The U.S. Federal Government's Response to AMR

The U.S. federal government is committed to combating antimicrobial resistance. Federal efforts to address resistant infections go back decades, but a coordinated response across agencies began in 2013 after the Centers for Disease Control and Prevention (CDC) released their first Antibiotic Resistance Threats Report | CDC. In 2014, the President signed an executive order that brought all federal efforts to combat antibiotic resistance together. This executive order established the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), the PACCARB, and formally established the Federal Interagency CARB Task Force to coordinate all federal efforts. The CARB Task Force develops, implements, and updates the CARB National Action Plan - PDF. The PACCARB and the CARB Task Force work and collaborate closely on all PACCARB tasks.

The PACCARB's Structure and Function

The PACCARB is a federal advisory council that provides advice, information, and recommendations on all things related to AMR to the Secretary of Health and Human Services (HHS) in close consultation with the Departments of Agriculture (USDA) and Defense (DoD). Federal advisory councils are a way for the federal government to use the knowledge of non-federal subject matter experts to help support and inform federal policies and actions in an open and public forum. The PACCARB, like all federal advisory councils, is subject to the rules listed under Federal Advisory Committee Act; legislation which sets standards for the formation and use of federal advisory councils. A full explanation of the roles, responsibilities, and structure can be found on the Charter page.

Both the PACCARB and the U.S. Government’s response to AMR take a One Health approach. One Health is a framework that recognizes that the health of people, animals, plants, and the environment are all connected. AMR plays a role in each of these fields, so it’s important to address AMR across them all. PACCARB has at least 30 members that have expertise in the health of people, animals, plants, and the environment. Currently, the council has 15 voting members. Voting members are non-federal subject matter experts (e.g., academicians, infectious disease doctors, veterinarians, public health specialists, etc.) that represent their own knowledge and views on combating AMR. These members are considered special government employees and are subject to federal ethics laws. The council also has eight liaison representative members that represent the perspective of larger organizations or associations (e.g., pharmaceutical companies, medical/veterinarian associations, etc.) as well as representation from 12 federal agencies (e.g., CDC, NIH, USDA, EPA, etc.). The federal agencies represented on the PACCARB are also members of the CARB Task Force. The liaison and federal agencies represented do not vote on council products such as the recommendation reports published by the PACCARB. The council is led by a Chair and Vice Chair that are designated by the Secretary of HHS from among the voting members. The PACCARB is supported by a Designated Federal Official and other staff members within HHS. A full roster of active members can be found on the Membership page.

PACCARB can form Working Groups (WGs) to assist in its functions. The formation of these WGs is based on tasks given by the Secretary of HHS or priorities set by the PACCARB Chairs. Once a WG completes its assigned task, it generates a report containing recommendations which is then presented to the entire PACCARB during a public meeting for discussion and vote. Upon approval through a majority vote, the final recommendation report is transmitted to the Secretary of HHS for consideration and is made publicly available online on the Reports and Recommendations page.

How PACCARB’s Recommendations are Used

The PACCARB's recommendations are used across the U.S. federal government, and they are also an important resource for scientific associations, academia, and government organizations who are working to combat AMR. PACCARB’s recommendations have been used to:

• Inform federal actions. The PACCARB provides advice, information, and recommendations to the Secretary of HHS and assists the CARB task force.

• Advise strategy. The PACCARB recommendations also identify changes or additions that could be made to help to combat AMR. These recommendations are used to advocate for change at the local, state, and federal levels.

• Enable the public. The PACCARB recommendations are publicly available and can be used to by members of the public to raise awareness of the issue of AMR and empower people to make their own choices about their health.

• Direct research. The PACCARB recommendations identify research gaps and priorities to help prevent or combat the rise of AMR. Scientific associations, professional organizations, and/or academics can use these priorities to guide their research and to help to ensure that their work is relevant to the needs of the public health community.

Image

PACCARB Public Meetings

Public meetings are an important part of the council's work. The purpose of these meetings is to discuss a range of AMR topics across the One Health spectrum with experts from the AMR community, both domestically and globally, in an open and transparent setting. The PACCARB holds public meetings two to three times a year. These public meetings are an opportunity to:

• Hear from a wide range of experts on issues related to antibiotic resistance.

• Provide the public with an opportunity to learn about the council's work and findings.

• Solicit public input on the council's plans and priorities.

• Network with federal and non-federal subject matter experts interested in fighting AMR.

Additional information on past and upcoming meetings can be found on the Meetings page. Further information about the council, reports, public meetings, and the U.S. federal response to AMR can be found on the FAQs page.