PASTEUR Act of 2026

#7352 | HR Congress #119

Policy Area: Health
Subjects:

Last Action: Referred to the Committee on Energy and Commerce, and in addition to the Committee on the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (2/4/2026)

Bill Text Source: Congress.gov

Summary and Impacts
Original Text

Bill Summary

The "Pioneering Antimicrobial Subscriptions To End Upsurging Resistance Act of 2026" (PASTEUR Act) seeks to amend the Public Health Service Act by establishing a comprehensive program designed to address the growing threat of antimicrobial resistance. The Act focuses on fostering the development of innovative antimicrobial drugs that target urgent and serious pathogens, while ensuring their availability through a structured contracting process with drug sponsors.

Key components of the legislation include:

1. **Contracting Framework**: The Secretary of Health and Human Services is authorized to enter into contracts with sponsors of eligible antimicrobial drugs that meet specific criteria, including targeting pathogens identified by the CDC as urgent threats. The application process for these contracts includes a scoring system to evaluate the drugs based on their potential contributions to public health and innovation.

2. **Incentives for Development**: Sponsors may receive annual payments between $75 million and $300 million over a contract duration of up to ten years, provided they meet certain requirements such as ensuring commercial availability and monitoring resistance data. Payments can be adjusted based on sales revenue, and may be terminated if sponsors fail to comply with contract conditions.

3. **Advisory Group**: The Act establishes a Critical Need Antimicrobial Advisory Group to provide expert guidance on antimicrobial resistance and drug use. This group will be composed of various qualified professionals and patient advocates, ensuring integrity and transparency in its operations.

4. **Promoting Responsible Use**: The legislation also includes initiatives to encourage appropriate antimicrobial use in healthcare settings through grant programs aimed at improving antibiotic stewardship, particularly in underserved areas and outpatient facilities. Additionally, it mandates enhanced surveillance and reporting of antimicrobial use and resistance trends to inform public health strategies.

Overall, the PASTEUR Act aims to revitalize the development pipeline for critical antimicrobials, promote their responsible use, and bolster efforts to combat antimicrobial resistance, thereby safeguarding public health.

Possible Impacts

Here are three examples of how people will be affected by the "Pioneering Antimicrobial Subscriptions To End Upsurging Resistance Act of 2026" (PASTEUR Act):

1. **Improved Access to Effective Treatments**: Patients suffering from serious infections caused by resistant pathogens will benefit significantly from the availability of new antimicrobial drugs developed under the PASTEUR Act. The legislation facilitates the development of innovative treatments targeting urgent threats identified by the CDC, ensuring that effective options are accessible when traditional antibiotics fail. This could lead to better health outcomes and potentially save lives for individuals facing critical infections.

2. **Enhanced Antibiotic Stewardship in Healthcare Facilities**: Healthcare providers will see increased support for implementing antibiotic stewardship programs designed to promote the responsible use of antimicrobials. Facilities, particularly those lacking existing programs or located in rural areas, will receive grants to adopt practices that prevent misuse of antibiotics, ultimately leading to a reduction in resistance and improved patient care. This focused effort will not only enhance the quality of healthcare but also reduce the long-term burden of antimicrobial resistance on the healthcare system.

3. **Informed Public and Improved Surveillance**: The establishment of comprehensive monitoring and reporting systems will provide the public and healthcare professionals with valuable information about antimicrobial use and resistance patterns. By making data publicly available, the legislation encourages a more informed approach to treatment decisions and fosters awareness of the importance of combating resistance. This transparency will empower patients to engage in discussions about their treatment options and the necessity of responsible antimicrobial use, contributing to a culture of accountability in healthcare.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7352 Introduced in House (IH)]

<DOC>






119th CONGRESS
  2d Session
                                H. R. 7352

   To amend the Public Health Service Act to establish a program to 
 develop innovative antimicrobial drugs targeting the most challenging 
   pathogens and most threatening infections, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 4, 2026

  Mr. Carter of Georgia (for himself, Mr. Peters, Mr. Langworthy, Mr. 
Levin, and Mr. Carey) introduced the following bill; which was referred 
    to the Committee on Energy and Commerce, and in addition to the 
Committee on the Budget, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to establish a program to 
 develop innovative antimicrobial drugs targeting the most challenging 
   pathogens and most threatening infections, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Pioneering Antimicrobial 
Subscriptions To End Upsurging Resistance Act of 2026'' or the 
``PASTEUR Act of 2026''.

