Trends in antimicrobial resistance legislation 2011-2019: A review of the US policy response to the antimicrobial resistance threat and its public health Impact.

Abstract

Antimicrobial resistance is a continued global threat to public health. In recognition of this threat, the executive branch of the United States government consolidated guidelines through the President's Council of Advisors on Science and Technology and Executive Order 13676. An analysis was conducted to assess the US government's response to this growing threat. Human and animal health legislation from 2011 to 2019 was reviewed using the congressional legislative database where 28 pieces of antimicrobial distinct legislation was identified. The majority of the bills identified were human health related and common themes found were incentivizing the development of new products, biodefense, expanded scope of use, and stewardship. Much fewer were identified pertaining to animal health; of those identified, common themes included stricter veterinary oversight, barriers to approval pathways for new products, and stewardship. The public health impact of these legislative efforts is in part related to a broader political tension of the role of government vs local authorities in managing regulatory enforcement and guidelines.