Fight Against Antibiotic Resistance Intensifies With Worldwide AMR Challenge

Unprecedented in scale, the AMR Challenge charges pharmaceutical and health insurance companies, food animal producers and purchasers, medical professionals, government health officials, and other industry leaders from around the world to work together to address antibiotic resistance.

The United States is leading an ambitious global initiative to combat the growing threat of antibiotic resistance (AR or AMR). The new AMR Challenge, announced during Tuesday’s United Nations (UN) General Assembly in New York, is spearheaded by the US Department of Health and Human Services (HHS) and the CDC, and CDC officials are noting that pharmacists play a key role in addressing resistance.

"Pharmacists are often the most accessible health care professional in the community and can play a key role in addressing antibiotic resistance," Lauri Hicks, who is the director of the CDC's Office of Antibiotic Stewardship in the Division of Healthcare Quality Promotion at the National Center for Emerging and Zoonotic Infectious Diseases, told Pharmacy Times in an interview. "Pharmacists are a resource for education about antibiotic use and can raise awareness about adverse events associated with antibiotic use. Community pharmacists, as medication experts, can guide patients with the common cold to remedies, such as a humidifier or saline nasal spray, and over-the-counter (OTC) medications tailored to the patient’s symptoms and needs. Patients and parents want to know what they can do to feel better or help their child feel better, and pharmacists are a great resource for this information."

Reduction of antibiotics and resistance in the environment, including water and soil;
Improvement of antibiotic use, such as ensuring that people can access antibiotic medicines when they are needed;
Development of new vaccines, drugs, and diagnostic tests;
Improvement of infection prevention and control; and
Enhancement of data sharing and data collection.

More than 100 organizations have already expressed intent to build on progress against one of the greatest global public health threats, according to the CDC.

“Untreatable infections are the reality for too many families around the world—and in the U.S.” said HHS Secretary Alex Azar, in a prepared statement. “We’ve had some success fighting antibiotic resistance but, if we don’t all act fast together, we will see global progress quickly unravel. Antibiotic resistance isn’t slowing down. Every country and industry has to step up.”

Among the first AMR Challenge commitments received include:

As part of the AMR Industry Alliance, generic and research-based pharmaceutical companies have agreed on a framework that promotes responsible antibiotic manufacturing. Antibiotics and their residues can be released (or discharged) into the environment when these drugs are made and can potentially contribute to the emergence and spread of resistance. AMR Industry Alliance companies took a further step by publishing the first list of discharge targets to guide environmental risk assessments for the manufacture of antibiotics.
Walmart U.S. is working with its animal protein suppliers to report antibiotic use throughout its supply chain and will conduct blockchain projects (a ledger of transactions) to improve responsible antibiotic use in farm animals, affecting its more than 5,000 stores and clubs nationwide.
NovaDigm Therapeutics is developing a vaccine for Candida auris, an emerging resistant fungal threat that has caused serious illness and death worldwide, to prevent infections.
CARB-X will invest $80 million globally by December 2019 to support more than 40 product developers as they pursue new drug classes to treat gram-negative bacteria, new diagnostics to identify new resistance and infections faster, and new treatment alternatives and vaccines. Each award agreement will include commitments to access and stewardship to ensure proper use of these live-saving innovations.
Aetna, whose healthcare network includes 1.2 million health care professionals and more than 5,700 hospitals, commits to partnering with state health departments to provide feedback to providers about their antibiotic prescribing performance and promote vaccinations.
Petco commits to not allowing prophylactic use of antibiotics in its supply chain and supporting veterinary oversight for access to antibiotics in its 1,500 locations across the U.S. and online channels.
Healthcare systems, which impact care at more than 20,000 healthcare facilities in the U.S. and abroad, are committed to reducing inappropriate antibiotic use—many between 20% and 45%—and hundreds have also committed to reducing infections.
Professional clinical societies, representing more than 283,000 providers across U.S. healthcare settings, are committed to improving antibiotic use among their members.
Patient representative organizations, representing individuals impacted by antibiotic resistance and sepsis, continue to provide education and awareness to patients and caregivers about this important threat.
APHL, ASTHO, and CSTE (see acronyms below) are working with state and local health departments to develop more than 50 tailored commitments that align with each state’s AR threats and goals.

“We are seeing resistance to life-saving antibiotics, and scientists worldwide are uncovering new types of resistance. Our shared commitment to confront this threat is critical to all American communities and companies, protecting our progress in healthcare outcomes, food production and even life expectancy,” said CDC Director Robert Redfield, in a prepared statement.

