ASM Recommendations to the Presidential Transition

Nov. 10, 2016

The American Society for Microbiology (ASM) urges support for federal policies and programs that strengthen science, technology and public health in the United States. 

The nation must continue to seize opportunities within the vast scope of scientific disciplines and areas of research funded by the federal government.  Science and technology are valuable investments in public health, national security, sustained innovation, and economic vitality and are essential to our nation’s global competitiveness.

The ASM, which represents over 47,000 members in the United States and worldwide, has identified the following three priority areas that should be addressed to directly benefit public health:

hospital-associated-methicillin-resistant-a

Antimicrobial Resistance
Expand Federal Efforts to Combat Drug Resistant Infectious Diseases

Investments should be expanded in multidisciplinary efforts against microorganisms that are increasingly resistant to some or all therapeutic drugs used to treat infections.  Antimicrobial resistance (AMR) persists as one of our most daunting challenges in safeguarding public health and well-being.  Although the specter of AMR is not new, the nation’s response and the global response thus far has not sufficiently dealt with the breadth and complexity of this threat such that it is now considered a global crisis by the WHO, the G7 and the UN.  The United States should fully implement and increase funding for the National Action Plan for Combatting Antibiotic Resistant Bacteria (CARB) to enable a comprehensive and coordinated federal response to AMR. 

Basic and applied research, clinical treatments, and prevention programs must be accelerated.  We need more precise clinical diagnostics, intensified public-private joint development of new novel therapeutics, heightened AMR surveillance, and increased public education on the inappropriate use and adverse effects of antimicrobials.  Defenses against AMR must be broadened beyond the current focus on bacterial pathogens to aggressively address rising resistance among viruses, (including but not limited to influenza and HIV), parasites (especially malaria), and fungi.

The One Health approach to AMR that links human health with animal health and with the environment needs more attention.  We should promote AMR research critical to understanding interconnected causes of resistant pathogens, as well as any effects of social and health disparities within an individual’s own environment.  We should encourage R&D areas thus far largely neglected, such as new veterinary therapies, roles of waste and wastewater in developing resistance, antibiotic usage in agriculture, and environmental factors affecting AMR emergence, surveillance and prevention. 

Federal AMR related investments should extend across the multiple stakeholders and scientific disciplines that must collaborate to halt the growing threat of AMR infections.  Issues related to international cooperation, such as data sharing, intellectual property agreements, and establishing sites for clinical trials and research, should be addressed to prevent delays in responding to epidemics worldwide.  We should specifically elicit greater industry and government cooperation to resolve complex AMR issues.  Expanded use of genomics technologies against AMR pathogens, such as broader application to veterinary and agricultural research, would offer additional opportunity for scientific partnerships among industry, government, and health agencies and would lead to more rapid and accurate diagnosis and treatment.  This genomics research, like all AMR efforts, should fully engage multiple federal agencies, including NIH, CDC, FDA, USDA, NSF, EPA and others. 

Zika tn

Microbial Threats Rapid Response Reserve Fund
Establish a Permanent, Dedicated Fund for Rapid Responses to Microbial Outbreaks

A permanent federal fund dedicated to preparing for and responding to emerging infectious disease (EID) events like Zika or Ebola infection and other microbial threats and disturbances should be created.  To respond efficiently to microbial disasters requires highly flexible technical capabilities and immediate, certain access to adequate resources.  The new fund would not be dependent upon or endangered by the slow and often politicized emergency supplemental funding process that has impinged the nation’s response to the Zika virus. 

The proposed EID fund would allow the country to mobilize rapidly with the necessary countermeasures, similar to our military readiness, without diverting emergency funding from ongoing programs.  The current haphazard approach to funding simply takes support away from R&D against a previous EID threat to fund the latest EID emergency.  Lurching from one EID to another subverts the progress of science as the de-funded research is delayed or even abandoned midway.  The proposed fund should contain at least $2 billion of new funding, which can be increased, and should be located at the Department of Health and Human Services, and be available as needed for coordinated efforts across federal agencies such as CDC, NIH, FDA, BARDA and USDA.

Other federal measures also are needed to optimize defenses against EIDs, such as a stronger alliance with industry as part of the mobilization efforts.  More attention must be given to veterinary and animal sciences and their role in preventing zoonotic EIDs, as well as the interplay between EIDs, human health, changes in environment and climate, and agriculture and food production.  The One Health approach correctly recognizes that the health of humans is connected to the health of animals and the environment.  To contain EID outbreaks, there must be more emphasis on collaborations among physicians, ecologists, veterinarians, microbiologists, and other specialists whose expertise is crucial.

Looking back, the large economic losses from the SARS epidemic (estimated over $50 billion) is a warning that the cost of not having a dedicated response fund and investment in research is far greater than increasing federal funding for research and the reserve fund.  Looking forward, it is inevitable that our nation will be challenged by more unexpected emerging infectious diseases, which must be met without barriers of uncertain funding or lethargic bureaucracy.

With the establishment of a Rapid Response Reserve Fund, there should be significant investment in those technologies which would accelerate development and manufacture of new rapid diagnostics (i.e. genome databases), therapies and vaccines. Synthetic biology, an interdisciplinary branch of biology and engineering, attempts to create new biological molecules and even novel living species capable of carrying out a range of important medical and industrial functions, from manufacturing pharmaceuticals to detoxifying polluted land and water.  In medicine, it offers prospects of using designer biological parts as a starting point for an entirely new class of therapies and diagnostic tool. 

virus

Microbes and Economic Growth
Accelerate the Growth of the U.S. Bioeconomy and its Potential Benefits

There are exciting opportunities to promote the commercial potential of a U.S. bioeconomy and should strongly support the relevant R&D sectors.  Microbes are key to growing the U.S. bioeconomy as makers of industrial catalysts and pharmaceuticals like antibiotics, sources of next generation biofuels, innovative food producers adaptable to changing environments and climate, and central participants in the earth’s geochemical cycle and environmental change.  Microbes are also the ultimate model organisms for molecular and cellular biology research that already has generated myriad impactful technologies. 

Many of today’s advances in health and biotechnology emerged from microbial research.  Some like genetic engineering are proving to be major influences on the national economy and the U.S. workforce.  Future U.S. discoveries will no doubt be equally dependent upon the use of microbes in research and product development, including those in newer, fiscally promising sectors like bioenergy and biomanufacturing.  This bioeconomy will yield not only new and unique products, but also sustainable replacements for existing chemicals and materials.  Today’s bioindustrial revolution will impact human and animal health, air and water quality, food production and safety, and environments across the United States.

Research using microorganisms routinely benefits science and technology well beyond the initial area of study.  Advances made by microbiologists focused on biofuel production could propel work by others to produce biochemicals that are not based on fossil fuels.  Basic research on microbial physiology and ecology could translate into revolutionary applied research in multiple economically important fields, including synthetic biology.  Current research on microbiomes, for example, is attracting numerous scientific disciplines, evident in the newly launched National Microbiome Initiative. 

……………………………….

Scientific research and development efforts have yielded huge benefits for the U.S. economy and the American quality of life.  Adequate support for basic research is the irreplaceable foundation for future innovations.  Fortifying government, industry and university partnerships can retain U.S. leadership in global science and technology. 

The ASM advocates the importance of soliciting nonpartisan, science based advice from researchers, public health officials, and other experts in academia, industry, government, nonprofits, and elsewhere.  The ASM is eager to help formulate policies and offer nonpartisan advice on key science and health related government appointments.