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  Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB)
                                            
            
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Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB)

Charter

FAQ's

The Rise of Antimicrobial Resistance

Antimicrobial resistance (AMR) is the ability of pathogens, whether bacteria or fungi, to overcome the effects of antimicrobial drugs. Antibiotics are one of the most important medical advances in history and have saved countless lives. However, the rise in AMR means that infections that were once easily treatable with these drugs can now be difficult or impossible to cure.

The World Health Organization (WHO) has warned that AMR is one of the biggest threats to global health, security, and development. In the United States, over 2.8 million antimicrobial-resistant infections occur annually, resulting in 35,000 deaths per year. A recent report from the Centers for Disease Control and Prevention (CDC) and experts at the University of Utah, determined treating six of the most alarming AMR threats costs the US over $4.6 billion in health care costs annually.1

The U.S. Federal Government's Response to AMR

The U.S. federal government is committed to combating antimicrobial resistance. Federal efforts to address resistant infections go back decades, but a coordinated response across agencies began in 2013 after the Centers for Disease Control and Prevention (CDC) released their first Antibiotic Resistance Threats Report | CDC. In 2014, President Barack Obama signed an executive order that brought all federal efforts to combat antibiotic resistance together. This executive order established the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), the PACCARB, and formally established the Federal Interagency CARB Task Force to coordinate all federal efforts. The CARB Task Force develops, implements, and updates the CARB National Action Plan. The PACCARB and the CARB Task Force work and collaborate closely on all PACCARB tasks.

The PACCARB's Structure and Function

The PACCARB is a federal advisory council that provides advice, information, and recommendations on all things related to AMR to the Secretary of Health and Human Services (HHS) in close consultation with the Departments of Agriculture (USDA) and Defense (DoD). Federal advisory councils are a way for the federal government to use the knowledge of non-federal subject matter experts to help support and inform federal policies and actions in an open and public forum. The PACCARB, like all federal advisory councils, is subject to the rules listed under Federal Advisory Committee Act; legislation which sets standards for the formation and use of federal advisory councils.

Infographic of the structure of the PACCARB and the flow of information from the PACCARB to the President.
Both the PACCARB and the U.S. Government’s response to AMR take a One Health approach. One Health is a framework that recognizes that the health of people, animals, plants, and the environment are all connected. AMR plays a role in each of these fields, so it’s important to address AMR across them all. PACCARB has at least 30 members that have expertise in the health of people, animals, plants, and the environment. Currently, the council has 15 voting members. Voting members are non-federal subject matter experts (e.g., academicians, infectious disease doctors, veterinarians, public health specialists, etc.) that represent their own knowledge and views on combating AMR. These members are considered special government employees and are subject to federal ethics laws. The council also has eight liaison representative members that represent the perspective of larger organizations or associations (e.g., pharmaceutical companies, medical/veterinarian associations, etc.) as well as representation from 12 federal agencies (e.g., CDC, NIH, USDA, EPA, etc.). The federal agencies represented on the PACCARB are also members of the CARB Task Force. The liaison and federal agencies represented do not vote on council products such as the recommendation reports published by the PACCARB. The council is led by a Chair and Vice Chair that are designated by the Secretary of HHS from among the voting members. The PACCARB is supported by a Designated Federal Official and other staff members within HHS. A full roster of active members can be found on the Membership page.

PACCARB can form Working Groups (WGs) to assist in its functions. The formation of these WGs is based on tasks given by the Secretary of HHS or priorities set by the PACCARB Chairs. Once a WG completes its assigned task, it generates a report containing recommendations which is then presented to the entire PACCARB during a public meeting for discussion and vote. Upon approval through a majority vote, the final recommendation report is transmitted to the Secretary of HHS for consideration and is made publicly available online on the Reports and Recommendations page.

How PACCARB’s Recommendations are Used

The PACCARB's recommendations are used across the U.S. federal government, and they are also an important resource for scientific associations, academia, and government organizations who are working to combat AMR. PACCARB’s recommendations have been used to:

**Inform policy.** The PACCARB provides advice, information, and recommendations to the Secretary of HHS and assists the CARB task force.
	**Advise strategy**. The PACCARB recommendations also identify policy changes or additions that could be made to help to combat AMR. These recommendations are used to advocate for policy change at the local, state, and federal levels.
	**Educate the public.**The PACCARB recommendations can be used to develop educational materials to raise public awareness of the issue of AMR.
	**Direct research.**The PACCARB recommendations identify research gaps and priorities to help prevent or combat the rise of AMR. Scientific associations, professional organizations, and/or academics can use these priorities to guide their research and to help to ensure that their work is relevant to the needs of the public health community.Infographic of how PACCARB recommendations have been used and by who.
PACCARB Public Meetings

Public meetings are an important part of the council's work. The purpose of these meetings is to discuss a range of AMR topics across the One Health spectrum with experts from the AMR community, both domestically and globally, in an open and transparent setting. The PACCARB holds public meetings two to three times a year. These public meetings are an opportunity to:

Hear from a wide range of experts on issues related to antibiotic resistance.
	Provide the public with an opportunity to learn about the council's work and findings.
	Solicit public input on the council's plans and priorities.
	Network with federal and non-federal subject matter experts interested in fighting AMR.Additional information on past and upcoming meetings can be found on the Meetings page. Further information about the council, reports, public meetings, and the U.S. federal response to AMR can be found on the FAQs page.

Endnotes

1 Nelson, R. E., Hatfield, K. M., Wolford, H., Samore, M. H., Scott, R. D., II, Reddy, S. C., Olubajo, B., Paul, P., Jernigan, J. A., & Baggs, J. (2021). National Estimates of Healthcare Costs Associated With Multidrug-Resistant Bacterial Infections Among Hospitalized Patients in the United States. *Clinical Infectious Diseases*,*72*(Supplement_1), S17-S26. https://doi.org/10.1093/cid/ciaa1581

                    
  


Content created by Assistant Secretary for Health (ASH) Content last reviewed August 22, 2023Back to top
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