[Congressional Record Volume 153, Number 145 (Thursday, September 27, 2007)]
[Extensions of Remarks]
[Pages E2006-E2007]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       STRATEGIES TO ADDRESS ANTIMICROBIAL RESISTANCE (STAAR) ACT

                                 ______
                                 

                           HON. JIM MATHESON

                                of utah

                    in the house of representatives

                      Thursday, September 27, 2007

  Mr. MATHESON. Madam Speaker, I rise to introduce the ``Strategies to 
Address Antimicrobial Resistance (STAAR) Act,'' which I believe has the 
potential to save many thousands of lives by strengthening the United 
States' response to infectious pathogens that are becoming increasingly 
resistant to existing antibiotics. I am proud to introduce this 
legislation with my colleague, Rep. Mike Ferguson, as a concrete step 
towards addressing antibiotic resistance.
  Media reports about the threat of resistant infections now occur on 
almost a daily basis. Earlier this year, media attention regarding 
extensively-drug resistant tuberculosis (XDR-TB) made this topic common 
conversation in our homes and offices. Suddenly we were forced to think 
about how quickly an infection can spread, especially in the age of 
international air travel, and the disastrous result if the cause was a 
strain of bacteria that failed to respond to our current antibiotics.
  Another resistant infection drastically on the rise is community-
acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). 
Historically, this infection was acquired during a hospital stay, but 
now is affecting young, healthy people and spreading in our 
communities. We've heard stories of high school, college and 
professional athletes losing their lives or careers as a result of 
these infections. Sadly, this infection has become far too common, 
difficult to treat and has few options to fight it. It can leave 
individuals disfigured, if they survive. In my own state of Utah, the 
number of children with MRSA infections at the Primary Children's 
Medical Center in Salt Lake City has increased by almost 20 fold since 
1989.
  There are still more infections to worry about. We have numerous 
reports of our soldiers coming home from Iraq with Acinetobactor--a 
resistant infection that is especially difficult to treat and the only 
option is a very toxic antibiotic.
  Other examples of concern include vancomycin-resistant Staphylococcus 
aureus (VRSA), an alarming development because vancomycin is the drug 
of last resort for treating several serious infections, and Escherichia 
coli (E. coli), which has caused outbreaks due to contamination of 
spinach, peanut butter, and other foods we regularly consume.
  We have taken antibiotic development for granted. Few of us remember 
medicine before the discovery of antibiotics. Antibiotics have allowed 
many medical advances, including routine invasive surgeries, organ 
transplants, and other procedures that otherwise would be impossible 
due to resulting infections. But we are falling behind in our ability 
to protect ourselves against infections, and we have a lot of catching 
up to do.
  In addition, there are problems of significant and inappropriate use 
of antibiotics; a lack of adequate research to address the many facets 
of resistance, including basic, clinical, interventional, and 
epidemiologic research as well as research to support the development 
of new diagnostics, biologics, devices and, of course, antibiotics; a 
fractured and underfunded resistance surveillance system; and 
insufficient coordination of the federal response, which is critically 
needed as the solutions to addressing antibiotic resistance involve 
multiple agencies and departments.
  I am not the first person in the United States Congress to take on 
this issue. I feel certain, however, that the STAAR Act is the most 
comprehensive legislation introduced to date to address this serious 
and life-threatening patient safety and public health problem. There is 
no doubt that we must act now to begin to reverse the alarming trend, 
and infectious disease experts tell me that the multi-pronged approach 
contained in the STAAR Act provides our best chance to address the 
multiple problems that face us.
  I commend my many colleagues who have demonstrated leadership on this 
issue over the years, especially Chairman Dingell. He recognized this 
issue nearly 15 years ago and asked the Congressional Office of 
Technology Assessment (OTA) to examine the problem of antimicrobial 
resistance. In 1995, OTA reported to Congress that ``The impacts of 
antibiotic-resistant bacteria can be reduced by preserving the 
effectiveness of current antibiotics through infection control, 
vaccination and prudent use of antibiotics, and by developing new 
antibiotics specifically to treat infections caused by antibiotic 
resistant bacteria.''
  Also, I would like to recognize the leadership of my colleague from 
Michigan, Mr. Stupak. In the 106th Congress, he and our former 
colleague, Mr. Burr, introduced the ``Public Health Threats and 
Emergencies Act.'' Parts of this bill became law and provide the basis 
of the legislation I introduce today. Specifically, that bill, which is 
expressed in Section 319E, ``Combating Antimicrobial Resistance'' of 
the Public Health Service Act, directed the Secretary to establish an 
Antimicrobial Resistance Task Force to coordinate Federal programs 
relating to antimicrobial resistance. Also, the bill required research 
and development of new antimicrobial drugs and diagnostics; educational 
programs for medical and health personnel in the use of antibiotics; 
and grants to establish demonstration programs promoting the judicious 
use of antimicrobial drugs and the detection and control of the spread 
of antimicrobial-resistant pathogens. Authorization for these programs 
expired September 30, 2006. The STAAR Act reauthorizes these programs 
and builds on the Federal efforts that have been highlighted in the 
Public Health Service Action Plan to Combat Antimicrobial Resistance, 
published in 2001 by the Task Force.
  The Action Plan identified thirteen key elements (out of 84 elements) 
as top priority action items that are critically necessary to address 
the growing resistance crisis. Only months after the release of the 
Action Plan, our former colleague Mr. Brown and many of my colleagues 
on the Energy and Commerce Committee, including Chairmen Dingell and 
Pallone, and Mr. Waxman, Mr. Towns, Mr. Green, and Ms. DeGette, 
introduced the ``Antibiotic Resistance Prevention Act of 2001.''