According to the CDC, the U.S. Government remains a global leader in the fight against antibiotic resistance. Earlier in September, the agency published The Core Elements of Human Antibiotic Stewardship Programs in Resource-Limited Settings: National and Hospital Levels to help improve antibiotic use in healthcare settings worldwide; and the FDA announced its plans to combat antibiotic resistance through antibiotic innovation and antibiotic stewardship in human medicine and animal agriculture. CARB-X, launched in 2016 by ASPR and NIH, continues its investments of more than $500 million by 2021 in research and development of new antibiotics, vaccines, rapid diagnostics, and other life-saving products.

Antibiotic resistance has been found in all regions of the world. In the U.S. alone, at least 2 million people get resistant infections each year and at least 23,000 die.

“Modern travel of people, animals, and goods means antibiotic resistance can easily spread across borders and continents. Antibiotic resistance in one country means antibiotic resistance in every country,” said Azar. “Fighting this threat requires a collaborative global approach across sectors to detect, prevent, and respond to these threats when they occur. Every country, regardless of resources, can take steps to slow antibiotic resistance.”

By Tuesday, commitments were made by the following 106 organizations:

AdvaMedDx
Aetna
American Academy of Orthopedic Surgeons
American Association of Avian Pathologists
American Cancer Society
American College of Physicians
American Hospital Association
American Society for Microbiology
American Society of Health-System Pharmacists
American Veterinary Medical Association
AMR Industry Alliance
Antibiotic Resistance Action Center
Ascension
Asolva, Inc.
Association for Professionals in Infection Control and Epidemiology (APIC)
Association of Public Health Laboratories (APHL)
Association of State and Territorial Health Officials (ASTHO)
Atrium Health
BD
Bill & Melinda Gates Foundation
bioMérieux
Biotia
Bugworks Research, Inc.
C Diff Foundation
CARB-X
CDC Foundation
Cepheid
Chicago Area Patient-Centered Outcomes Research Network
Chicago Prevention and Intervention Epicenter
Conduent
Council of State and Territorial Epidemiologists (CSTE)
CVS Health
Doctor on Demand, Inc.
Duke University and the Duke Center for Antimicrobial Stewardship and Infection Prevention
Ecolab, Inc.
Elanco
Emory Antibiotic Resistance Center
Emory University
Express Scripts
Global Health Alliance Melbourne
Global Health Technologies Coalition
GoHealth Urgent Care
Government of Finland
Government of India — Department of Biotechnology, Ministry of Science and Technology
Government of India — Indian Council of Medical Research, Ministry of Health and Family Welfare
Government of Japan
Government of Nigeria
Government of Pakistan
HCA Healthcare
Henry Ford Health System
HP, Inc.
Infectious Disease Society of America (IDSA)
Intermountain Healthcare
International Livestock Research Institute
Kaiser Permanente
Making a Difference in Infectious Diseases
Max Healthcare
Merck
Milken Institute
Mountaire Farms, Inc.
National Institute for Antimicrobial Resistance Research and Education
National Milk Producers Federation
National Pork Board
National Pork Producers Council
North American Meat Institute
Northwest Antimicrobial Resistance Coalition
NovaDigm
PATH
Pediatric Infectious Disease Society (PIDS)
Pet Industry Joint Advisory Council (PIJAC)
Petco
Pew Charitable Trusts
Premier, Inc.
Roche Diagnostics
Rush University Medical Center
Sackler Institute for Nutrition Science
SCYNEXIS, Inc.
Society for Healthcare Epidemiology of America (SHEA)
Society of Infectious Disease Pharmacists (SIDP)
The Children’s Hospital of Philadelphia (CHOP)
The Joint Commission
The Perelman School of Medicine of the University of Pennsylvania
Trinity Health
U.S. Agency for Healthcare Research and Quality (AHRQ)
U.S. Biomedical Advanced Research and Development Authority (BARDA)
U.S. Centers for Disease Control and Prevention (CDC)
U.S. Centers for Medicare and Medicaid Services (CMS)
U.S. Department of Agriculture (USDA)
U.S. Department of Defense (DoD)
U.S. Department of Health and Human Services Office of Global Affairs (HHS/OGA)
U.S. Department of State (DOS)
U.S. Department of Veterans Affairs (VA)
U.S. Food and Drug Administration (FDA)
U.S. National Institutes of Health (NIH)
U.S.-India Strategic Partnership Forum
United Nations Foundation
University of Illinois at Chicago
University of Illinois Hospital and Health Sciences System
University of Illinois, College of Medicine, Chicago
University of Iowa
University of Maryland
University of Utah
Urgent Care Association of America
Vermont Oxford Network
Walmart
Wellcome Trust

Read the commitments received to date at CDC.gov.

Reference

U.S. Challenges World to Intensify Global Fight Against Antibiotic Resistance [news release]. Atlanta, GA; September 25, 2018: CDC website. https://www.cdc.gov/media/releases/2018/p0925-global-antibiotic-resistance.html. Accessed September 25, 2018.