The discovery last month of colistin-resistant bacteria
infecting a woman in Pennsylvania was disheartening and brought us one step
closer to an eventuality that members of our field have been concerned about
for many years: the day we have nothing left in our arsenal to fight
For a long time now, IDSA has mobilized key leaders and
resources around this cause. Through legislative, regulatory, advocacy, and
public awareness efforts, we have brought together like-minded organizations
and agencies to join in the fight against antimicrobial resistance. Here’s a
brief look back (with an eye toward the future):
antimicrobial resistance was an area of focus for the Society from its
inception, it is officially identified as a strategic priority.
2004: The Society
issues its landmark report, “Bad Bugs, No Drugs,” calling attention to a
frightening twist in the antibiotic resistance problem that—until that time—had
not received adequate attention from federal policymakers: The pharmaceutical
pipeline for new antibiotics was drying up.
2006: Thanks in
part to IDSA’s efforts, the Biomedical Advanced Research and Development
Authority (BARDA) is established and serves as the focal point within the Department
of Health and Human Services to provide an integrated, systematic approach to
the development of vaccines, drugs, therapies, and diagnostics for public
health emergencies—including antimicrobial resistance.
launches the 10 x ’20 Initiative, “Bad Bugs Need Drugs,” an advocacy campaign
focused on one specific goal: to create an antibacterial research and
development enterprise powerful enough to produce 10 new antibiotics by
2011: The Society
issues “Combating Antimicrobial Resistance: Policy Recommendations to Save
Lives” to spur federal action on a range of issues, including antibiotic
research and development, stewardship, surveillance, and data collection.
Generating Antibiotic Incentives Now (GAIN) Act is signed into law, providing
incentives for drug development by extending the period of exclusivity for
certain new antibiotics.
convenes the Stakeholder Forum on Antimicrobial Resistance (S-FAR), a group of
85 like-minded organizations committed to advancing policies to address
2015: President Obama
issues the National Action Plan, which includes key IDSA priorities and
benchmarks to assess progress, and establishes the Presidential Advisory
Council, on which several IDSA leaders serve.
Limited Population Antibacterial Drugs (LPAD) bill passes the full House of
Representatives and the Senate Health Committee. The bill would allow
antibiotics for the most deadly and highly resistant infections to be studied
in smaller clinical trials and approved only for the limited populations of patients
who most need them.
antibiotic and diagnostics tax credit bill (the Reinvigorating Antibiotic and
Diagnostic Innovation [READI] Act) continues to gain bipartisan support. The
bill would provide a much needed economic incentive for the most urgently
needed new antibiotics and rapid diagnostic tests, which are crucial for
guiding appropriate antibiotic use.
successfully leads advocacy for significant funding increases for antimicrobial
resistance activities at the Centers for Disease Control and Prevention, the
National Institute for Allergy and Infectious Diseases, BARDA and other
As of today, six of our 10 x ’20 new drugs have been approved, S-FAR
now boasts over 110 partner organizations, and IDSA continues to push forward
on LPAD, tax credits and other efforts.
But that’s not the whole story. As ID doctors, we know that
developing new drugs is but one aspect of fighting resistance. Of equal
importance is protecting the drugs that we do have in our arsenal, and the key
to that is antimicrobial stewardship.
The recent proposals by the Centers for Medicare and
Medicaid Services to require antimicrobial stewardship programs (ASPs) as a
Condition of Participation for acute care and critical access hospitals and
long-term care facilities are major steps forward. IDSA has long been
advocating that ASPs be required and has promoted that they be the standard of
care for all health care facilities. We
are at a critical juncture at which we as experts in infectious diseases, with
our unique understanding of prescribing the right drug, at the right time for
the appropriate duration, need to take a leadership role in stewardship. IDSA
has a variety of resources
to prepare you for this role.
These are all achievements to be celebrated, but, as the
recent colistin-resistant case painfully illustrates, our work is not done and
we must not slow down. The pipeline of new antibiotics is still fragile and
woefully few pharmaceutical companies are engaged in research and development of
these desperately needed new drugs. With the active engagement of our
membership, we will continue to advocate for legislative solutions and for the
critical role of the ID physician in stewardship. Now more than ever is the
time to be a vocal advocate for the field of infectious diseases.
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