The White House released its National Action Plan for Combating Antibiotic-Resistant Bacteria on Friday, but some critics say it doesn’t do enough to tackle antibiotic use on farms. “Antibiotic resistance is one of the most pressing public health issues facing the world today. It causes tens of thousands of deaths and millions of illnesses every year — just in the United States alone,” said President Obama in a Q&A with WebMD, calling the new plan “comprehensive” and one that “addresses the problem from multiple angles at once.” The five-year plan was developed by an interagency task force established last September and co-chaired by the Secretaries of Defense, Agriculture, and Health and Human Services. It’s a “roadmap” for implementing the administration’s National Strategy on Combating Antibiotic-Resistant Bacteria and addresses the recommendations made in the President’s Council of Advisors on Science and Technology (PCAST) report on antibiotic resistance. Broadly, the plan has five goals: slow the emergence of resistant bacteria and prevent the spread of resistant infections, strengthen national One Health surveillance efforts, develop rapid diagnostic tests, accelerate the research and development of new antibiotics and other therapies, and improve international collaboration on prevention, surveillance, control and research. Some Animal Antibiotics Specifics Cattle_feed_406x250The plan supports FDA’s Guidance for Industry #213, which will ban the use of medically important antibiotics for growth promotion in food-producing animals, and the Veterinary Feed Directive, which ensures that the products can no longer be used without veterinary oversight. Within the year, FDA has been directed to publish an enhanced summary report of the antibiotics sold or distributed for use in food-producing animals from 2009 to 2013 as a baseline against which to measure the effectiveness of Guidance #213. The agency also has to begin publishing periodic updates summarizing progress in adoption of the policy. A five-year goal set for FDA, USDA and the animal agricultural industry is to analyze antibiotic use data and evaluate the impact of Guidance #213. Another goal for FDA and USDA is to develop and implement a plan to increase monitoring of antibiotic-resistance patterns, as well as antibiotic sales, usage, and management practices, at multiple points in the production chain for food animals and retail meat. Within three years, CDC has been directed to halve the time required to detect and characterize drug-resistant enteric pathogens through NARMS surveillance and reduce how long it takes to report susceptibility testing. The action plan also calls on CDC to increase susceptibility testing on Campylobacter isolates. The plan advocates research into emerging zoonotic antibiotic-resistant pathogens on the farm and at slaughter, alternatives to antibiotics used for promoting growth in animals, the association between antibiotic-resistant urinary tract infections and foodborne bacteria, and genes that confer resistance to facilitate genetic selection for animals with less susceptibility to infections whose treatments typically require significant use of antibiotics. What Antibiotic Preservation Advocates Say While the primary focus of the plan is human medicine, some critics say it doesn’t do enough in terms of animal antibiotic use. “More than ever before, the White House is acknowledging the dangerous public health threat posed by the misuse of antibiotics in both human medicine and the livestock industry,” said Mae Wu, health attorney at the Natural Resources Defense Council. “But the Obama administration needs to do more to reduce antibiotic use in animals that are not sick.” Rep. Louise Slaughter (D-NY), who reintroduced the Preservation of Antibiotics for Medical Treatment Act (PAMTA) earlier in the week, said the plan had “fallen woefully short of taking meaningful action.” “With 80 percent of the antibiotics produced in the United States being used in agriculture mostly for prevention, any meaningful solution to the looming antibiotic resistance crisis must begin with limits on the farm,” Slaughter said. Steven Roach, senior analyst for Keep Antibiotics Working, said that the administration had “missed an opportunity” with regard to gaps in FDA’s Guidance #213 and Veterinary Feed Directive. “Drug makers regularly exploit this loophole by advertising the growth benefits that can result from using antibiotics for disease prevention, and FDA has failed to crack down on this practice,” Roach said. Keep Antibiotics Working believes Slaughter’s legislation would be more effective at cutting down antibiotic use on farms than FDA’s policies. PAMTA would ban all non-therapeutic uses of medically important antibiotics in food animal production. At a PCAST meeting Friday, Council Co-Chair Dr. Eric Lander said that using antibiotics to support animal health can have “fuzzy” boundaries. “One of the issues we had on the PCAST study was the feeling that there just was not the kind of data that we needed to know how much of the resistance that arises on farms comes into the human health care system.” When asked about failures to set targets for reductions in animal antibiotic use, an administration official said the action plan calls for better data regarding when and where antibiotics are fed to animals before deciding whether or not to impose further restrictions. “While we’re pleased with the action plan’s continued emphasis on tracking antibiotic use in human medicine, we urge the administration to make even greater progress in reducing the use of antibiotics,” said Allan Coukell, senior director for health programs at The Pew Charitable Trusts. “This administration has taken important first steps towards phasing out the use of antibiotics to promote growth in livestock,” he added. “We call now for a clear plan to review the safety of antibiotic use for disease prevention in food animals and establish systems to provide better and faster collection of data about antibiotic sales and use.”