SEC. 2. PURPOSE.

    The purpose of this Act is to ensure the availability of 
antimicrobials to--
            (1) stimulate a new age of research, development, and 
        market access to lifesaving medicines;
            (2) ensure the appropriate use of lifesaving medicines;
            (3) maintain the highest medical care standards for 
        American patients;
            (4) promote national health system preparedness; and
            (5) defend the United States and its military.

SEC. 3. DEVELOPING ANTIMICROBIAL INNOVATIONS.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following:

          ``PART X--U.S. NOVEL ANTIMICROBIAL SUPPLY CONTRACTS

``SEC. 399PP. CONTRACT APPLICATION, AWARD, AND IMPLEMENTATION.

    ``(a) In General.--The Secretary may enter into contracts with 
sponsors of eligible antimicrobials for the purpose of ensuring the 
availability of such eligible antimicrobials.
    ``(b) Eligible Antimicrobial.--To be eligible for a contract under 
this section, an antimicrobial drug shall--
            ``(1) treat a pathogen--
                    ``(A) included as an `urgent' or `serious' threat 
                in the most recent Antibiotic Resistance Threats in the 
                United States report published by the Centers for 
                Disease Control and Prevention; or
                    ``(B) that the Secretary has determined appropriate 
                in consultation with the Advisory Group established 
                under section 399PP-1; and
            ``(2) address an unmet medical need.
    ``(c) Applications.--
            ``(1) Submission.--To be eligible to enter into a contract 
        under this section, a sponsor of an eligible antimicrobial 
        shall submit to the Secretary an application not later than 2 
        years after the date on which the eligible antimicrobial is--
                    ``(A) approved under section 505(c) of the Federal 
                Food, Drug, and Cosmetic Act (including in accordance 
                with section 506(h) of such Act); or
                    ``(B) licensed under section 351(a) of this Act.
            ``(2) Contents.--An application submitted under paragraph 
        (1) with respect to an eligible antimicrobial--
                    ``(A) shall include--
                            ``(i) appropriate information to determine 
                        the score of the eligible antimicrobial in 
                        accordance with the methodology established 
                        under subsection (d); and
                            ``(ii) such other information as the 
                        Secretary determines appropriate; and
                    ``(B) is not required to include information 
                relating to pricing or research and development costs 
                of the eligible antimicrobial.
            ``(3) Review.--Not later than 90 days after the date on 
        which the Secretary receives an application under this 
        subsection with respect to an eligible antimicrobial (including 
        a revised application under paragraph (4)), the Secretary 
        shall--
                    ``(A) review the application;
                    ``(B) if the eligible antimicrobial's score is 
                below the minimum scoring threshold described in 
                subsection (d)(1)(B), deny the application; and
                    ``(C) if the eligible antimicrobial's score meets 
                or exceeds such minimum scoring threshold, approve the 
                application and calculate annual payments for the 
                contract under subsection (f).
            ``(4) Revised applications.--Beginning 1 year after the 
        denial of an application with respect to an eligible 
        antimicrobial under paragraph (3), and not more frequently than 
        once every 2 years thereafter, the sponsor of the eligible 
        antimicrobial may submit to the Secretary a revised application 
        for the eligible antimicrobial with additional information that 
        may materially affect the eligible antimicrobial's score under 
        subsection (d).
    ``(d) Scoring.--
            ``(1) In general.--Not later than 270 days after the date 
        of enactment of this part, the Secretary, in consultation with 
        the Advisory Group established under section 399PP-1, the 
        Assistant Secretary for Preparedness and Response, the Director 
        of the Biomedical Advanced Research and Development Authority, 
        and the Commissioner of Food and Drugs, shall promulgate 
        regulations, after the consideration of comments received in 
        response to a public request for information and a public 
        hearing, establishing--
                    ``(A) a quantitative scoring methodology for 
                eligible antimicrobials for which applications are 
                submitted under this section; and
                    ``(B) a minimum scoring threshold that the score of 
                an eligible antimicrobial under paragraph (2) must meet 
