By Thomas M. Burton And Tennille Tracy
WASHINGTON--The White House issued the most extensive action
plan ever against drug-resistant bacteria, or superbugs, seeking to
curb antibiotic use at farms and hospitals--and promote tests to
find lethal bugs, and antibiotics to kill them.
The plan, formally known as the National Action Plan for
Combating Antibiotic-Resistant Bacteria, sets goals to reduce by
50% to 60% by 2020 the incidents of illnesses caused by some of the
most lethal microbes known to man. It seeks enhanced laboratory
capacity across the U.S. to detect the worst pathogens. And it
calls on federal agencies to set new rules aimed at curbing
dangerous microbes.
The Obama administration's strategy calls on federal and state
agencies to engage in sweeping coordinated efforts, all largely
based on the idea that whatever is measured can be managed.
"It is the boldest move against antibiotic resistance by any
U.S. administration ever," said Kevin Outterson, a Boston
University law professor, researcher and author on antibiotic
resistance. He predicted the initiative, along with voluntary
efforts by companies such as McDonald's Corp. and Costco Wholesale
Corp. to stop or phase out using meat from animals routinely fed
antibiotics, "will actually bear fruit quickly."
Some doctors noted that there have previously existed similar,
but lower-profile, interagency action plans on drug resistance at
the Food and Drug Administration and other U.S. health agencies.
But in this case, they noted, President Barack Obama's budget calls
for an additional $1.2 billion to be spent in the effort and, if
enacted by Congress, that money can make a difference.
Drug-resistant bacteria are responsible for some two million
illnesses annually in the U.S. alone, and more than 23,000 deaths.
Recent outbreaks at U.S. hospitals after routine scope-diagnostic
procedures have made the threat from superbugs more vivid in the
public's mind.
John H. Powers, a George Washington University medical
professor, generally praised the plan but said it "needs to be more
patient-focused, not bug focused." He called on federal officials,
for instance, to measure patient outcomes and see if they improve
with new measures and antibiotics.
Dr. Powers has noted that current law carries rewards to
companies that develop antibiotics even when they haven't been
tested specifically against drug-resistant bugs.
The White House plan proposes to eliminate a farming practice
whereby antibiotics are given to cows, chickens and other food
animals to help them gain weight faster. This overuse has greatly
contributed to drug resistance.
In late 2013, the FDA asked drug companies to voluntarily stop
making antibiotics to promote animal growth.
The Obama plan said the Agriculture Department should finance
the development of alternatives to antibiotics that are used to
treat diseases in livestock and poultry and promote growth.
Some public-health groups criticized the Obama administration
for not doing more to curb the use of antibiotics in poultry and
livestock. Mae Wu, an attorney at the Natural Resources Defense
Council, said the drugs should be used only to treat animals that
are sick.
"The plan continues to allow the routine feeding of antibiotics
to animals that live in the crowded conditions endemic to
industrial farms, " Ms. Wu said.
Steven Gordon, chairman of infectious diseases at the Cleveland
Clinic, said the number of antibiotics prescribed to human patients
when they weren't needed has been increasing over recent years, so
he hailed the plan as "elevating this issue to a level we haven't
seen before."
Other specifics in the initiative include calling for states to
set up programs to combat drug resistance. Within five years, it
urges, all 50 states plus the District of Columbia and Puerto Rico
should have such programs in place. It also urges the Centers for
Disease Control and Prevention to double tuberculosis screening
among migrants, to prevent the importation of multidrug-resistant
TB.
Write to Thomas M. Burton at tom.burton@wsj.com and Tennille
Tracy at tennille.tracy@wsj.com
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