Recognized as one of the best internet providers and we are just Getting Started building 100,000 miles of new infrastructure to reach those who need it most. Charter communications supports cspan as a Public Service along withhese other Television Providers givingou a frontrow seat to democracy. Next a hearing on a report about Antimicrobial Resistance. And how federal agencies are addressing the problem. Witnesses testified on Public Health concerns at the house energy and commerce subcommittee investigates the threat posed to the u. S. Health care system. This is two hours. I ask all guests to take their seats. Welcome to what i hope would be a welcome to the hearing on Antimicrobial Resistance. We heard that the risk of a pathogen escaping from a lab and causing a pandemic is real. Just as real as the threat posed by antimicrobial resistant pathogens. Significant research was being done on bacteria phage therapy. Its where we search for a virus to provide attack harmful bacteria. Ever since penicillin, antibiotics have been developed to treat previously untreatable infections and they truly are lifesavers. Unfortunately face therapy phage therapy fell to the wayside. The problem is over time pathogens become resistant to the commonly used classes of antibiotics. If a new way to kill a pathogen is not found, the patient is defenseless to the disease caused by the pathogens. Now, antibiotic resistance infections can be difficult to treat. Amr is referred to as the silent pandemic and has become one of the biggest medical concerns today. The pipelines for amr drugs have been drying up due to various regions, that deserve our attention. We hope to highlight that today. Despite the increased demand there has been an reduction in investment and development of new antimicrobials. According to the data, 70 of Major Drug Companies have cut or scaled back antibiotic research due to develop metal challenges. According to the centers for Disease Control and prevention, at least two point 8 Million People 2. 8 Million People are infected with antibiotic resistant bacteria in the u. S. Each year. More than 35,000 people will die as a result of such infection. The rise of drugresistant infections places a heavy burden on our Nations Health care system. The cdc suggests 30 of all antibiotics prescribed in the u. S. Are for infections that do not require antibiotics, which amassed to 47 million antibiotic courses prescribed. That said, often what happens, individual doctors face perplexing symptoms, while trying to save their patients, they will turn to antibiotics. Amr is not just an issue that arises in the hospital or health care setting. Humans and animals have the possibility of developing antimicrobials with expanding resistance. Its a problem that sometimes we dont understand. Its everything nature is doing. I met with a veterinarian which is in my district about her work in southern africa. While there, she came across abandoned mongoose who had an antimicrobial resistant, to antibiotics, that she had never seen before. This shows that the Antimicrobial Resistance can appear anywhere and everywhere. I look forward to hearing from our witnesses about potential, Innovative Solutions like phase therapy. Well hear from the gao about deficiencies at the department of health and Human Services, the agency with the most responsibility for tackling the amr problem. One issue i hope we can bring more oversight into is the number of federal programs and initiatives the government currently has to address Antimicrobial Resistance. Im pleased to see we are addressing this style of pandemic, it is congresss duty to provide oversight for how dollars are being spent. Have the programs found any success . Which of these programs are duplicate of . As we consider solutions to confront the antimicrobials, wwe must consider the work being done in the dollars being spent to combat the crisis, and look for ways that we yield more successful while there is no easy solution to the problems of amr, we are committed to exploring potential solutions to address this doublet health crisis. I want to emphasize and be clear that this hearing is not about taking a position on any legislation introduced, but rather, as the committee usually does, it is to gather information, and to find out the facts. I want to examine the amr problem, and examine the role of federal government, and find potential solutions. I look forward to hearing from our Witnesses Today. I yield back and now recognize the ranking matter member of the subcommittee. Good morning, and thank you mr. Chairman for holding this important meeting on the issue of Antimicrobial Resistance. If we have learned anything from covid19, it is that we must dedicate sufficient resources to prepare for the Public Health threats that we know of, while also working to prepare for the new and emerging threat. The cdcs 2019 threat assessment report, identified 18 bacteria and fungi that are showing resistance to available treatments. That trend is expected to rise. The u. S. Government has been aware of the threat for some time and has taken steps to address it. In 2015, president obama, the federal government, in accordance with an executive order issued by obama, the federal government released an action plan for combating antibiotic resistant bacteria that outline the framework for the federal response to this