Federal agencies play a variety of roles in supporting and protecting the optimal use of drugs and other antimicrobial products. For example, the National Institutes of Health (NIH) support research to develop new antimicrobial products. Once developed, the Food and Drug Administration (FDA) approves them for marketing and sale. The Centers for Disease Control and Prevention (CDC) engage in public education campaigns to inform doctors and consumers how the drugs should be appropriately utilized in humans and the Centers for Medicare and Medicaid Services (CMS) determine reimbursement for antimicrobials consumed by most of the country's poor, elderly, and disabled people. The federal government has a responsibility to act, but without any one agency clearly positioned to lead, it is nearly impossible for all of these different actors to coordinate their activities to create a systematic national response to the problem of antibiotic resistance.
In light of this leadership vacuum, the Interagency Task Force on Antimicrobial Resistance (ITFAR) was created in 1999. This policy brief from RWJF grantee Extending the Cure contends that ITFAR is uniquely positioned to direct and support the federal response to antimicrobial resistance but has done little to shape federal action in its first 10 years. The task force has successfully documented progress on federal antimicrobial resistance-related projects and increased communication both within the agencies and between the agencies and external partners, yet it has failed to live up to its potential as a priority-setting and decision-making body.