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E-M:/ Dingell, Kildee cosponsor antibiotic resistance bill



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Enviro-Mich message from "Alex J. Sagady & Associates" <ajs@sagady.com>
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From: "Kendra Kimbirauskas" <kendra.kimbirauskas@sierraclub.org>
To: "Ed Hopkins" <ed.hopkins@sierraclub.org>,
    "Dean Rebuffoni" <crebuff@aol.com>, "Alex Sagady" <ajs@sagady.com>,
    "Jon Rosenblatt" <rosenblatt.jon@mayo.edu>
Subject: FW: H.R.1771.IH, Antibiotic Resistance Prevention Act of 2001
Date: Wed, 22 May 2002 10:30:31 -0500
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Antibiotic Resistance Prevention Act of 2001 (Introduced in
House)[H.R.1771.IH]

Antibiotic Resistance Prevention Act of 2001 (Introduced in House)

HR 1771 IH
107th CONGRESS
1st Session
To provide for funding for the top priority action items in the interagency
public health action plan that has been developed in response to the problem
of antimicrobial resistance, to the extent that the activities involved are
within the jurisdiction of the Department of Health and Human Services.


IN THE HOUSE OF REPRESENTATIVES

May 9, 2001
Mr. BROWN of Ohio (for himself, Mr. Bilirakis, Mr. Dingell, Mr. Waxman, Mr.
Ganske, Mr. Towns, Ms. Slaughter, Mr. Pallone, Ms. DeGette, Mr. Green of
Texas, Mr. Sawyer, Mr. Filner, Ms. Lee, Mrs. Jones of Ohio, Mr. Kildee, Mr.
Hinchey, Mr. Capuano, Mr. Kucinich, Mr. Tierney, and Mr. DeFazio) introduced
the following bill; which was referred to the Committee on Energy and
Commerce


------
A BILL
To provide for funding for the top priority action items in the interagency
public health action plan that has been developed in response to the problem
of antimicrobial resistance, to the extent that the activities involved are
within the jurisdiction of the Department of Health and Human Services.


Be it enacted by the Senate and House of Representatives of the United States
of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Antibiotic Resistance Prevention Act of 2001'.

SEC. 2. FINDINGS.

The Congress finds as follows:

(1) The discovery in the 1940s of antimicrobial drugs, such as penicillin and
streptomycin, led to ground breaking treatment of day-to-day illnesses and
fatal diseases.

(2) Drug-resistant pathogens have developed because many physicians and other
health professionals have historically overprescribed antimicrobial drugs.

(3) Antimicrobial resistance can be spurred by patients seeking antibiotics
for viruses rather than bacterial infections. Antibiotics are effective only
for bacterial infections, not viral infections.

(4) Patients who fail to finish their prescribed doses of antibiotics leave
themselves vulnerable to certain bacteria, strengthening antibiotic
resistance.

(5) Microbes that have increasingly built up resistance to antibiotics
include the microbes involved in pneumonia; ear infections and meningitis;
skin, bone, lung, and bloodstream infections; urinary tract infections; food
borne infections; and infections transmitted in health care settings.

(6) Many other pathogens are also becoming resistant to conventional
treatments, including the bacteria that cause tuberculosis and gonorrhea; the
fungi that cause yeast infections; and the parasites that cause malaria.

(7) A substantial but as yet undetermined percentage of all antibiotics
produced in the United States are used in animals, with estimates ranging
from 40 to 80 percent. A substantial percentage of these antibiotics are used
nontherapeutically in feed or in the water of farm animals to make them grow
faster, while only about 20 percent of antibiotic feed additives are used to
treat established infections.

(8) This usage of antibiotics in farm animals, at levels too low to cure
bacterial diseases but high enough to control them, is creating selective
pressure on bacteria, causing them to develop resistance to the antibiotics.

(9) Antibiotic resistant bacteria selected in animals can reach humans and
pass their resistance to bacteria pathogenic to humans or, if pathogenic
themselves, can cause disease that is not easily treatable, prolonging
recovery.

(10) Statistics have shown that antibiotic resistance can cause the total
costs of inpatient care to be more than double the direct costs of such care.

(11) Expenses incurred by hospitals around the Nation have risen to nearly
$1.3 billion per year as a result of six ordinary types of resistant bacteria.

(12) The Institute of Medicine, the American Society for Microbiology, the
World Health Organization, the Congressional Office of Technology Assessment,
and the General Accounting Office each have found that the Nation should
improve surveillance for mounting antimicrobial resistance problems; prolong
the useful life of antimicrobial drugs; develop new drugs; and utilize other
measures, such as improved vaccines, diagnostics, and infection control
measures, to prevent and control antimicrobial resistance.

SEC. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES; FUNDING FOR TOP PRIORITY
ACTION ITEMS UNDER PUBLIC HEALTH ACTION PLAN TO COMBAT ANTIMICROBIAL
RESISTANCE.

