Message From Our President

The year 2011 will mark a major milestone for APUA – a celebration of our 30th year leading the global battle to improve antimicrobial use and curbing antimicrobial resistance. In the decade since our 20th anniversary, drug resistance has continued to permeate the globe, with more and newer multidrug resistance combinations confronting the treatment of bacterial, fungal, viral and parasitic diseases. The world is clearly in need of more accessible first-line agents and discovery of new antimicrobials. At the same time we need incentives to improve patient and provider use of antibiotics to conserve their power once in line.  APUA has instituted new programs and expanded several ongoing projects over this period of time, including the Global Advisory on Antimicrobial Resistance Data (GAARD) and the Reservoirs of Antibiotic Resistance (ROAR) programs. In 2003 our Shadow Epidemic Executive Report was distributed to public and legislative bodies, presenting the first global snapshot of resistance in the world’s major viral, parasitic and bacterial pathogens.  Comprehensive reviews of antimicrobial resistance were published in Clinical Infectious Diseases. Hundreds of individuals have joined our ROAR project list-serv. Since inauguration of this novel collaboration of international investigators, greater attention has focused on commensal bacteria, i.e., those normally unassociated with disease, but which harbor the resistance determinants that can be transferred to more infectious agents. In fact, an important and worrisome development over the past decade is the appearance of many of these commensals as pathogens, such asStaphylococcus epidermidis and S. aureus that cause skin diseases and septicemia, E. coliand enterococci associated with systemic and urinary tract problems, and certain non-invasive species of Hemophilus and streptococci involved in respiratory tract infections.

APUA was created as an alliance of individuals, groups and countries with a common concern and vision.  What are the fruits of this growing alliance?  First, antimicrobial resistance has become a priority focus for organizations such as WHO, CDC, FDA and USAID. We now see a better understanding by the consumer (the patient) of the need to respect our valuable antimicrobial agents. There is a broader comprehension among physicians and patients that antibiotics are not always to be expected or needed. Finally there is increased reluctance by the prescriber to dispense antimicrobials unless absolutely necessary.  Encouraged by this increased awareness, APUA now seeks to develop tools and implement concrete interventions that can significantly reduce morbidity and mortality

APUA’s mission remains steadfast – to improve and strengthen society’s defenses against infectious diseases through improved antimicrobial availability and use. We have extended our focus beyond bacteria to include other microbial agents, namely viruses, parasites and fungi.

By building coordinated global partnerships, APUA has laid the groundwork for a more aggressive campaign to curb resistance and improve access to appropriate antibiotics. APUA counts on its national and international partners and countrywide members to work with us in our continuing efforts to achieve our goals. As we enter the next quarter century, we recognize the vital role of our partners: our chapters, public health organizations and corporate sponsors supporting the mission of the Alliance. Our professional, expert staff has grown and crafted new initiatives to advance our mission. We thank all members and friends of APUA for your past support and look forward to working with you as we encounter new opportunities to conserve and build an antimicrobial armamentarium that will meet the infectious disease challenges worldwide.

We are all in this together.

Dr. Stuart B. Levy
President, APUA

APUA Timeline 1975-2011

2002: APUA expands its scope in response to pressing global epidemics of HIV, malaria, and tuberculosis with three Nobel Prize winners (Dr. Paul Farmer, Dr. Thomas Wellems, and Dr. Jay Levy) serving on the Scientific Advisory Board

2002: APUA publishes FAAIR I report, “The Need to Improve Antimicrobial Use in Agriculture: Ecological and Human Health Consequences,” in Clinical Infectious Diseases

2002: APUA’s Global Research to Improve Antimicrobial Policy and Practice (GRIP) Program distributes research grants to 10 APUA chapters

2002: APUA and the Pan American Health Organization (PAHO) collaborate on a survey on physician antibiotic prescribing practices and knowledge in seven countries in Latin America and the Caribbean

2003: McDonald’s Corporation requires its meat suppliers to stop using antibiotics important in human medicine to promote animal growth based on findings from APUA’s FAAIR report as scientific evidence.

