One of the deadliest enemies waging war against the American people and killing thousands of our citizens is not a terrorist group or a foreign army. It is an unseen microscopic menace – antibiotic-resistant bacteria.
The U.S. Defense Department reports that more than 4,400 Americans have died in Iraq since 2003 and more than 2,200 have died in Afghanistan since 2001 in our long war against violent extremism. Our nation mourns the loss of these brave men and women. Tragically, antibiotic-resistant bacteria claim far more lives – approximately 23,000 every year.
The CDC laid out a battle plan Aug. 4 for giving these superbugs the equivalent of a shot of kryptonite – estimating that the plan could have a dramatic impact by preventing 37,000 deaths and 619,000 infections over the next five years, saving $7.7 billion in direct medical costs over the period. If we don’t act, the CDC predicts the number of such bacterial infections will continue to increase.
In a nutshell, the CDC is recommending that federal, state and local public health agencies work with hospitals, nursing homes and long-term care facilities to share more information about superbug infections and coordinate their efforts to stop these germs from becoming an even more serious threat.
This is sound science, good medicine and common sense. America’s 2,800 local health departments – represented by the National Association of County and City Health Officials (NACCHO), where I serve as executive director – can play a critical role working with their state health departments to make the CDC’s battle plan a winning strategy.
President Obama’s proposed budget for the 2016 fiscal year contains over $1.2 billion in federal funding for antimicrobial resistance.This amount includes $264 million to the CDC for an Antibiotic Resistance Solutions Initiative. The funding is critical to enhance the ability of state and local health department to combat antibiotic resistance.
I led the fight against superbugs at the state level when I headed the Illinois Department of Public Health before coming to NACCHO earlier this year. Reporting and information-sharing requirements we created at the state level enabled hospitals, other healthcare facilities and local health departments to know when patients carrying antibiotic-resistant germs were being transferred from one facility to another, enabling them to work together effectively to keep other patients safe. The CDC report highlights Illinois’ work as an example of what can be done.
State health departments can do many things. For example, they can: strengthen and improve requirements for hospitals and other healthcare facilities to report superbug infections; share information with local health departments about state efforts to prevent, detect, and control antibiotic resistance; foster closer relationships between local health departments and healthcare facilities; and provide local health departments with data on superbugs in their communities.
Armed with community-level superbug data, local health departments can promote antibiotic- resistance stewardship programs in their facilities and educate residents about the importance of responsible antibiotic use.
We also need improvements in electronic health records, so healthcare facilities can more easily share information about patients and so patients can get more information about themselves. Ultimately, patients who know their medical test results are the best sources of information about the risk they pose in infecting others.
It’s understandable that many people who are sick ask their doctor to prescribe an antibiotic, because they think taking an antibiotic “can’t hurt” – like carrying an umbrella on a cloudy day just as a precaution. But in fact, taking antibiotics when they can give you no benefit is harmful, not helpful – not just to the individual patient, but to the entire population. This overuse is what allows bacteria to develop antibiotic resistance. Doctors have to say “no” to patients who want an antibiotic just for peace of mind.
Finally, we need to work with veterinarians and livestock and poultry producers to stop the overprescribing and overuse of antibiotics in the animals we eat, especially those antibiotics that are similar to antibiotics prescribed for people. This practice only accelerates antibiotic resistance.
We are at a tipping point. If the problem of superbugs grows worse, many of the life-saving antibiotics that have protected us for decades and saved countless lives will be unable to protect us, our children and grandchildren in the future. This is why it is urgent that we act swiftly to follow the CDC’s recommendations on stepping up the fight against antibiotic resistance.
Hasbrouck, is executive director of the National Association of County and City Health Officials (NACCHO). He earlier headed the Illinois Department of Public Health and the Ulster County (N.Y.) Department of Health and Mental Health, and was an official with the U.S. Centers for Disease Control and Prevention, and the World Health Organization.