growing health threat. While we have made strides in preventing and treating antibiotic resistance, there is ground to regain as we emerge from three years of a pandemic that put unprecedented strains on the entire health care system, and rolled back some of the progress. The effort to combat antibiotic resistance requires a strong, coordinated response involving both private and Public Sector stakeholders to advance new technologies, effectively collect data on incidents of antibiotic resistant infections, make Resources Available for hospitals and providers to practice sound antibiotic stewardship. We have to foster Scientific Research and implement prevention measures. At yesterdays hearing, some republicans on the subcommittee expressed skepticism about the value of pandemic research. Today we are hearing about the importance of addressing Antimicrobial Resistance, which will require a strong supportive medical and scientific workforce. The tones of these back hearings are intentional, i hope we can come out of them with a better appreciation for the work of our scientific community. Let me make a point, while there are many fronts on which to have on which we have to fight the serious threats, we make no progress without consistent investment in Scientific Research. If the republicans proceed with appropriation in accordance with the default on america act that they passed this week, Scientific Research will suffer greatly. We need scientists to study these threats, to help us prepare against them. They should be able to do so, free of political interference, or banning Public Health research. Our important oversight responsibility include pressing for improvement across the scientific and research enterprise. In doing so, to build trust and confidence in the agencies at the forefront of a national response, like the cdc and nih. Im pleased that the gao is testifying on its third report that was completed right at the start of the covid19 pandemic. Its an excellent resource to build from, as we enter pandemic recovery, and turn our attention to the array of Public Health threats. Hopefully, with a new appreciation for the importance of preparedness. Id like to think our other witnesses for being here to share your expertise on these different angles of this complex issue. Antimicrobial resistance is a problem for patients, Health Care Professionals and researchers across the health care system. It is important to emphasize that there are environmental and agricultural aspects contribute into the rise in resistance that we have to address as well. A multipronged issue requires a multipronged solution. I look forward to the discussion today, coming out of this hearing with a deeper understanding of the nature and scope of the threat of Antimicrobial Resistance, so we can make more informed policy decisions to help combat it. Thank you again mr. Chairman, for holding this important hearing. I yield back. Thank you gentlelady for yielding back. I recognizing the chair of the committee for her five minute opening statement. Thank you, for convening this hearing about this growing threat of Antimicrobial Resistance or amr. Facing our nation and indeed the world. Thank you to our panel of Witnesses Today. More than 2. 8 million antibiotic resistant infections occur in the u. S. Each year, resulting in more than 35,000 deaths. In 2019, an estimated 1. 3 Million Deaths globally were a direct result of drug resistance. Amr is a real threat. Weve had eyedrop recalls due to contamination by an extensively drug resistant of bacteria, that has led to multiple deaths, loss of vision among patients in 16 this outbreak strain has never been ordered in the united eats prior to the outbreak. Just this week a hospital in downtown seattle announced an outbreak often found in Health Care Settings which infected 31 people for whom have died. This morning we seek to gain a better understanding of am i anr examining this ongoing Public Health threat and explore innovative path forward. Antibiotics are powerful lifesaving drug drugs. This discovery revolutionized modern medicine in addition to their use to protect human lives they are used to that care to treat the animals and keep our food supply safe from harmful passages. Globally and in the u. S. Antifungals are relatively inexpensive way to control plant diseases and protect agricultural crops. Over time, however, through an natural adaption and use, microbes can develop into superbugs, making drugs ineffective against them. Amr is a complex web that could develop and spread through a variety of settings, including Health Care Facilities, food production, the community and the environment. Theres a need to learn more about amr amr, its underlying causes to address this threat. We also must examine and understand the already existing efforts and initiatives underway and assessed how these programs are operating, including any successes and shortcomings. In 2016, theres an unprecedented hundred 16 million new investments for cdc this i amr. By fiscal year 2022, this appropriation had increased to more than 180 2 million. We are working understand how this funding has been used, what initiative cdc is undertaking, and how effective they have been. In addition to cdc funding, there are countless numbers of hhs interagency efforts focused on amr, including the creation of numerous federal task force