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Remarks to Foreign Ambassadors on Anti-Microbial Resistance

Eric D. Hargan
Foreign Ambassadors
April 16, 2019
Washington, D.C.

No country or community is immune from the threat of AMR. While the exact disease burden varies, high levels of resistance have been found across sectors—human health, animal health, and the environment—and in every region of the world. Because of the huge risk this poses to the global community, AMR is a priority for the U.S. Department of Health and Human Services—and for the entire U.S. government.

As Prepared for Delivery

Thank you for that introduction, Garrett [Grigsby], and thank you all for joining us here today.

I would like to extend my personal welcome, that of Secretary Azar, and that of the entire United States Government, to everyone who's joined us for this briefing. I would particularly like to thank the ambassadors and charges d'affaires who've joined us here today.

I'd also like to thank the representatives from across the U.S. government for contributing to this event, including representation from the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration, the Department of State, and the Department of Agriculture.

I know Secretary Azar wished he could be here today, because he cares deeply about this topic as well, and has been involved in this fight since we began work together at HHS in the 2000s.

We've here to bring attention to one of the gravest dangers to human and animal health, economic well-being, and ultimately, national security, that faces our world today: antimicrobial resistance or AMR.

AMR has been a naturally occurring challenge since the introduction of antibiotics, but misuse of antibiotics in humans and animals is accelerating the process.

A growing number of infections—from pneumonia and tuberculosis to gonorrhea and salmonella—are becoming harder, and sometimes impossible, to treat because antibiotics are becoming less effective.

Because of the huge risk this poses to the global community, AMR is a priority for the U.S. Department of Health and Human Services—and for the entire U.S. government.

No country or community is immune from the threat of AMR.  While the exact disease burden varies, high levels of resistance have been found across sectors—human health, animal health, and the environment—and in every region of the world.  In the United States, antibiotic-resistant bacteria and fungi leave at least 2 million people ill every year, and 23,000 people die as a result.

Under our first National Action Plan for Combating Antibiotic-Resistant Bacteria, the United States has made significant progress over the past four years. Investments in research and development, surveillance, and infection prevention and control are paying off.

In human healthcare, for example, we've made great strides in improving antibiotic prescribing for some of our most vulnerable patients. Antibiotics are powerful tools but any antibiotic use contributes to AMR. Because of CDC's efforts, working with the Centers for Medicare & Medicaid Services and others, we've seen an increased number of hospitals with antibiotic stewardship programs.

We have also seen a 13 percent reduction in prescribing to children, thought to be due in part to CDC's campaign to educate parents of young children and pediatric clinicians about the importance of appropriate antibiotic use.

Increased use of vaccines, which prevent infections in the first place, have also helped drive down antibiotic use.

We've seen this in the animal arena, too. From 2016 to 2017, for instance, the U.S. Food and Drug Administration's survey of antibiotics for use in food-producing animals saw a 33 percent drop in their sales and distribution. That is part of a 45 percent decline since 2015, which means we actually saw progress accelerate.

We are also working with partners to improve antibiotic use and accelerate the development of new drugs, diagnostics, and vaccines, and ensuring access to these innovations worldwide. All of this is part of our multi-sectoral, "One Health" approach to AMR.

But we can't beat this threat by ourselves at HHS, or within the walls of any government.

We need bold, coordinated global action to slow the emergence of new drug resistant microorganisms, prevent the spread of existing drug resistant bacteria, and stimulate and accelerate  development of new antimicrobial products.

Just as AMR threatens every country and every sector, regardless of resources, every country and every sector can take steps to limit its spread.

That's why, at last fall's U.N. General Assembly, Secretary Azar and Dr. Redfield launched the AMR Challenge, a year-long global call to action.

This challenge invites stakeholders around the world to think creatively about how they can contribute to countering AMR, both locally and globally, and encourages public commitments to action.

The AMR Challenge has now generated nearly 200 commitments.

A number of countries, including the governments of Japan, Netherlands, Singapore, Australia, Nigeria, Peru, Sweden, Finland, Canada, Pakistan, and the India Department of Biotechnology and the Indian Council of Medical Research, have joined with the U.S.

I want to highlight a few particular actions already taken by diverse actors.

The Nigeria Centre for Disease Control has committed to develop and scale Nigeria's new national surveillance system for AMR to inform evidence-based policy and practices and to develop and distribute a national toolkit for antimicrobial stewardship in healthcare institutions, among other measures.

McDonald's Corporation committed to partnering with suppliers and producers on the responsible use of antibiotics in food animals in its supply chain, including a policy for chicken not just in the U.S., but around the world, which is a significant step, and a newly launched antibiotic-use policy for beef, which is a more complex area for addressing antibiotic use and an almost unprecedented step for such a large firm.

The First Arabian Drug Information Centre, a professional healthcare organization in the Middle East, committed to providing certification in antimicrobial stewardship training programs for pharmacists, physicians, nurses, and other healthcare professionals.

As you can see, the commitments are as diverse as the organizations making them. The strength of the AMR Challenge lies in this diversity, building momentum across sectors and around the world to combat this global threat.

This afternoon, my colleagues from HHS and across the U.S. Government will highlight some of the major actions we have taken to combat AMR both domestically and with partners around the world.

We hope today's event will encourage you to reflect on your own country's efforts and accomplishments in this area and think boldly about what you can do to join this global effort.

Secretary Azar and I want to encourage you to consider three actions in particular:

One, bring the AMR Challengeto your own country and encourage ministries and local governments, non-governmental organizations, academia, and industry partners to join in.

Second, develop and implement an AMR national action plan if you have not already done so. These plans are invaluable tools in taking stock of your country's specific needs and available resources.

In the United States, we have found our national action plan to be a powerful mechanism for ensuring a coordinated and efficient response to AMR.

Third, commit or re-commit to partnering with one another as nations. Only through coordinated global action, with each nation playing its own part, can we effectively combat AMR.

Each of our countries and all sectors have a role to play in protecting people, animals, and the environment from AMR.  If your government or organization has yet to join the AMR Challenge, we urge you to consider what kind of commitment you could make.

At this fall's U.N. General Assembly, we look forward to joining all of you in celebrating new commitments made this year and further progress made together to combat AMR.

Thank you for joining us in this fight, and I wish you a productive rest of the day here at HHS.

Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on April 25, 2019