I 
111TH CONGRESS 
1ST SESSION H. R. 2400 
To amend the Public Health Service Act to enhance efforts to address 
antimicrobial resistance. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 13, 2009 
Mr. MATHESON introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to enhance efforts 
to address antimicrobial resistance. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Strategies to Address 
Antimicrobial Resistance Act’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) The advent of the antibiotic era has saved 
millions of lives and allowed for incredible medical 
progress; however, the increased use and overuse of 
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antimicrobial drugs have correlated with increased 
rates of antimicrobial resistance. 
(2) Through mutation as well as other mecha-
nisms, bacteria and other infectious disease-causing 
organisms—viruses, fungi, and parasites—develop 
resistance to antimicrobial drugs over time. The 
more antimicrobial drugs are used, whether appro-
priately or inappropriately, the more this contributes 
to the development of antimicrobial resistance. 
(3) The recent 2009 Influenza A: H1N1 virus 
(also known as ‘‘Swine Flu Virus’’) outbreak clearly 
illustrates why infectious diseases experts are con-
cerned about drug resistance; although the H1N1 
virus currently appears to be treatable by two class-
es of available antiviral drugs, it is resistant to other 
classes, and should the virus mutate and become re-
sistant to all classes, which is possible, we would be 
left extremely vulnerable. 
(4) Scientific evidence suggests that the devel-
opment of antimicrobial resistance in humans is not 
due only to use of antimicrobial drugs in humans, 
but also may be caused by the use of antimicrobial 
drugs in food-producing animals. 
(5) A study estimates that in 2005 more than 
94,000 invasive methicillin-resistant Staphylococcus 
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aureus (MRSA) infections occurred in the United 
States and more than 18,500 of these infections re-
sulted in death—7 times more than a decade earlier. 
(6) The recent 2009 Influenza A: H1N1 virus 
outbreak exacerbates concerns about MRSA and 
other bacteria that cause respiratory diseases given 
that, during the 1918 influenza pandemic, many 
thousands of deaths were caused by complications 
due to secondary bacterial infections and not by the 
influenza virus itself. 
(7) Each year, nearly 2,000,000 people contract 
bacterial infections in hospitals and approximately 
90,000 of these people die from these infections. 
(8) The current annual costs of antimicrobial- 
resistant bacterial diseases are hard to quantify, but 
a 1995 report by the Office of Technology Assess-
ment, an agency of Congress, which looked at 6 dif-
ferent antimicrobial-resistant strains of bacteria, cal-
culated that the minimum nationwide hospital costs 
of just these strains of bacteria accounted for 
$1,300,000,000 
annually 
in 
1992 
dollars 
($1,870,000,000 in 2006 dollars). 
(9) A 1998 Institute of Medicine report esti-
mated the societal cost of resistance as between 
$4,000,000,000 to $5,000,000,000; many experts 
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argue the cost in 2009 may be close to 10 times 
greater. 
(10) The costs of antimicrobial-resistant infec-
tions in terms of lives lost and economically will only 
rise as antimicrobial resistance continues to spread. 
SEC. 3. ANTIMICROBIAL RESISTANCE TASK FORCE. 
(a) IN GENERAL.—Section 319E of the Public 
Health Service Act (42 U.S.C. 247d–5) is amended— 
(1) in subsection (a)— 
(A) in the subsection heading, by striking 
‘‘TASK FORCE’’ and inserting the following: 
‘‘ANTIMICROBIAL RESISTANCE OFFICE, TASK 
FORCE, AND ADVISORY BOARD’’; 
(B) in paragraph (1)— 
(i) by striking ‘‘as of the date of the 
enactment of this section’’ and inserting 
‘‘as of September 30, 2006’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall, not later 
than 1 year after the date of enactment of 
the Strategies to Address Antimicrobial 
Resistance Act, establish an Antimicrobial 
Resistance Office in the Office of the Sec-
retary and appoint a director to that Of-
fice. The Secretary shall, not later than 1 
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year after the date of enactment of such 
Act, establish the Public Health Anti-
microbial Advisory Board as an advisory 
board to the Director of the Antimicrobial 
Resistance Office. The Director of the 
Antimicrobial Resistance Office shall serve 
as the Director of the task force. To avoid 
duplication and ensure that Federal re-
sources are used efficiently and effectively, 
the Director shall work in conjunction with 
the Federal agencies represented on the 
Task Force to coordinate all antimicrobial 
resistance activities undertaken and sup-
ported by the Federal Government, includ-
ing the activities and budgetary allocations 
of the Office, task force, and Public Health 
Antimicrobial Advisory Board.’’; 
(C) by amending paragraph (2) to read as 
follows: 
‘‘(2) MEMBERS.— 
‘‘(A) MEMBERS
OF
THE
ANTIMICROBIAL 
RESISTANCE TASK FORCE.—The task force de-
scribed in paragraph (1) shall be composed of 
representatives of such Federal agencies as the 
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Secretary determines necessary, including rep-
resentation of the following: 
‘‘(i) The Antimicrobial Resistance Of-
fice. 
