,,ii #aae? ,,congress #b;d ,session ,s4 #bdfi ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,febru>y #bh1 #bjah ,mr4 ,br[n introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to am5d ! ,public ,heal? ,s]vice ,act to enhance ef=ts to address antibiotic resi/ance1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,/rategies to ,address ,antibiotic ,resi/ance ,act or ! ,,/a> ,act4 #b4 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,antibiotic resi/ance is "o ( ! greate/ ?reats to human heal? worldwide1 necessitat+ increas$ prev5tion ef=ts1 antimicrobial /ew>d%ip programs & surveillance programs1 & rese>* & developm5t ( new antibiotics & rapid diagno/ics4 7#b7 ,s9ce ! discov]y ( antibiotic drugs1 ^! p[]ful drugs h sav$ millions ( lives & all[$ = incr$ible m$ical progress4 ,h[ev]1 antibiotic resi/ance is accel]at$ by ov]- & inappropriate use ( antibiotic drugs by :i* bact]ia1 ?r\gh mutation & o!r me*anisms1 c develop resi/ance to antibiotic drugs4 7#c7 ,antibiotic-resi/ant infections significantly complicate a wide v>iety ( complex m$ical s]vices1 includ+ *emo!rapy to treat canc]1 solid organ & bone m>r[ transplants1 jo9t replacem5ts & o!r surg]ies1 & c>e ( pret]m infants & o!r immunocompromis$ individuals4 7#d7 ,accord+ to ! ,c5t]s = ,disease ,control & ,prev5tion1 ea* ye> 9 ! ,unit$ ,/ates at lea/ #b1jjj1jjj p become infect$ ) bact]ia t are resi/ant to antibiotics & at lea/ #bc1jjj p die z a result ( antibiotic-resi/ant infections4 ,_m m p die f o!r conditions t 7 complicat$ by an antibiotic-resi/ant infection4 7#e7 ,accord+ to a #bjae report f ! ,new ,engl& ,j\rnal ( ,m$ic9e1 ,clo/ridium difficile infects approximately #ejj1jjj pati5ts 9 ! ,unit$ ,/ates ea* ye>1 result+ 9 almo/ #cj1jjj dea?s & an e/imat$ #d1hjj1jjj1jjj 9 excess heal? c>e co/s ea* ye>4 ,clo/ridium difficile infections are mo/ common z a result ( ov]-prescrib+ antibiotics1 & antibiotic-resi/ant /ra9s ( ,clo/ridium difficile are on ! rise4 7#f7 ,! ,c5t]s = ,disease ,control & ,prev5tion e/imate t ! annual impact ( antibioticresi/ant infections on ! ,unit$ ,/ates economy is m ?an #bj1jjj1jjj1jjj 9 excess direct heal? c>e co/s4 ,additional co/s to ! ,unit$ ,/ates economy = lo/ productivity f antibiotic-resi/ant infections may be z great z #ce1jjj1jjj1jjj p] ye>4 7#g7 ,data f ! ,c5t]s = ,disease ,control & ,prev5tion indicate t at lea/ #cj p]c5t ( antibiotic drugs us$ 9 hospitals are unnecess>y or prescrib$ incorrectly4 ,simil>ly1 ! ,c5t]s = ,disease ,control & ,prev5tion e/imate t approximately #cj p]c5t ( antibiotic drugs prescrib$ 9 outpati5t cl9ics are unnecess>y & t approximately #dj p]c5t ( ord]s = antibiotic drugs 9 nurs+ homes lack$ important prescrib+ in=mation4 ,?us1 improvem5ts 9 prescrib+ antibiotic drugs are necess>y across heal? c>e sett+s4 7#h7 ,! ,national ,action ,plan = ,combat+ ,antibiotic-,resi/ant ,bact]ia1 publi%$ 9 ,m>* #bjae1 9 response to ,executive ,ord] #acfgf ( ,septemb] #ah1 #bjad 7#gi ,f$4 ,reg4 #efica2 relat+ to combat+ antibiotic-resi/ant bact]ia71 outl9es ! dome/ic & int]national ef=ts to be conduct$ by ! ,unit$ ,/ates to prev5t1 detect1 & control illness & dea? relat$ to infections caus$ by antibiotic-resi/ant bact]ia4 #c4 ,combat+ antimicrobial resi/ance ,section #cai;,e ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;d-#e7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 p>agraph 7#a71 9 ! fir/ s5t5ce1 by /rik+ & coord9ate ,f$]al programs relat+ to antimicrobial resi/ance & ins]t+ relat+ to antimicrobial resi/ance1 coord9ate ,f$]al programs relat+ to antimicrobial resi/ance1 & implem5t ! objectives ( ! ,national ,action ,plan = ,combat+ ,antibiotic-,resi/ant ,bact]ia1 publi%$ 9 ,m>* #bjae 9 response to ,executive ,ord] #acfgf ( ,septemb] #ah1 #bjad 7#gi ,f$4 ,reg4 #efica2 relat+ to combat+ antibiotic-resi/ant bact]ia7 7ref]r$ to 9 ?is section z ! ,action ,plan72 7,b7 by am5d+ p>agraph 7#b7 to read z foll[s3 7#b7 ,memb]s ( task =ce ,! task =ce describ$ 9 p>agraph 7#a7 %all be co-*air$ by ! ,secret>y ( ,heal? & ,human ,s]vices1 ! ,secret>y ( ,agriculture1 & ! ,secret>y ( ,def5se1 & %all be compos$ ( repres5tatives ( relevant ,f$]al ag5cies & su* executive dep>tm5ts1 ag5cies1 or (fices z ! co-*airs may designate4 2 7,c7 by am5d+ p>agraph 7#d7 to read z foll[s3 7#d7 ,meet+s ,at lea/ twice a ye>1 ! task =ce describ$ 9 p>agraph 7#a7 %all h a public meet+ to assess progress & ob/acles to implem5t+ ! objectives ( ! ,action ,plan4 ,! task =ce may discuss & review bas$ on ne$ or conc]n ! foll[+ 7among o!r issues73 7,a7 ,f$]al activities to sl[ ! em]g5ce ( antimicrobial-resi/ant bact]ia & prev5t ! spread ( resi/ant infections4 ,su* activities may include optimal use ( vacc9es & o!r infection control measures to prev5t infections1 implem5tation ( heal? c>e policies & antimicrobial /ew>d%ip programs t improve pati5t outcomes1 regional ef=ts to control transmission across community & heal? c>e sett+s1 & public aw>5ess campaigns4 7,b7 ,f$]al activities to /r5g!n national ,"o-,heal? surveillance ef=ts1 :i* are ef=ts address+ ! int]actions betwe5 human1 animal1 & environm5tal heal?1 to combat antibiotic resi/ance4 ,"o-,heal? surveillance ef=ts to combat antibiotic resi/ance may include enhanc$ data %>+ & coord9ation ( surveillance & laboratory sy/ems across human & animal sett+s1 & enhanc$ monitor+ ( sales1 usage1 resi/ance1 & managem5t practices ( antibiotic drugs along ! food-production *a94 ,su* surveillance & laboratory sy/ems may include ! ,national ,heal?c>e ,safety ,network1 ! ,em]g+ ,infections ,program1 ! ,national ,antimicrobial ,resi/ance ,monitor+ ,sy/em1 ! ,national ,animal ,heal? ,monitor+ ,sy/em1 ! ,national ,animal ,heal? ,laboratory ,network1 ! ,vet]9>y ,laboratory ,inve/igation & ,response ,network1 & ! ,antibiotic ,resi/ance ,laboratory ,network4 7,c7 ,f$]al ef=ts to advance ! developm5t & use ( rapid & innovative diagno/ic te/s = id5tification & *>act]ization ( antibiotic-resi/ant bact]ia4 ,su* ef=ts may include developm5t ( new diagno/ic te/s & expansion ( _! availability & use to improve treatm5t1 infection control1 & outbreak response4 7,d7 ,f$]al ef=ts to accel]ate basic & appli$ rese>* & developm5t = new antibiotic drugs1 o!r !rapeutics1 prev5tion ef=ts1 & vacc9es4 ,su* ef=ts may include support = basic & appli$ rese>*1 provision ( sci5tific s]vices & guidance to rese>*]s1 & fo/]+ ( public-private p>tn]%ips4 7,e7 ,f$]al ef=ts to improve