Q&A with NCEZID’s Khabbaz: Health threat of antibiotic resistance urgent: New challenge calls on world to take action
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* Julia Haskins

Public health needs new partners to help address the growing problem of antibiotic resistance, and now is the time for them to come together and act, according to the Centers for Disease Control and Prevention.

Under a new challenge released in September, CDC is calling on governments, businesses and other organizations around the world to commit to taking action against antibiotic resistance, which is one of the world’s most urgent threats to health. In the U.S. alone, at least 2 million people annually get an infection that is resistant to antibiotics, leading to 23,000 deaths, according to CDC.

At the time of the challenge’s release during the U.N. General Assembly meeting Sept. 25, more than 100 organizations had made a pledge in the Antimicrobial Resistance Challenge, including pharmaceutical companies, health organizations and national governments, such as Finland, India and Japan. Participants are encouraged to take action in one or more of five areas: tracking and data, infection prevention and control, antibiotic use, environment and sanitation, and vaccines, therapeutics and diagnostics.

Challenge participants have committed in a range of ways. Walmart US, for example, said it will ask animal protein suppliers to report antibiotic use. The Joint Commission said it will implement antibiotic stewardship requirements in accredited hospitals. And Petco said it will support veterinary oversight for access to antibiotics in its retail locations.

APHA signed the challenge as well, committing to raise awareness of antibiotic resistance and advocate for funding for research and development of new drugs and vaccines.

*The Nation’s Health* spoke with Rima Khabbaz, MD, director of the National Center for Emerging and Zoonotic Infectious Diseases, about the challenge.

## Why should Americans be concerned about antbiotic resistance?

It’s one of the most urgent public health threats of our time. It affects everyone. It is threatening much of the public health progress that we have made.

We have seen high levels of antimicrobial-resistant bacteria all over the world. With modern travel and movement of goods, the resistance spread across the planet.

We started seeing it soon after the first antibiotic came to be. Every time we’ve had an antibiotic, it was just a matter of time where bugs would be resistant to it.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/48/9/6/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/48/9/6/F1)

Khabbaz

## What was the motivation behind the AMR Challenge?

The AMR Challenge came about as thinking of a way to build on previous momentum around antimicrobial resistance and addressing it. The idea of this challenge is both to take the progress that we’ve made here domestically and highlight it to other countries and others for discussion.

We’ve been quite impressed and overwhelmed by the...level of interest from a whole range of groups, including other countries, to participate and make commitments and industry to move us forward.

## How are organizations beyond the field of public health addressing the problem of antibiotic resistance?

Antimicrobial resistance is an important public health issue, but it’s not an issue for a single country or region.

For example...with the food industry, already we’ve seen some changes in terms of antibiotics and food, animals and antibiotics.

Some of it is driven by consumers, frankly, where they come to the realization that they have a role to play. Others in the health care side committing to focus on improving infection control practices in hospitals. Or professional organizations wanting to improve education on proper antibiotic use training for nurses and doctors.

And in industry, with a commitment to focus on prioritizing newer diagnostics, vaccines and make antibiotics to help protect the environment from the influx of antibiotics — a whole range of commitment from organizations in and outside public health, because everyone has a role to play.

## How is public health leading the fight on antibiotic resistance?

Public health...has really come to the forefront of addressing the problem of antibiotic resistance.

We have an antibiotic lab response network where we have seven regions that have now the ability to improve diagnostics to be able to detect emerging infections.

Resistance is not just a problem of individual health care facilities. Resistance spreads from facilities to other facilities and to the community, so (public health) has stepped in to address it and be part of the solution to detect emerging infections quickly.

If you quickly and aggressively are able to detect new and emerging resistance…(you can) go full speed to contain it.

We also, I think, need public health workers to be involved in the fight by being able to talk about this, about the risk and best practices as far as antibiotic prescribing both in the professional work and in their personal role as champions of public health.

*For more on antibiotic resistance and to commit to the challenge, visit [www.cdc.gov/drugresistance](http://www.cdc.gov/drugresistance)*.

*   Copyright The Nation’s Health, American Public Health Association