                or exceed in order for the sponsor of such eligible 
                antimicrobial to enter into a contract under this 
                section.
            ``(2) Methodology.--An eligible antimicrobial shall receive 
        a score, calculated by points awarded based on criteria 
        developed in consultation with the Advisory Group established 
        under section 399PP-1 within the following three categories, 
        with a weighting assigned to each criterion established under 
        such categories and a greater number of points resulting in a 
        higher score:
                    ``(A) Category i.--The eligible antimicrobial's 
                major contributions to patient care, including--
                            ``(i) improving clinical outcomes for 
                        patients with multi-drug-resistant infections;
                            ``(ii) improved dose frequency;
                            ``(iii) reduced toxicity;
                            ``(iv) reductions in adverse events; and
                            ``(v) benefits from the eligible 
                        antimicrobial's route of administration, 
                        especially through oral administration or more 
                        than one administration method.
                    ``(B) Category ii.--The innovative characteristics 
                of the eligible antimicrobial, including--
                            ``(i) being a first-approved antimicrobial 
                        drug that has the potential to address, or has 
                        the evidence of addressing, unmet medical needs 
                        for the treatment of a serious or life-
                        threatening infection, or, to a lesser extent, 
                        second and third drugs that treat such 
                        infection;
                            ``(ii) containing no active moiety (as 
                        defined in section 314.3 of title 21, Code of 
                        Federal Regulations (or any successor 
                        regulations)) that has been approved in any 
                        other application under section 505(b) of the 
                        Federal Food, Drug, and Cosmetic Act and 
                        containing no active ingredient licensed in any 
                        other biological product license application 
                        under section 351(a) of this Act;
                            ``(iii) being a member of a new class of 
                        drugs with a novel target or novel mode of 
                        action that are distinctly different from the 
                        target or mode of any antimicrobial drug 
                        approved under such section 505(b) or licensed 
                        under such section 351(a); and
                            ``(iv) addressing a multi-drug resistant 
                        infection through a novel chemical scaffold or 
                        mode of action.
                    ``(C) Category iii.--The benefit of the eligible 
                antimicrobial to health systems and public health, 
                including--
                            ``(i) not being affected by cross-
                        resistance to one or more antimicrobials 
                        approved under such section 505(b) or licensed 
                        under such section 351(a);
                            ``(ii) manufacturing capabilities within 
                        the United States;
                            ``(iii) improved product stability and 
                        storage;
                            ``(iv) increased activity against 
                        resistance mechanisms; and
                            ``(v) reduction of the economic or 
                        population burden of antimicrobial resistance 
                        in the United States.
    ``(e) Contract Requirements.--As a condition of entering into a 
contract under this section with respect to an eligible antimicrobial, 
the sponsor of the eligible antimicrobial shall--
            ``(1) beginning on the date that is 30 days after the 
        sponsor receives its first payment under the contract and for 
        the remainder of the contract term, ensure--
                    ``(A) the commercial availability of the eligible 
                antimicrobial in the United States; and
                    ``(B) sufficient supply of the eligible 
                antimicrobial for antimicrobial susceptibility test 
                device manufacturers;
            ``(2) identify, track, and publicly report drug resistance 
        data and trends using available data related to the eligible 
        antimicrobial, including the use of data collected by the 
        Secretary under section 399PP-2(c);
            ``(3) develop and implement education and communications 
        strategies for health care professionals and patients 
