President’s Budget Request for the National Action Plan to Combat Antibiotic-Resistant Bacteria

Building on the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB) released in March 2015 and endorsed by the President’s Council of Advisors on Science and Technology, the administration’s budget for fiscal year 2017, released Feb. 9, proposes $1.1 billion in federal funding to combat the growing public health crisis of antibiotic resistance.

The table below shows the fiscal 2016 funds that were enacted and allocated to CARB, as well as the president’s fiscal 2017 budget request for continued CARB work by each agency and the difference between these two figures. (In cases where agencies’ publicly available budget documents indicate some funding for CARB but do not specify the total, no funding amount is listed.) This funding is critical to achieving the goals and milestones outlined in the national action plan. These allocations must continue in the coming years to ensure full and successful implementation of the plan.

The fiscal 2017 $1.1 billion funding request would support the following activities at each federal agency:

• Centers for Disease Control and Prevention ($218 million): Funding would go toward programs reducing inappropriate antibiotic use and preserving the effectiveness of existing antibiotics. It would expand antibiotic-resistance prevention programs and enhance resistance detection and reporting capacity in all 50 states, six large cities, and Puerto Rico.
• Agency for Healthcare Research and Quality ($12 million):  Funding would promote the implementation of stewardship programs, which would help reduce the inappropriate use of antibiotics.
• National Institutes of Health ($413 million): Funding would support activities to advance the discovery and development of new antibiotics, other therapeutics, and vaccines, as well as to spur research and development of rapid, point-of-care diagnostics, and to facilitate large-scale analyses of the microbiome to address the risks of antibiotic-resistant microbes.
• Biomedical Advanced Research and Development Authority ($192 million): Funding would be dedicated to antimicrobial research and development. It would utilize novel public-private partnerships to address the market failure in antibiotic R&D.
• Food and Drug Administration ($42 million): Funding would support five activities: ensuring licensed veterinary oversight of antibiotics in animal feed and water; eliminating medically important antimicrobials for growth promotion in food-producing animals; monitoring antimicrobial use in food-producing animals; identifying emerging antimicrobial resistance threats in the food supply; and streamlining clinical trials.
• Department of Agriculture ($61 million): Funding would be used to develop monitoring programs and increase data collection and analysis to better understand the impact of on-farm antibiotic use on antimicrobial resistance. It would also support research on the spread of resistance as well as on alternative interventions that could reduce antibiotic use, including vaccines.
• Department of Defense (total funding unspecified): Funding would support research to prevent, detect, and control antibiotic- and other drug-resistant pathogens, and to discover and develop new therapeutics, including new antibiotics. Funding would also support efforts to promote best practices such as ensuring the appropriateness of antibiotics used to treat patients and proper wound care.
• Department of Veterans Affairs (total funding unspecified): Funding would support efforts to effectively implement the VA’s Antimicrobial Stewardship Program, which promotes judicious antimicrobial use and includes surveillance to prevent, detect, and control antibiotic- and other drug-resistant pathogens that pose a particular threat to military veterans.