Tuesday, April 30, 2019

Very Brief Blog: United Nations Issues Urgent Report on Antibiotic Crisis

On April 29, 2019, the United Nations issued an urgent report on the antibiotic crisis and the emergence of antibiotic resistant-bacteria.

  • United Nations report here.
  • New York Times coverage here.
  • CNN here.  Business Week here.
In addition to the summary report, there are a number of additional supplemental and research reports at the UN page.  The workgroup is "UN Interagency Coordination Group on AMR," or IACG.


There are a few remarks about diagnostics, e.g. " The Organization is also working to improve the accessibility and use of diagnostics and laboratory services to reduce diagnostic uncertainty and inform treatment choices."   They refer to "the inadequacy of the clinical pipeline of new vaccines, medicines and diagnostics..."  Diagnostics "form a core element of the response in helping to select appropriate antimicrobials to treat a disease." Adding:  "Diagnostics are often perceived as an additional expense to the cost of treatment, even though their use may be associated with significant cost savings and efficiency downstream."

Additional Policy Notes

Medicare.  In Medicare policy, just a few weeks ago the President's Counsel on Combatting Antibiotic-Resistant Bacteria held a special meeting resulting in a vote, to urge CMS to finalize mothballed rules requiring US hospitals to have antibiotic stewardship committees.   Here.

Pew and Wellcome.  See links to very recent Op-Eds by groups like the Pew Foundation and Wellcome Trust on the topic, hereFDA.  This topic was also a high priority of recently departed FDA commissioner Scott Gottlieb (here).

NIH and Speech.  In related news, earlier this week, WSJ and SCIENCE reported that NIH had "barred" several scientists from speaking about the sepsis treatment crisis, here and here and here.  One of them, Eichacker, had written two recent articles that were quite critical of CMS sepsis policy ("SEP-1"), here and here.  (Other authors outside NIH had been equally critical, here.)

CMS NTAP & ABx Dx.  I believe for the first time ever, CMS is considering granting a diagnostic test add-on payment in its current inpatient policy rulemaking; see discussion of T2 septicemia test, here.