int]national collaboration & capacities = antibiotic-resi/ance prev5tion1 surveillance1 & control & antibiotic rese>* & developm5t4 ,su* ef=ts may include collaborations ) =eign m9i/ries ( heal? & agriculture1 ! ,_w ,heal? ,organization1 ! ,food & ,agriculture ,organization1 ! ,_w ,organization = ,animal ,heal?1 & o!r mult9ational organizations4 2 & 7,d7 by add+ at ! end ! foll[+3 7#e7 ,availability ( in=mation ,! task =ce describ$ 9 p>agraph 7#a71 to ! ext5t p]mitt$ by law1 %all-- 7,a7 provide ! ,advisory ,c\ncil def9$ 9 section #cai;,e-#a7;a7 ) su* in=mation z may be requir$ = c>ry+ out ! functions ( su* ,advisory ,c\ncil1 includ+ in=mation on progress 9 advanc+ ! ,action ,plan1 meet+ m9utes1 & o!r key in=mation ( ! task =ce2 & 7,b7 ensure t all in=mation describ$ 9 subp>agraph 7,a7 is made available on ! websites ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 ! ,dep>tm5t ( ,agriculture1 & ! ,dep>tm5t ( ,def5se4 2 7#b7 9 subsection 7h7-- 7,a7 9 ! head+1 by /rik+ ,in=mation relat$ to2 7,b7 by /rik+ ,! ,secret>y & ins]t+ ! foll[+3 7#a7 ,dissem9ation ( in=mation ,! ,secret>y 2 & 7,c7 by add+ at ! end ! foll[+3 7#b7 ,enc\rag+ antimicrobial /ew>d%ip programs ,! ,secret>y %all enc\rage heal? c>e facilities to e/abli% antimicrobial /ew>d%ip programs t are consi/5t ) docum5ts issu$ by ! ,c5t]s = ,disease ,control & ,prev5tion relat+ to ! core elem5ts ( antimicrobial /ew>d%ip programs4 7#c7 ,def9ition ( antimicrobial /ew>d%ip ,= purposes ( ?is section1 ! t]m antimicrobial /ew>d%ip means coord9at$ int]v5tions design$ to improve & evaluate ! appropriate use ( antimicrobial ag5ts1 includ+ promot+ ! use ( antimicrobial drugs only :5 cl9ically indicat$1 &1 :5 antimicrobial drugs are cl9ically indicat$1 promot+ ! selection ( ! optimal antimicrobial drug regim51 includ+ ?r\gh factors su* z dosage1 duration ( !rapy1 & r\te ( adm9i/ration4 2 7#c7 9 subsection 7m71 by /rik+ #dj1jjj1jjj & all t foll[s ?r\gh ! p]iod at ! end & ins]t+ su* sums z may be necess>y = ea* ( fiscal ye>s #bjah ?r\gh #bjbd42 & 7#d7 by add+ at ! end ! foll[+3 7n7 ,annual report on implem5t+ ! ,action ,plan objectives ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ! ,/rategies to ,address ,antibiotic ,resi/ance ,act1 & annually !reaft]1 ! ,secret>y1 9 coop]ation ) ! ,secret>y ( ,agriculture1 ! ,secret>y ( ,def5se1 & ! task =ce describ$ 9 subsection 7a71 %all submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives1 & make available on ! websites ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 ! ,dep>tm5t ( ,agriculture1 & ! ,dep>tm5t ( ,def5se1 a report on ! progress made 9 implem5t+ ! objectives ( ! ,action ,plan4 4 #d4 ,additional /rategies = combat+ antibiotic resi/ance ,"p ,b ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdc et seq47 is am5d$ by ins]t+ aft] section #cai;,e ! foll[+3 #cai;,e-#a4 ,presid5tial ,advisory ,c\ncil on ,combat+ ,antibiotic-,resi/ant ,bact]ia 7a7 ,def9itions ,9 ?is section3 7#a7 ,action ,plan ,! t]m ,action ,plan means ! ,action ,plan describ$ 9 section #cai;,e7a77#a74 7#b7 ,advisory ,c\ncil ,! t]m ,advisory ,c\ncil means ! ,presid5tial ,advisory ,c\ncil on ,combat+ ,antibiotic-,resi/ant ,bact]ia e/abli%$ by ,executive ,ord] #acfgf ( ,septemb] #ah1 #bjad 7#gi ,f$4 ,reg4 #efica2 relat+ to combat+ antibiotic-resi/ant bact]ia74 7#c7 ,national ,/rategy ,! t]m ,national ,/rategy means ! ,national ,/rategy = ,combat+ ,antibiotic-,resi/ant ,bact]ia issu$ by ! ,:ite ,h\se 9 ,septemb] #bjad1 & any subsequ5t update to su* /rategy or a successor /rategy4 7b7 ,advisory ,c\ncil ,! ,advisory ,c\ncil %all provide advice1 in=mation1 & recomm5dations to ! ,secret>y reg>d+ programs & policies int5d$ to support & evaluate ! implem5tation ( ,executive ,ord] #acfgf ( ,septemb] #ah1 #bjad 7#gi ,f$4 ,reg4 #efica2 relat+ to combat+ antibiotic-resi/ant bact]ia71 includ+ ! ,national ,/rategy1 & ! ,action ,plan4 7c7 ,meet+s & duties 7#a7 ,meet+s ,! ,advisory ,c\ncil %all meet z ! ,*air det]m9es appropriate b n less ?an twice p] ye>1 &1 to ! ext5t practicable1 9 conjunction ) meet+s ( ! task =ce describ$ 9 section #cai;,e4 7#b7 ,recomm5dations ,! ,advisory ,c\ncil %all make recomm5dations to ! ,secret>y1 9 consultation ) ! ,secret>y ( ,agriculture & ! ,secret>y ( ,def5se1 reg>d+ programs & policies int5d$ to-- 7,a7 pres]ve ! effectiv5ess ( antibiotics by optimiz+ _! use2 7,b7 advance rese>* to develop improv$ me?ods = combat+ antibiotic resi/ance & conduct+ antimicrobial /ew>d%ip1 z def9$ 9 section #cai;,e7h77#c72 7,c7 /r5g!n surveillance ( antibiotic-resi/ant bact]ial infections2 7,d7 prev5t ! transmission ( antibiotic-resi/ant bact]ial infections2 7,e7 advance ! developm5t ( rapid po9t-(-c>e & agricultural diagno/ics2 7,f7 fur!r rese>* on new treatm5ts = bact]ial infections2 7,g7 develop alt]natives to antibiotics = animal heal? purposes2 7,h7 maximize ! dissem9ation ( up-to-date in=mation on ! appropriate & prop] use ( antibiotics to ! g5]al public & human & animal heal? c>e provid]s2 & 7,i7 improve int]national coord9ation ( ef=ts to combat antibiotic resi/ance4 #cai;,e-#b4 ,surveillance & report+ ( antibiotic use & resi/ance 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all use ! ,national ,heal?c>e ,safety ,network & o!r appropriate surveillance sy/ems to assess-- 7#a7 appropriate conditions1 outcomes1 & measures causally relat$ to antibact]ial resi/ance1 includ+ types ( infections1 ! causes = infections1 & :e!r infections are acquir$ 9 a community or hospital sett+1 increas$ l5g?s ( hospital /ay1 increas$ co/s1 & rates ( mortality2 & 7#b7 *anges 9 bact]ial resi/ance to drugs 9 relation to pati5t outcomes1 includ+ *anges 9 p]c5t resi/ance1 preval5ce ( antibiotic-resi/ant infections1 & o!r su* *anges4 7b7 ,antibiotic use data ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all "w ) ,f$]al ag5cies 7includ+ ! ,dep>tm5t ( ,vet]ans ,affairs1 ! ,dep>tm5t ( ,def5se1 & ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices71 private v5dors1 heal? c>e organizations1 ph>macy b5efit manag]s1 & o!r entities z appropriate to obta9 reliable & comp>able human antibiotic drug consumption data 7includ+1 z available & appropriate1 volume antibiotic di/ribution data & antibiotic use data1 includ+ prescription data7 by ,/ate or metropolitan areas4 7c7 ,antibiotic resi/ance tr5d data ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all int5sify & exp& ef=ts to collect antibiotic resi/ance