and committees, such as the president ial Advisory Council on combating antibiotic bacterial in the combating any biotic task force, as well as an array of National Plans, strategies, databases and monitoring systems, guided documents, toolkits and guides. These efforts are not restricted to hhs. According to the Congressional Research service, the dod, state department, epa, usaid, and interior, each have their own individual existing initiatives and programs. Several sub agencies within these agencies also have separate programs. Hhs has at least eight sub agencies with individual initiatives. The fact that amr continues to be a growing threat and a Health Burden despite this heavy investment of resources is alarming and im hopeful our witnesses here today will be able to provide greater insight into why this is a case in how we can improve our ongoing efforts to address the problem. I thank you to the Ranking Member, my colleagues across the aisle, thank you to the chairman in the Ranking Member who are working together on this, i look forward to todays hearing as we explore the increasing burden and threat of amr facing our nation and world. Thank you, i yelled back. The chair recognizes the Ranking Member for his fiveminute opening statement. Thank you mr. German faq to our witnesses to help us better understand the serious threat that Antimicrobial Resistance causes to Public Health. It is not a new phenomena, it has been vexing scientists in congress for years, however, it has been increasing across the board and imposes health risks to the public. According to the center for Disease Control and prevention, more than two point eight americans have an infection in 2019 and one and 35,000 americans died from the infection in these numbers are expected to grow as more and more dangerous organisms develop resistance to the treatments available today. And that is deeply concerning tower Public Health. There is not seem to be one obvious solution to the issue and it cuts across the board to how we identify resistant threats to how we administer available drugs while also fostering the developments of new treatments. The challenging balance between withholding certain antibiotics for patients in order to avoid unintentionally promoting more resistant strains of bacteria and providing the patients the best treatment available. In terms of developing new treatments, the normal market is not always encourage the development of new drugs in this space. We want antibiotics to be developed at a more that are more powerful for those who needed and as little as possible. This is the challenge repeatedly addressed in our witness testimony and i look forward to all of your perspectives and how we might navigate this dilemma. The National Institutes of health will need to continue to support Good Research into the risk poses and how we combat those risks. We need to ensure that our health and Research Work force is Strong Enough to address these challenges from physicians and nurses, the whole spectrum of the Health Workforce has a role to play and we need to make sure our Health Centers and Research Labs are equipped. While the threat is increasing on the radar for the general public, it presents a constant threat for some individuals with Certain Health conditions, such as Cystic Fibrosis. They rely on antibiotics to treat ongoing risks of infections. Patients know the serious threats that antibiotic dash cam posed to your health if you have Cystic Fibrosis. The Public Health challenges are serious and are growing, i think that chairman for holding this hearing and look forward to the discussion with our witnesses. I yelled back. That conclude i yield back. That concludes Opening Statements. Members Opening Statements will be made a part of the record. I want to thank our witnesses for being here today and take the time to testify before our subcommittee. Each witness has an opportunity to give an opening statement. Our Witnesses Today are mary, director of health care u. S. Health care accountability office. Professor of law and executive of karp x at boston university. Amanda, Senior Vice President of Infectious Disease society of america. Amy, associate professor of medicine and pathology at university of Virginia School of medicine. We appreciate you all being here today and i look forward to supporting you on the issue. You are where the committee is holding this oversight hearing and when we hold oversight hearings we have the practice of taking testimony under oath. Do any of you have an objection to testifying under oath . Seeing no objections will proceed. You are also advised that you have the right to have counsel present should you use wish to do so pursuant to house rules. Do any of you wish to be advised by counsel during your testimony today . Seeing that none require, would you please rise in rage see her right hand. Do you promise to tell the truth, the whole truth and nothing but the truth so help you god . Seeing all witness answer in the affirmative, you are now sworn in and under oath. Title 18, section 1001 of the United States code, you may be seated. We will now recognize mary for her five minute opening statement. Thank you very much. Ranking members and members of the subcommittee, thank you for the opportunity to discuss the work on antibiotic resistance. As we address the covid19 pandemic, another pandemic has