        concerning the appropriate use of the eligible antimicrobial, 
        such as--
                    ``(A) information from labeling approved by the 
                Food and Drug Administration; and
                    ``(B) communications for individuals with limited 
                English proficiency and individuals with disabilities;
            ``(4) submit to the Secretary a plan regarding the 
        appropriate use of the eligible antimicrobial, including best 
        practices for antimicrobial stewardship and a general 
        description of how the product will be marketed. The 
        appropriate use plan may include a plan to collect data on the 
        impact of diagnostics, antimicrobial stewardship programs, and 
        other appropriate use efforts on patient outcomes and health-
        care costs;
            ``(5) upon the request of the Secretary, submit to the 
        Secretary a plan for registering the eligible antimicrobial in 
        countries other than the United States where an unmet medical 
        need exists;
            ``(6) undertake efforts to ensure a reliable drug supply 
        chain, including, in the event of the Food and Drug 
        Administration determining that a shortage exists for the 
        eligible antimicrobial, not later than 30 days after such 
        determination submitting to the Secretary a plan to address 
        such shortage;
            ``(7) beginning on the date that is 30 days after the 
        sponsor receives its first payment under the contract and for 
        the remainder of the contract term, manufacture the eligible 
        antimicrobial drug at a volume that reasonably ensures the 
        availability of sufficient quantities of the drug to meet the 
        needs of individuals with the disease or condition for which 
        the eligible antimicrobial is approved in the United States;
            ``(8) abide by manufacturing and environmental best 
        practices for the control of discharge of antimicrobial active 
        pharmaceutical ingredients and other antimicrobial agents or 
        products, including the antibiotic manufacturing standard 
        developed by the AMR Industry Alliance (as described in the 
        report titled `Minimizing risk of developing antibiotic 
        resistance and aquatic ecotoxicity in the environment resulting 
        from the manufacturing of human antibiotics' published in May 
        2025) or seeking a sustainability certification from BSI 
        Standards Limited; and
            ``(9) abide by such other terms as the Secretary may 
        require under the contract.
    ``(f) Annual Payments.--
            ``(1) In general.--Pursuant to a contract entered into 
        under this section, the Secretary shall make annual payments to 
        the sponsor of an eligible antimicrobial for the duration of 
        the contract term. Such payments shall begin not later than 180 
        days after the date on which the Secretary approves the 
        contract.
            ``(2) Calculation system.--The Secretary, in consultation 
        with the Administrator of the Centers for Medicare & Medicaid 
        Services, shall promulgate regulations establishing a system 
        for the calculation of the annual payments described in 
        paragraph (1). Such system shall adhere to the following:
                    ``(A) Minimum and maximum amount.--An annual 
                payment may not be less than $75,000,000 or more than 
                $300,000,000, adjusted on an annual basis in accordance 
                with the consumer price index for all urban consumers 
                (all items; United States city average).
                    ``(B) Adjustment for net revenue.--The annual 
                payment shall be adjusted downward by the amount of net 
                revenue from sales in the United States of the eligible 
                antimicrobial during the previous 12-month period, 
                including any legally mandated or voluntary discounts 
                and rebates provided by the sponsor of the eligible 
                antimicrobial, such as volume discounts, prompt pay 
                discounts, cash discounts, free goods that are 
                contingent on any purchase requirement, chargebacks, 
                and rebates.
            ``(3) Disclosure of information.--The Secretary may require 
        the sponsor of an eligible antimicrobial to disclose to the 
        Secretary such information as the Secretary requires to 
        calculate an annual payment under this subsection. 
        Notwithstanding any other provision of law, such information 
        shall be kept confidential and may not be--
                    ``(A) disclosed by the Secretary to any entity, 
                including other governmental or private parties, in a 
                form that reveals the identity of a specific 
                manufacturer or the prices charged for drugs by such 
                manufacturer; or
