31 March 2023

The PACCARB has identified four major areas in which improvements can strengthen our preparedness
for future PHEs and reduce the toll of resistant infections now and during a PHE. In each of these areas,
investments in steady-state capabilities and capacities are needed to help address the current rise in
AMR infections and to respond to the next PHE quickly and effectively.

The recommendations in the draft report:

Equity, Trust, and Communication
Recommendation 1: Prioritize social, structural, and behavioral interventions that build trust
in public health guidance and increase uptake of both pharmaceutical and nonpharmaceutical interventions in steady-state and during a PHE.
Recommendation 2: Include marginalized and vulnerable communities during the
development, implementation, and communication of all pandemic preparedness policies.
Infection Prevention and Control and Antimicrobial Stewardship
Recommendation 3: Include infection prevention and control and antimicrobial
stewardship as core capabilities and goals in pandemic preparedness policies including
through dissemination of existing and updated guidelines.
Recommendation 4: Create a mechanism for rapid guideline development for appropriate
antimicrobial use in response to an emerging AMR pathogen and to maintain antimicrobial
stewardship during an emergency.
Workforce Expansion
Recommendation 5: Bolster the workforce by expanding recruitment and support of
infection preventionists and infectious diseases specialists and engaging a broader set of
providers in human and animal healthcare.
Recommendation 6: Develop pathways that would allow for qualified practitioners in other
One Health domains to provide support to human healthcare during a PHE.
Recommendation 7: Build capacity for both human and animal diagnostic laboratory
networks to meet emergency surge testing demands.
Data Sharing and Security
Recommendation 8: Invest in global capacity for AMR pathogen surveillance and early
detection of novel AMR pathogens.
Recommendation 9: Expand and diversify sectors participating in domestic AMR
surveillance efforts to include outpatient clinical settings, independent/clinical laboratories,
wildlife, companion animals, wastewater, and others.
Recommendation 10: Modernize existing surveillance databases for One Health
interoperability to accommodate data input from different human, animal, and
environmental health sources, as well as variables that capture social determinants of
Recommendation 11: Invest in improved data privacy and security to encourage more
private entities to contribute data, including AMR data, to federal data management
systems used in public health, agricultural, and environmental sectors.
Product Innovation
Recommendation 12: Develop novel antimicrobials, vaccines, diagnostics, and threatagnostic platform technologies focused on resistant bacterial and fungal pathogens, which
are material threats likely to arise during a PHE.
Recommendation 13: In anticipation of a PHE, establish flexible, response-ready clinical trial
networks that include outpatient settings and vulnerable populations, such as pediatrics,
and that can easily adapt in an emergency to determine the safety and efficacy of novel
Recommendation 14: Develop accelerated regulatory approval pathways to assess novel,
unique, or nontraditional technologies or products and ensure sufficient funding and
procedures are in place to support and maintain the FDA review process during a PHE.


Further reading: PACCARB
Author(s): Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Effective Surveillance  


Unrestricted financial support by:


Antimicrobial Resistance Fighter Coalition

Bangalore Bioinnovation Centre


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