(a) IN GENERAL- For the purpose of carrying out the top priority action items
designated in the Antimicrobial Resistance Action Plan, but only to the
extent that the activities involved are within the jurisdiction of the
Department of Health and Human Services (as determined under Federal laws
other than this Act), there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2002 through 2006. Such
authorization is in addition to other authorizations of appropriations that
are available for such purpose.

(b) TOP PRIORITY ACTION ITEMS- For purposes of this Act, the term `top
priority action items' are action items designated by number in the
Antimicrobial Resistance Action Plan and included (by reference to such
numbers and to the categories used in such Plan) in the following list:

(1) In the category `Surveillance', the following action items:

(A) Action Item #2, described in the Plan as follows: `With partners, design
and implement a national AR surveillance plan that defines national,
regional, state, and local surveillance activities and the roles of clinical,
reference, public health, and veterinary laboratories. The plan should be
consistent with local and national surveillance methodology and
infrastructure that currently exist or are being developed.'.

(B) Action Item #5, described in the Plan as follows: `Develop and implement
procedures for monitoring patterns of antimicrobial drug use in human
medicine, agriculture, veterinary medicine, and consumer products.'.

(2) In the category `Prevention and Control', the following action items:

(A) Action Item #25, described in the Plan as follows: `Conduct a public
health education campaign to promote appropriate antimicrobial use as a
national health priority.'.

(B) Action Item #26, described in the Plan as follows: `In collaboration with
many partners, develop and facilitate the implementation of educational and
behavioral interventions that will assist clinicians in appropriate
antimicrobial prescribing.'.

(C) Action Item #39, described in the Plan as follows: `Evaluate the
effectiveness (including cost-effectiveness) of current and novel
infection-control practices for health care and extended care settings and in
the community. Promote adherence to practices proven to be effective.'.

(D) Action Item #58, described in the Plan as follows: `In consultation with
stakeholders, refine and implement the proposed FDA framework for approving
new antimicrobial drugs for use in food-animal production and, when
appropriate, for re-evaluating currently approved veterinary antimicrobial
drugs.'.

(E) Action Item #63, described in the Plan as follows: `Support demonstration
projects to evaluate comprehensive strategies that use multiple interventions
to promote appropriate drug use and reduce infection rates, in order to
assess how interventions found effective in research studies can be applied
routinely and most cost-effectively on a large scale.'.

(3) In the category `Research', the following action items:

(A) Action Item #70, described in the Plan as follows: `Provide the research
community genomics and other powerful technologies to identify targets in
critical areas for the development of new rapid diagnostics methodologies,
novel therapeutics, and interventions to prevent
the emergence and spread of resistant pathogens.'.


(B) Action Item #75, described in the Plan as follows: `In consultation with
academia and the private sector, identify and conduct human clinical studies
addressing AR issues of public health significance that are unlikely to be
studied in the private sector (e.g., novel therapies, new treatment regimens,
and other products and practices).'.

(C) Action Item #76, described in the Plan as follows: `Identify, develop,
test, and evaluate new rapid diagnostic methods for human and veterinary uses
with partners, including academia and the private sector. Such methods should
be accurate, affordable, and easily implemented in routine clinical settings
(e.g., tests for resistance genes, point-of-care diagnostics for patients
with respiratory infections and syndromes, and diagnostics for drug
resistance in microbial pathogens, including in nonculture specimens).'.

(D) Action Item #77, described in the Plan as follows: `Encourage basic and
clinical research in support of the development and appropriate use of
vaccines in human and veterinary medicine in partnership with academia and
the private sector.'.

(4) In the category `Product Development', the following action items:

(A) Action Item #79, described in the Plan as follows: `Create an Interagency
AR Product Development Working Group to identify and publicize priority
public health needs in human and animal medicine for new AR products (e.g.,
innovative drugs, targeted spectrum antibiotics, point-of-care diagnostics,
vaccines and other biologics, anti-infective medical devices, and
disinfectants).'.

(B) Action Item #80, described in the Plan as follows: `Identify ways (e.g.
financial and/or other incentives or investments) to promote the development
and/or appropriate use of priority AR products, such as novel compounds and
approaches, for human and veterinary medicine for which market incentives are
inadequate.'.

The 13 action items specified in this subsection all have top priority under
the Plan, regardless of their order on the list.

(c) ANTIMICROBIAL RESISTANCE ACTION PLAN- For purposes of this Act, the term
`Antimicrobial Resistance Action Plan' means the plan that--

(1) is entitled `A Public Health Action Plan to Combat Antimicrobial
Resistance'; and

(2) was developed by an interagency Task Force on Antimicrobial Resistance,
created in 1999, that--

(A) is cochaired by the Centers for Disease Control and Prevention, the Food
and Drug Administration, and the National Institutes of Health; and

(B) in addition includes--

(i) the Agency for Healthcare Research and Quality and the Health Resources
and Services Administration;

(ii) the Health Care Financing Administration;

(iii) the Environmental Protection Agency; and

(iv) the Department of Agriculture, the Department of Defense, and the
Department of Veterans Affairs.

(d) AR- For purposes of this Act, the term `AR' means antimicrobial
resistance.


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