‘‘(ii) The Assistant Secretary of Pre-
paredness and Response. 
‘‘(iii) The Centers for Disease Control 
and Prevention. 
‘‘(iv) The Food and Drug Administra-
tion. 
‘‘(v) 
The 
National 
Institutes 
of 
Health. 
‘‘(vi) The Agency for Healthcare Re-
search and Quality. 
‘‘(vii) The Centers for Medicare & 
Medicaid Services. 
‘‘(viii) The Health Resources and 
Services Administration. 
‘‘(ix) The Department of Agriculture. 
‘‘(x) The Department of Education. 
‘‘(xi) The Department of Defense. 
‘‘(xii) The Department of Veterans 
Affairs. 
‘‘(xiii) The Environmental Protection 
Agency. 
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‘‘(xiv) The Department of Homeland 
Security. 
‘‘(xv) The United States Agency for 
International Development. 
‘‘(B) MEMBERS OF THE PUBLIC HEALTH 
ANTIMICROBIAL ADVISORY BOARD.— 
‘‘(i) IN GENERAL.—The Public Health 
Antimicrobial Advisory Board shall be 
composed of 19 voting members, appointed 
by the Secretary. Such members shall in-
clude experts from the medical professions 
(including hospital and community-based 
physicians), pharmacy, public health, vet-
erinary, research, and international health 
communities, as well as one representative 
from a public interest group. 
‘‘(ii) 
TERMS.—Each 
member 
ap-
pointed under clause (i) shall be appointed 
for a term of 3 years, except that of the 
19 members first appointed— 
‘‘(I) 6 shall be appointed for a 
term of 12 months; and 
‘‘(II) 6 shall be appointed for a 
term of 2 years. 
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‘‘(iii) CHAIR.—The Secretary shall ap-
point a Chair of the Public Health Anti-
microbial Advisory Board from among its 
members to lead and supervise the activi-
ties of the Advisory Board. 
‘‘(iv) DISCLOSURE OF FINANCIAL IN-
TERESTS.—Prior to a meeting of the Pub-
lic Health Antimicrobial Advisory Board, 
each member of the Advisory Board shall 
disclose to the Secretary any potential, rel-
evant financial interests as defined under 
section 208(a) of title 18, United States 
Code.’’; 
(D) in paragraph (3)(B), by striking ‘‘in 
consultation with the task force described in 
paragraph (1) and’’ and inserting ‘‘acting 
through the Director of the Antimicrobial Re-
sistance Office and the Director of the Centers 
for Disease Control and Prevention, and in con-
sultation with’’; and 
(E) by amending paragraph (4) to read as 
follows: 
‘‘(4) MEETINGS AND DUTIES.— 
‘‘(A) ANTIMICROBIAL RESISTANCE OFFICE 
RESISTANCE
DUTIES.—The Director of the 
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Antimicrobial Resistance Office, working in 
conjunction with the Federal agencies that are 
represented on the task force described in para-
graph (1), shall issue an update to the Public 
Health Action Plan to Combat Antimicrobial 
Resistance within 18 months of the establish-
ment of the Office and biennial updates there-
after. The updates shall include enhanced plans 
for addressing antimicrobial resistance in the 
United States and internationally. The Director 
of the Office shall post on a website these up-
dates as well as summaries of all non-propri-
etary data the Task Force makes available. The 
Director of the Antimicrobial Resistance Office 
shall work in conjunction with the Federal 
agencies that are represented on the task force 
described in paragraph (1), and in consultation 
with the Public Health Antimicrobial Advisory 
Board, to— 
‘‘(i) establish benchmarks for achiev-
ing the goals set forth in the action plan; 
‘‘(ii) assess the ongoing, observed pat-
terns of emergence of antimicrobial resist-
ance, and their impact on clinical outcomes 
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in terms of how patients feel, function, or 
survive; 
‘‘(iii) assess how antimicrobial prod-
ucts are being used in humans, animals, 
and plants, and the impact of such use in 
furthering the development of resistance 
and the implications thereof for patient 
safety and public health; 
‘‘(iv) establish a priority list of human 
infectious diseases with the greatest need 
for development of new point-of-care and 
other diagnostics, antimicrobial drugs, and 
vaccines, and in particular serious and life- 
threatening bacterial diseases, for which 
there are few or no diagnostic or treatment 
options; 
‘‘(v) recommend basic, clinical, epide-
miological, prevention, and translational 
research where additional federally sup-
ported studies may be beneficial; 
‘‘(vi) recommend how to support anti-
microbial development through Food and 
Drug Administration activities, including 
through the agency’s Critical Path Initia-
tive; 
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