WHEN SOME of the best science minds in the United States say a problem has become “dire,” requires “urgent attention,” is growing at an “alarming rate” and has become “a crisis” that threatens medicine, economic growth, public health, agriculture and national security, it might be wise to listen. That is what President Obama’s outside science advisers told him Thursday about the rise of antibiotic resistance, the growing tendency of bacteria to overcome the antibiotics that are a bedrock of modern medicine.
The President’s Council of Advisors on Science and Technology provided thoughtful recommendations, some modest and others quite ambitious, in a long-awaited report on this issue. The advisers deserve credit for confronting a problem that results in 23,000 deaths and 2 million illnesses a year in the United States. Mr. Obama should embrace their conclusions and be prepared to do more in the five-year action plan due to be created between now and February.
Antimicrobial resistance has been low on the list of public health priorities for way too long. The science advisers say federal funding is now approximately $450 million a year, or $1.40 per American, and they rightly insist that it should be more. Mr. Obama signed an executive order creating two government structures, and the White House issued a “national strategy.” That’s a good start, but the harder decisions are to come. For example, the science advisers suggested creating a national network based on the latest genomics to track resistant pathogens. This could be enormously helpful in monitoring trends and preventing outbreaks, but building it will require hundreds of millions of dollars. Will the White House and Congress actually put their shoulders to the wheel and assemble the necessary resources?
It is also essential to deal with the dearth of new antibiotics. The pipeline has been running dry, largely for economic reasons — the return on investment is often insufficient for companies to justify the more than $1 billion needed to develop a drug, although some smaller biotechs are trying. The science advisers declare “there is no way to sustain a robust pipeline of antibiotic development without a major influx of private investment.” Where will it come from? They sketch out ambitious ideas for direct government funding and for incentives, but again, it will demand serious political effort by a president and Congress.
The use of antibiotics in animal agriculture remains a difficult issue. The farm lobby has resisted change for decades. The science advisers say that using antibiotics for livestock can generate resistant strains of bacteria that in some cases spread to humans. They call for “substantial changes” in farm practices but did not come up with ambitious ideas. They endorsed modest steps already announced by the Food and Drug Administration to limit antibiotic use to promote growth of farm animals as well as “additional measures to protect human health” if necessary.
The president and his science advisers have wisely focused attention on this long-neglected public health issue. Now they, and Congress, must act on it.