2003: APUA’s 20th Anniversary: APUA receives scores of professional accolades and letters of commendation

2004: APUA Educational Symposium preceding the 42nd annual meeting of IDSA, “Facing the Next Pandemic of Pan-Resistant Gram-negative Bacilli”

2005: APUA FAAIR II Report is published as a supplement in Preventive Veterinary Medicine

2005: “Shadow Epidemic: The Growing Menace of Drug Resistance (2005 GAARD Report),” the world’s first comprehensive report on global antimicrobial resistance in HIV, malaria, TB, and other priority bacterial pathogens, is published as a Clinical Infectious Diseases journal supplement

2005: APUA sponsors a Congressional Staff Briefing on Capitol Hill called “Drug-Resistant Infections in the U.S.: A Threat to Patient Safety, National Security and Health Care Costs”

2006: APUA celebrates its 25th Anniversary

2006: APUA Symposium at ICAAC entitled “Reversing Antibiotic Resistance: Population biology suggests different resistance management strategies for different pathogens”

2006: APUA World Congress: Strengthening Society’s Infectious Disease Defenses: Accelerating Incentives for Research and Development

2006: APUA conducts a national consumer survey called “Antibiotics and the Consumer: Perceptions and Use” to learn about patient behaviors and beliefs regarding antibiotic use and its implications for clinical practice. Funded by Pfizer.

2006: APUA launches a research and education campaign funded by Clorox called “Hygiene for a Healthy Household”

2007: APUA’s 2nd World Congress: Devising Improved Methods for Identification and Treatment of Infectious Diseases

2008: APUA conducts the first comprehensive studies of antibiotic resistance and use in Uganda and Zambia called “Antibiotic Resistance Situation Analysis and Needs Assessment in Uganda and Zambia.” Funded by the Bill and Melinda Gates Foundation.

2008: APUA begins its International Surveillance of Reservoirs of Antibiotic Resistance (ISRAR) project to collect global environmental and veterinary commensal isolates

2009: APUA and Cook County Hospital publish first study of the cost of antibiotic resistance in US hospitals called “Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship”

2010: APUA hosts a roundtable meeting in Paris called “The EU Ban on Use of Antibiotics for Growth Promotion in Agriculture: Review of Scientific Evidence and Implications for Public Health.” Funded by Pew Charitable Trusts.

2011: APUA celebrates its 30th anniversary.

1975-76: Dr. Stuart B. Levy and his research group performed the first, and only, prospective study of the effect of introducing antibiotic-laced feed on a farm. This study demonstrated the ecological and environmental impact of antibiotic use on both farm animals and on farm dwellers themselves.

1980: The Levy lab makes the seminal discovery of drug efflux as a mechanism of tetracycline resistance.

1981: SBL founded APUA as a global nonprofit organization with the goals of improving antimicrobial use and containing antibiotic resistance worldwide.

1981: A meeting is convened in Santo Domingo, Dominican Republic, bringing together over 200 clinicians and scientists to discuss antibiotic treatment problems and the ecology of resistance.

1981: The “Antibiotic Misuse Statement” is drafted and presented at a press conference. It is endorsed by hundreds of clinicians, researchers, and scientific societies.

1981: The antibiotic resistance issue is picked up by Newsweek, Time, The New York Times, the Washington Post, and other media outlets and scientific journals.

1982: APUA released a statement regarding worldwide antibiotic misuse at a conference on Molecular Biology, Pathogenicity and Ecology of Bacterial Plasmids

1983: 1st APUA Scientific Newsletter on antimicrobial resistance

1994: Establishment of APUA EU chapter network

1996: APUA expands its programs and links to government and professional societies

1997: APUA sponsors symposium on antimicrobials and chemotherapy in Oaxaca, Mexico

1997: APUA is awarded a grant from NIAID for the Reservoirs of Antibiotic Resistance (ROAR) project, a national research network to study resistance in commensal organisms

1998: Working with the Massachusetts Infectious Disease Society and the Massachusetts Department of Public Health, APUA conducts an opinion survey to assess physicians’ decision making and prescribing practices

1998: Global Surveillance Roundtable at ICID

1998: APUA conducts a national public awareness campaign about the environmental impact of antibiotics. Funded by the Nathan Cummings Foundation.

1998: Coordination of the GAARD network, the first public-private partnership to track resistance worldwide

1999: APUA hosts the Summit on Antimicrobial Resistance in San Francisco entitled “Truth and Consequences in Community Medical Practice.” Funded by Procter and Gamble Pharmaceuticals.

2000: Key findings stating that “elimination of non-therapeutic use antimicrobials in food animals and with consequent benefits to human and animal health” are presented at the National Press Clubagriculture would lower the burden of antimicrobial resistance in the environment

2000: First international network of APUA chapters in Latin America is established

2001: Dr. Levy announces the release of the WHO’s Global Strategy for Containment of Antimicrobial Resistance

2001: First network of chapters in Sub Saharan Africa dedicated to ABR is established.

2001: “Antibiotic resistance: synthesis of recommendations by expert policy groups,” APUA’s background document for the WHO Global Strategy for Containment of Antimicrobial Resistance, is published

2002: SBL publishes The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers

2002: 1st APUA strategic plan is developed by board