Appendix A
Statement of Task
An ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine will plan a 2-day public workshop that will examine the key areas in human, animal, and environmental health that contribute to the emergence and spread of antimicrobial resistance. Through a One Health approach, this workshop will discuss gaps in these areas and present the complexities of bridging the different sectors and disciplines to address this global threat. A key focus of the workshop will be to explore immediate and short-term actions and research needs that will have the greatest impact on reducing antimicrobial resistance. This workshop will feature invited presentations and discussions on topics including
- The implications and effect on human health of the movement of resistance genes across different ecosystems;
- The antimicrobial resistance burden in humans attributed to human health care practices, the use of antimicrobials in livestock, and the effect of environmental sources;
- The expected effect of the implementation of U.S. Food and Drug Administration Guidances #209 and #213, and changes to the existing veterinary feed directive that were rolled out in January 2017 and the exploration of key measures determining the future success of these actions;
- The role and effectiveness of stewardship programs in reducing and preventing antimicrobial resistance through changes in the use, prescription, sales, regulation, and manufacturing of antimicrobials;
- The importance of data availability and data sharing to monitor and evaluate the implementation and progress strategies, to maintain the effectiveness of existing drugs, to develop new drugs and diagnostics, and to implement disease prevention strategies, including vaccine use and the adoption of alternatives to antibiotics to better understand the clinical value and patient outcomes; and
- The need for collaboration and coordination mechanisms across the One Health domains for prevention, control, and research and development of new antimicrobials, other therapeutics, diagnostics, and disease prevention strategies to combat antimicrobial resistance.
Workshop speakers will discuss the key elements that may be prioritized for achieving the greatest impact in the short term, and immediate research that could be conducted in the next few years. Workshop speakers and discussants will contribute perspectives from government, academia, private, and nonprofit sectors. The committee will plan and organize the workshop, select and invite speakers and discussants, and moderate the discussions. A proceedings of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines. The designated rapporteur will not be a member of the committee, and no committee members will be consulted in the development of the workshop proceedings.