[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1771 Introduced in House (IH)]







107th CONGRESS
  1st Session
                                H. R. 1771

    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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