http://www.nytimes.com/2014/09/19/health/us-lays-out-strategy-to-combat-crisis-of-antibiotic-resistance.html 2014-09-18 21:52:08 U.S. Lays Out Strategy to Combat Crisis of Antibiotic Resistance The Obama administration’s measures are part of the first major federal effort to confront a public health problem that takes at least 23,000 lives a year. === WASHINGTON — The Obama administration on Thursday announced measures to tackle the growing threat of antibiotic resistance, outlining a national strategy that includes incentives to spur the development of new drugs, tighter stewardship of existing ones and a national tracking system for antibiotic-resistant illness. The actions are part of the first major federal effort to confront a public health crisis that takes at least 23,000 lives a year. Researchers have been warning for years that antibiotics — miracle drugs that changed the course of human health in the 20th century — are losing their power because of overuse. Some warn that if the trend is not halted, we could return to the time before antibiotics when it was common for people to die from ordinary infections and for children to not survive On Thursday, the administration took aim at the problem. Dr. John P. Holdren, the director of the White House Office of Science and Technology Policy, told reporters that the new strategy — established by an executive order that President Obama signed on Thursday — was intended to jolt the federal government into action to combat a health crisis that many experts say it has been slow to recognize. Under the order, Mr. Obama created a national task force to be led by the secretaries of health and human services, defense and agriculture, and required that they deliver a five-year action plan by Feb. 15. He also directed federal agencies to create an integrated system for surveillance of antibiotic-resistant illnesses and for data gathering to help Americans better understand the scope of the problem and the main factors driving it. “This represents a major elevation of the issue,” Dr. Holdren said. He talked of the problem as a national security issue. The announcement came with a report from the “Such aggressive action and investments in the antibiotic crisis are justified to contain the public health and economic impacts, which are likely to increase even more rapidly in the future if not checked,” the report said. Americans use more antibiotics than people in other industrialized nations, with rates more than twice those in Germany and the Netherlands, according to the Pew Charitable Trusts, a Washington-based research and advocacy group. The United States also uses far more antibiotics in livestock than many other nations; animals raised for food in America are given about six times as much antibiotics as are animals in Norway and Denmark. The fact that Mr. Obama took on the question was significant in itself, some experts said. Many researchers have been warning of the dangers for years, but there has been little high-level attention to the problem. “We’ve been like a frog in the pot as the water heats up,” said Allan Coukell, the senior director for drugs and medical devices at the Pew Charitable Trusts, who contributed to the report. “Now the administration is saying we can’t keep going like this, that we have to tackle this crisis, and here’s a road map. That’s a very significant step.” One point of contention has been the extent to which industrial-scale animal farming contributes to antibiotic-resistant infections in humans. The government has estimated that more than 70 percent of antibiotics in the United States are given to animals. Companies use them to prevent sickness when animals are packed together in ways that breed infection. They also use them to make animals grow faster, though the Food and Drug Administration has taken steps that it says will stop that. But many advocates remain skeptical that the agency’s actions will be effective, because they rely on voluntary action from industry, and some were disappointed that the efforts outlined on Thursday did not call for more. “The report recommends a wait-and-see attitude on reducing antibiotic use in food animals,” the advocacy group Keep Antibiotics Working said in a statement. “Waiting for an agency that has failed for over 40 years to take action on the overuse of antibiotics in livestock feed is not a wise strategy.”