Pew, IDSA Urge Increased Federal Funding to Combat Resistant Bacteria

On Nov. 9, The Pew Charitable Trusts and the Infectious Diseases Society of America submitted a letter to leaders of the Appropriations Subcommittees on Labor, Health and Human Services, Education, and Related Agencies in both the U.S. House of Representatives and the U.S. Senate, urging increased funding to support implementation of the National Action Plan for Combating Antibiotic-Resistant Bacteria.

With passage of the Bipartisan Budget Agreement of 2015 making additional nondefense discretionary funding available, the letter urges support of specific antibiotic resistance efforts at the Biomedical Advanced Research and Development Authority, the Centers for Disease Control and Prevention, and the National Institutes of Health.

Read the full letter (PDF) 

November 9, 2015

Dear Chairmen Blunt and Cole, and Ranking Members Murray and DeLauro:

On behalf of The Pew Charitable Trusts and The Infectious Diseases Society of America, we urge you to increase funding in the Labor, Health and Human Services, Education, and Related Agencies Appropriations bill to support the Administration’s implementation of the National Action Plan for Combating Antibiotic-Resistant Bacteria through the Biomedical Advanced Research and Development Authority (BARDA), Centers for Disease Control and Prevention (CDC), and the National Institute of Health (NIH).  We thank you for including new resources to address antibiotic resistance in the House and Senate Committee-passed FY 2016 Labor-HHS-Education Appropriations bills, and urge you to sustain and build upon those investments.  We are deeply concerned that the growing threat from antimicrobial resistance (AR) puts many people at risk for serious and life threatening infections with few or no treatment options.  Groups that are particularly vulnerable to this threat include people with compromised immune systems, such as patients undergoing chemotherapy for cancer or receiving organ transplants, the elderly, preterm babies, and people living with HIV/AIDS.  Combating this threat will require increased and sustained federal investments in biomedical research and public health infrastructure.  With passage of the Bipartisan Budget Agreement of 2015 making additional non-defense discretionary funding available, we urge you to provide funding to support AR efforts at BARDA, CDC, and NIH, and we are pleased to offer more specific recommendations below.

The President’s FY 2016 Budget requested $522 million for BARDA, of which $192 million would be dedicated to antimicrobial research and development (R&D).  The President’s Council of Advisors on Science and Technology (PCAST) recommended a commitment of $800 million annually in its Report to the President on Combating Antibiotic Resistance.  BARDA utilizes novel public-private partnerships to address the market failure in antibiotic R&D.  BARDA was established to facilitate the procurement and advanced development of medical countermeasures against bioterror threats and emerging infectious diseases.  These are areas for which traditional market mechanisms have failed to encourage the development of needed products. Because antibiotics are traditionally low-margin drugs that are meant to be used sparingly, they fall squarely into the types of products to combat emerging infections BARDA was authorized to develop.  The House bill level-funded BARDA at $415 million and the Senate bill provided $473 million.  While the Senate level is preferable to the House level, providing the level requested in the President’s budget would support an expansion of BARDA’s antimicrobial program to include 3 to 4 new public-private partnerships for the development of novel and urgently needed antimicrobial therapies and diagnostics. 

The President’s Budget requested $264 million for CDC to fund the Antibiotic Resistance Solutions Initiative.  The goal of this program is to build prevention programs through existing state and local health departments in all 50 states and 10 large cities, utilizing evidence-based approaches to stop the spread of drug-resistant bacteria and preserve the effectiveness of existing antibiotics.  The initiative also supports a new network to connect existing regional labs to improve tracking of and response to outbreaks of serious and potentially deadly bacteria.  The House bill provides $120 million for this effort whereas the Senate bill provides only $30 million.  While the House level is the minimum we believe is necessary to begin these activities, additional funding above the House level will allow for more complete and rapid implementation across the country.  Additionally, the President’s Budget requested $32 million for the National Healthcare Safety Network (NHSN), which would facilitate data reporting on antibiotic use and resistance patterns in more than 17,000 healthcare facilities. NHSN is a critical component of the strategy to address AR.  Increased resources would allow CDC to provide real-time data about antibiotic use and resistance trends, which are needed to evaluate the effectiveness of interventions to reduce AR.  The House bill level-funded NHSN and the Senate bill provided only $23 million.  We ask that a final bill fully support the budget request.

The National Institute of Allergy and Infectious Diseases (NIAID) plays a leading role in the basic research necessary to understand the development of antimicrobial resistance and the translational research leading to potential treatments, diagnostic tests, and vaccines.  The House and Senate reports indicate the Committees have provided $100 million within NIH’s budget to the National Institute of Allergy and Infectious Diseases (NIAID) to: spur R&D for new rapid diagnostics to help ensure that antibiotics are prescribed appropriately; develop a national database of genome sequence data of all reported human infections with antimicrobial-resistant microorganisms; launch a large-scale effort to better understand drug resistance; and create a rapid-response clinical trial network to test new antibiotics on individuals infected with highly resistant strains.  We appreciate this funding level and encourage it to be maintained in the final legislation.

In summary, below is a brief listing of funding requests associated with the National Action Plan for Combating Antibiotic Resistant Bacteria along with the funding level provided by the House and Senate bills.  We urge you to provide the highest funding level possible for each of these vital initiatives.

Once again, we strongly urge you to support the antimicrobial resistance line-items in the CDC, BARDA, and NIH budgets.  You can obtain additional information by contacting Jonathan Nurse at the Infectious Diseases Society of America at jnurse@idsociety.org or Lindsey Berman at The Pew Charitable Trusts at lberman@pewtrusts.org.  We thank you for your leadership and working with us to prevent a post-antibiotic era where common infections prove fatal.

Sincerely,

Johan Bakken, MD, PhD, FIDSA
President
Infectious Diseases Society of America  

Kathy Talkington
Director, Antibiotic Resistance Project
The Pew Charitable Trusts

CC:

The Honorable Thad Cochran
The Honorable Barbara Mikulski
The Honorable Hal Rogers
The Honorable Nita Lowey