Good afternoon, everyone. I am Harvey Fineberg, President of the Institute of Medicine (IOM). It is my great pleasure to welcome all of you to this 2014 Richard & Hinda Rosenthal Symposium. Our topic this year is Antimicrobial Resistance: A Problem Without Borders.
This endowed lecture and symposium series is sponsored by the Rosenthal Family Foundation. It has been a special annual activity at the Institute of Medicine for more than a quarter century. Every year, we bring forward at these discussions a key health policy issue that is facing our country right now. We try to deal with that issue from a range of informed perspectives. The series has had many important leaders in health care and policy and academia, in government and in the private sector, who have participated.
The very first lecture in the Rosenthal series dealt with the question of providing universal and affordable health care. How little changes over time. Recently, we have had other symposiums that have dealt with important and critical topics, most recently last year, on the future of nursing, which was a very important subject for the Institute of Medicine, for the United States domestically, and, indeed, for the world.
Many of the subjects have really emphasized, particularly, the United States and our needs, in general, our health challenges. Today, we are going to be focusing on a topic that deals with every country in the world, truly a topic with global implications. As we will undoubtedly hear in the course of the presentations from our eminent panel, it requires global thought and collective action in order to find solutions.
Consider for a moment how much attention is now attending the problem of antimicrobial resistance. The Centers for Disease Control and Prevention (CDC) identified antimicrobial resistance as one of five
urgent health threats facing the United States this year. In its recent report, Antibiotic Resistance Threats in the United States, released last year, the CDC notes that at least 2 million people in the United States acquire infections with bacteria that are resistant to one or more antibiotics and 23,000 deaths follow.
The White House launched, in its Global Health Security Agenda earlier this year, a recognition of the threat that is caused by the confluence of emerging microbes, globalization of food and travel, and increase in drug-resistant pathogens. The agenda at the White House calls for a diverse set of government agencies to work more closely together on these related problems, including the Department of Health and Human Services, especially the CDC, the Departments of Defense, of State, and of Agriculture, as well as USAID [U.S. Agency for International Development].
The World Health Organization (WHO) devoted its 2011 World Health Day to the topic of antimicrobial resistance, noting that many drug-resistant microbes render medications around the world ineffective and more will be ineffective in coming years. Last week, WHO released its first global report on antimicrobial resistance surveillance. Among the key findings that they released are, first, alarming increases in antimicrobial resistance and major gaps on the collection of surveillance data and the coordination of surveillance efforts. This report from WHO also described antimicrobial resistance as a global health security threat that will demand collaboration from many stakeholders around the world.
This is a topic that has been of sustained and important interest also here at the National Academies, at the National Research Council, especially in our Board on Life Sciences and our Division of Earth and Life Studies, and at the Institute of Medicine. It is of particular interest, for example, in the Institute of Medicine’s Forum on Medical and Public Health Preparedness for Catastrophic Events. It has also had a direct bearing on the work of the Forum on Drug Discovery, Development, and Translation. Most especially, this topic has been central to the work of our Forum on Microbial Threats.
This forum was established in 1996 after the IOM published the report Emerging Infections: Microbial Threats to Health in the United States, which, in turn, followed a request from the CDC and the NIH [National Institutes of Health]. Initially, this forum was called the Forum on Emerging Infections, but the name was changed to Microbial Threats about a decade ago to reflect the more broad concerns. Many leaders in government, in academia, in industry, and from the public come together
in this forum to illuminate ways that this field can be brought together and how we can more effectively deal with the problem of antimicrobial resistance. You will find as you leave if you have not noticed as you came in, a number of publications from the forum that you are welcome to take, including Infectious Disease Movement in a Borderless World and Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies.
In the course of our discussion this evening, we hope to highlight the crosscutting character of antimicrobial resistance and the needs for many disciplines to be brought together to be able to deal with it more effectively. It is not only a medical issue. It is not only a public health issue. It has significant implications for population well-being and security more broadly. It deserves to be a focus of attention for leaders in medicine, public health, agriculture, veterinary health, security, and policy more broadly.
We have a very, very distinguished panel with us tonight. I am very pleased to be able to introduce them to you. As I do, I also want to take just a moment to acknowledge and to thank the staff who have made this evening possible. First, I want to thank Lauren Shern and Brad Eckert for organizing this event. Thank you both so very, very much. I also want to acknowledge the leadership of Clyde Behney, our Interim Leonard D. Schaeffer Executive Officer at the Institute of Medicine, who has overseen the development of tonight’s event, and to thank Meghan Mott at registration, who has been helping us this evening, particularly, to make all of our entries so smooth.
Now, to introduce the four panelists, I am going to introduce them in the reverse order that they will be speaking. The last will be introduced first. At the end, I will introduce the first of the speakers.
The speaker who will come toward the end is Dr. Brad Spellberg. Brad is Associate Medical Director for Inpatient Services and Associate Program Director for the Internal Medicine Residency Training Program at the Harbor-UCLA Medical Center. His work with the Infectious Disease Society of America and particularly a number of position papers that he has put forward based on a dataset related to new drug development has certainly raised considerable attention to the problem of antimicrobial resistance. Indeed, it is going to be a pleasure for us to hear Brad’s comments this evening.
Just before Brad speaks, Dr. Peg Riley will address us. Peg Riley is a Professor in the Department of Biology at the University of Massachusetts Amherst. Her research focuses on, among other things, the evolution of
antibiotic resistance and the development of novel antimicrobials. Dr. Riley was a member of the National Research Council’s Committee on New Directions in the Study of Antimicrobial Therapeutics and currently serves as a member of the NRC’s Board on Life Sciences. Thank you so very much for being with us tonight.
Our second speaker will be Dr. Stuart Levy. Dr. Levy is Distinguished Professor of Molecular Biology and Microbiology and of Medicine and Director of the Center for Adaptation Genetics and Drug Resistance at Tufts University Medical School. He is also the cofounder and the president of the Alliance for the Prudent Use of Antibiotics. This organization, established in 1981, conducts public health advocacy, research, and surveillance, as well as consumer and practitioner engagement and education. It has, over the years, developed more than 60 affiliated chapters around the globe, an important institutional achievement. It will be a pleasure, Stuart, to hear from you.
Our first speaker this evening, Dr. Rima Khabbaz, is the Deputy Director of Infectious Diseases and Director of the Office of Infectious Diseases at the CDC. Dr. Khabbaz has held positions at the CDC since 1980, beginning as an epidemic intelligence service officer in the National Center for Infectious Diseases’ Hospital Infections Program. She has seen this problem in virtually every expression and in every setting over the years. I am very grateful to Rima, also, for her service as a member of the Institute of Medicine’s Forum on Microbial Threats.
More complete background information on some of the achievements and experience of our speakers may be found in the program. I know you will enjoy as much as I hearing from each and then participating in the roundtable discussion that will follow. Now, let me turn to Rima Khabbaz, our first speaker. The floor is yours.