[[Page E2007]]

This legislation sought to provide additional funding specifically for 
the top priority action items in the Action Plan. My colleagues 
recognized the urgency of this situation and explained that ``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.''

  Although Congress has taken steps in the past to address the problem, 
antimicrobial resistance continues to grow. In 2004, the Infectious 
Diseases Society of America (IDSA) published, ``Bad Bugs, No Drugs: As 
Antibiotic Discovery Stagnates a Public Health Crisis Brews'' to 
highlight the lack of research and development for new antibiotics. 
Antibiotics are not profitable compared to those that treat chronic 
(long-term) conditions and lifestyle issues. In addition, when a new 
antibiotic comes on the market, it is discouraged from use to avoid the 
development of resistance. Also, antibiotics are taken for short 
periods of time--unlike those for chronic disease which may be taken 
daily.
  Earlier this year, Mr. Baird, Ms. Cubin and I introduced legislation 
to provide tax credits and other incentives for antibiotic research and 
development, as well as to encourage that antibiotics, vaccines, and 
diagnostics become more commonly manufactured in the United States.
  Last week, Congress sent the FDA Amendments Act to the President for 
signature. This legislation included antibiotic provisions I supported 
and offered as an amendment during committee consideration. 
Specifically, the FDA Amendments Act promotes education regarding what 
incentives may be available through the Orphan Drug program for 
antibiotics and improves information laboratories and clinicians have 
about antibiotic resistance.
  The ``Strategies to Address Antimicrobial Resistance (STAAR) Act'' 
compliments these past legislative efforts. The STAAR Act is 
comprehensive legislation that advances the thirteen key elements 
identified in the Action Plan and authorizes adequate funding for these 
strategies.
  My bill strengthens existing efforts by establishing an Office of 
Antimicrobial Resistance (OAR) within the HHS Office of the Assistant 
Secretary of Health. The Director of OAR would serve as the director of 
the existing interagency task force. Also, to encourage input from 
experts outside the federal government, my bill would establish a 
Public Health Antimicrobial Advisory Board (PHAAB) to provide much 
needed advice about antimicrobial resistance and strategies to address 
it. The STAAR Act will strengthen existing surveillance, data 
collection, and research activities as a means to reduce the 
inappropriate use of antimicrobials, develop and test new interventions 
to limit the spread of resistant organisms, and create new tools to 
detect, prevent and treat these ``bad bugs'' for which there are no 
drugs. Infectious diseases experts, including the IDSA, have said it 
strongly supports this multi-faceted, strategic approach.
  I appreciate the interest and leadership many of my colleagues have 
demonstrated on this issue in the past. This legislation has been a 
long time coming. I appreciate the effort of my colleague, Mr. 
Ferguson, who joins me to introduce this bipartisan legislation. 
Finally, I urge my colleagues to work with me to give our federal 
agencies the tools they need to ensure that combating antimicrobial 
resistance becomes a priority.

                          ____________________