NY), who has pursued legislation on the issue, said in a statement. "Any meaningful solution to the looming antibiotic resistance crisis must begin with limits on the farm."

Outterson explained that the lack of specific targets wasn't all that surprising: while the Centers for Disease Control and Prevention have been collecting information on prescription practices and resistant pathogens in humans for a decade, the USDA hasn't been doing the same. "It's hard to set a target when you don't have a baseline," he said. "If this was a war, we'd only now be counting the number of enemy soldiers."

Part of the lack of data has been the result of fierce industry opposition and lobbying, which has squashed efforts to curb agricultural use for things like growth promotion to make animals grow more quickly with a lower volume of feed.

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