data & enc\rage adoption ( ! antibiotic resi/ance & use module )9 ! ,national ,heal?c>e ,safety ,network among all heal? c>e facilities across ! cont9uum ( c>e1 includ+1 z appropriate1 acute c>e hospitals1 dialysis facilities1 nurs+ homes1 & ambulatory surgical c5t]s4 ,! ,secret>y %all seek to collect su* data f electronic m$ication adm9i/ration reports & laboratory sy/ems to produce ! reports describ$ 9 subsection 7d74 7d7 ,public availability ( data ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all1 = ! purposes ( improv+ ! monitor+ ( important tr5ds 9 pati5t outcomes 9 relation to antibact]ial resi/ance-- 7#a7 make ! data d]iv$ f surveillance "u ?is section publicly available ?r\gh reports issu$ on a regul> basis t is n less ?an annually2 & 7#b7 exam9e opportunities to make su* data available 9 ne> real "t4 #cai;,e-#c4 ,detect+ network ( antibiotic resi/ance regional laboratories 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all e/abli% n less ?an #g ,antibiotic ,resi/ance ,surveillance & ,laboratory ,network sites1 build+ ^u ! intramural & extramural programs & laboratories ( ! ,c5t]s = ,disease ,control & ,prev5tion1 to int5sify1 /r5g!n1 & exp& ! national capacity to-- 7#a7 monitor ! em]g5ce & *anges 9 ! patt]ns ( antibiotic-resi/ant bact]ia2 7#b7 describe1 confirm1 &1 z necess>y1 facilitate a response to1 local or regional outbreaks ( resi/ant bact]ia2 7#c7 assess & describe antibiotic resi/ance patt]ns to in=m public heal? & improve prev5tion practices2 7#d7 obta9 isolates ( pa?og5s1 & 9 p>ticul>1 bact]ia t %[ new or atypical patt]ns ( resi/ance adv]sely affect+ public heal?2 7#e7 assi/ 9 /udy+ ! epidemiology ( infections f su* pa?og5s2 7#f7 evaluate commonly us$ antibiotic susceptibility te/+ me?ods to improve ! accuracy ( resi/ance te/+ & report+2 7#g7 z necess>y1 develop or evaluate novel diagno/ic te/s capable ( detect+ new or em]g+ resi/ance 9 bact]ia2 7#h7 l9k data g5]at$ by regional laboratory networks "u exi/+ public heal? surveillance networks & relevant gov]nm5t ag5cies2 & 7#i7 provide laboratory assi/ance & ref]5ce te/+ ( antibiotic-resi/ant bact]ia to enhance infection control & facilitate outbreak detection & response 9 heal? c>e & community sett+s4 7b7 ,geographic di/ribution ,! sites e/abli%$ "u subsection 7a7 %all be geographically di/ribut$ across ! ,unit$ ,/ates4 7c7 ,nonduplication ( curr5t national capacity ,! sites e/abli%$ "u subsection 7a7 may be bas$ 9 academic c5t]s1 heal? dep>tm5ts1 & exi/+ surveillance & laboratory sites4 #cai;,e-#d4 ,cl9ical trials network on antibact]ial resi/ance 7a7 ,9 ,g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,national ,in/itute ( ,all]gy & ,infecti\s ,diseases1 %all ma9ta9 a ,cl9ical ,trials ,network on ,antibact]ial ,resi/ance to enhance1 /r5g!n1 & exp& rese>* on cl9ical sci5ce1 antibact]ial & diagno/ic developm5t1 & optimal usage /rategies ) respect to address+ antibact]ial resi/ance4 ,su* ,network %all1 at a m9imum-- 7#a7 facilitate rese>* to bett] und]/& resi/ance me*anisms & h[ to prev5t1 control1 & treat resi/ant organisms2 7#b7 advance cl9ical trial ef=ts to develop antibiotics diagno/ics1 & evaluate & optimize ! usage ( su* antibiotics diagno/ics2 