By Thomas M. Burton And Tennille Tracy
WASHINGTON--The White House on Friday issued the most extensive
plan ever to fight drug-resistant bacteria, or superbugs, seeking
to curb antibiotic use at farms and hospitals--and promote
discovery of 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% illnesses caused by some of the most lethal microbes
known to man by 2020. 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, which can mostly be
achieved through agency regulations and guidance but needs Congress
to appropriate the funds, envisions federal and state agencies
engaging in 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 reduce the use of meat from animals routinely fed
antibiotics "will actually bear fruit quickly."
Sen. Lamar Alexander (R., Tenn.), chairman of a key Senate
committee on health issues, said, "The President has focused on a
real concern....The Senate health committee already is working to
help spur the development of new and effective antibiotics. I look
forward to reviewing the details of the President's plan."
Some doctors noted that there have previously existed similar,
but lower-profile, interagency plans regarding 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 potentially 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 gauge 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 eliminating a farming practice in
which cows, chickens and other food animals receive antibiotics to
help them gain weight faster. This overuse is widely believed to
have contributed to drug resistance.
In late 2013, the FDA asked drug companies to voluntarily stop
using antibiotics to promote animal growth. The Obama plan says the
Agriculture Department should finance the development of
alternatives to antibiotics that are used to treat diseases in
livestock and poultry and promote growth.
The White House effort comes as a number of meat processors and
restaurant chains have voluntarily moved to reduce or eliminate
antibiotics use in their meat supply in response to consumer
preferences, rather than any regulations.
Meat and animal-drug-industry officials said the Obama
administration plan largely matched what the industry is already
doing to comply with the 2013 FDA guidance.
"Most of the [Obama administration] plan outlines actions that
are already well under way," said Tom Super, spokesman for the
National Chicken Council, which represents poultry companies.
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 haven't been needed has been increasing in recent years,
and 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 multi-drug-resistant
tuberculosis.
Write to Thomas M. Burton at tom.burton@wsj.com and Tennille
Tracy at tennille.tracy@wsj.com
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