7#c7 conduct cl9ical rese>* to develop natural hi/ories ( resi/ant infecti\s diseases2 7#d7 exam9e pati5t outcomes ) curr5tly available antibiotic !rapy & validate & improve ^u biom>k]s & o!r surrogate endpo9ts2 & 7#e7 /udy %ort] treatm5t duration & e>ly cessation ( antibiotic !rapy = treatm5t efficacy & ! effect on developm5t ( resi/ance4 7b7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjah ?r\gh #bjbd4 #cai;,e-#e4 ,regional prev5tion collaborative ef=ts 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all "w ) ,/ate & local heal? dep>tm5ts to support ! expansion ( collaborative ef=ts by gr\ps ( heal? c>e facilities t focus on prev5t+ ! spread ( antibiotic-resi/ant bact]ia t pose a s]i\s ?reat to public heal?1 & t are design$ to int]rupt & prev5t ! transmission ( significant antibiotic-resi/ant pa?og5s be+ transmitt$ across heal? c>e sett+s 9 a geographic region4 ,su* collaborative ef=ts %all-- 7#a7 id5tify significant drug resi/ant pa?og5s be+ transmitt$ across heal? c>e sett+s locally2 7#b7 implem5t evid5ce-bas$ int]v5tions to int]rupt ! transmission ( antibiotic-resi/ant /ra9s ( bact]ia & prev5t ! infections caus$ by su* bact]ia1 includ+ evid5ce-bas$ transmission prev5tion guidel9es1 rigor\s h&-hygi5e protocols1 & infection control & prev5tion measures2 7#c7 assess compliance & id5tify b>ri]s to adh]5ce to su* measures2 7#d7 evaluate ! impact ( su* measures1 to ! ext5t possible1 on hospital readmissions 9 heal? c>e facilities across ! cont9uum ( c>e1 rates ( heal? c>e associat$ infections1 or any o!r relevant measures t *>act]ize ! heal? or economic impact ( ! collaborative ef=ts2 & 7#e7 provide recomm5dations = improv$ outcomes & compliance ) su* measures4 7b7 ,prev5tion epic5t]s 7#a7 ,expansion ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 may int5sify & exp& academic public heal? p>tn]%ips ?r\gh ! ,prev5tion ,epic5t]s ,program to provide ! regional prev5tion collaboration ef=ts describ$ 9 subsection 7a7 ) tools1 /rategies1 & evid5ce-bas$ int]v5tions4 7#b7 ,evaluations & rese>* ,! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion & ! epic5t]s p>ticipat+ 9 ! ,prev5tion ,epic5t]s ,program %all "w ) entities1 includ+ ! entities p>ticipat+ 9 ! regional prev5tion collaborative ef=ts1 to-- 7,a7 evaluate new & exi/+ int]v5tions to prev5t or limit infection rates 9 heal? c>e facilities across ! cont9uum ( c>e & 9 community sett+s2 7,b7 facilitate public heal? rese>* on ! prev5tion & control ( resi/ant organisms2 & 7,c7 assess ! feasibility1 co/-effectiv5ess1 & appropriat5ess ( surveillance & prev5tion programs 9 diff]+ heal? c>e & in/itutional sett+s4 7c7 ,educational mat]ials ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all use ! evaluations1 rese>*1 & assessm5ts describ$ 9 subsection 7b7 to create & dissem9ate educational mat]ials focus$ on infection prev5tion & control = use 9 heal? c>e facilities across ! cont9uum ( c>e & 9 community sett+s4 4 #e4 ,protection ( confid5tial & national security in=mation ,?is ,act1 & ! am5dm5ts made by ?is ,act1 %all n be con/ru$ to p]mit ! disclosure ( any trade secret1 confid5tial comm]cial in=mation1 or mat]ial inconsi/5t ) national security1 t is o!rwise prohibit$ by law4