                    ``(B) used by the Secretary for any purpose other 
                than calculating the annual payments under this 
                subsection.
            ``(4) Termination of payments.--The Secretary may cease 
        annual payments pursuant to a contract entered into under this 
        section if the Secretary determines that the sponsor of the 
        eligible antimicrobial subject to such contract--
                    ``(A) permanently withdraws the eligible 
                antimicrobial from the market in the United States;
                    ``(B) materially fails to meet one or more of the 
                requirements described in subsection (e) after notice 
                by the Secretary and an opportunity to correct; or
                    ``(C) does not conduct with due diligence a 
                postmarket study required to be completed by the Food 
                and Drug Administration during the term of the 
                contract.
            ``(5) Rule of construction.--Nothing in this subsection 
        shall be construed as authorizing the Secretary--
                    ``(A) to disclose any information that is a trade 
                secret or confidential information subject to section 
                552(b)(4) of title 5, United States Code, or section 
                1905 of title 18, United States Code; or
                    ``(B) to use evidence from comparative clinical 
                effectiveness research in a manner that treats 
                extending the life of an elderly, disabled, or 
                terminally ill individual as of lower value than 
                extending the life of an individual who is younger, 
                nondisabled, or not terminally ill for the purposes of 
                calculating annual payments under this subsection, 
                including in such a way that would limit patient 
                access.
    ``(g) Contract Term.--
            ``(1) Length of term.--The term of a contract entered into 
        under this section shall end on the earlier of--
                    ``(A) the date that is 10 years after the date on 
                which the contract is approved; and
                    ``(B) the date on which the Secretary determines at 
                least one drug or biological product is--
                            ``(i) approved or licensed (as 
                        applicable)--
                                    ``(I) under section 505(j) of the 
                                Federal Food, Drug, and Cosmetic Act, 
                                using the contract antimicrobial as the 
                                listed drug; or
                                    ``(II) under section 351(k) of the 
                                Public Health Service Act, using the 
                                contract antimicrobial as the reference 
                                product; and
                            ``(ii) marketed pursuant to such approval 
                        or licensure.
            ``(2) Effect.--A contract shall remain in effect for the 
        term described in paragraph (1) even if the pathogen treated by 
        the eligible antimicrobial is later removed from the Antibiotic 
        Resistance Threats in the United States report described in 
        subsection (b)(1)(A).
    ``(h) Other Government Participation.--The Secretary shall make 
efforts to increase the participation of other governmental bodies in 
offering financial incentives to create commercial access to new and 
novel antimicrobials that are similar to the contracts under this 
section.
    ``(i) Authority Vested in the Secretary.--The authority vested in 
the Secretary by this section to enter into contracts may be performed 
without regard to such provisions of law or regulations relating to the 
making, performance, amendment, or modification of contracts of the 
United States, as the Secretary may determine to be inconsistent with 
the furtherance of the purposes of this part.

``SEC. 399PP-1. CRITICAL NEED ANTIMICROBIAL ADVISORY GROUP.

    ``(a) In General.--Not later than 60 days after the date of 
enactment of this part, the Secretary shall establish a Critical Need 
Antimicrobial Advisory Group (referred to in this part as the `Advisory 
Group') and appoint its members.
    ``(b) Members.--The Advisory Group shall be composed of 15 members, 
to be appointed by the Secretary as follows:
            ``(1) 4 individuals who are physicians board-certified in 
        infectious diseases.
            ``(2) 4 individuals who are experts with demonstrated 
        expertise in antimicrobial resistance, health economics, or 
        research and development or commercialization of antimicrobial 
        drugs.
            ``(3) 4 individuals to serve as patient advocates, who are 
        well versed in antimicrobial treatment or resistance, either as 
        patients themselves or as caretakers.
            ``(4) 3 additional individuals who meet the qualifications 
        specified in paragraph (1), (2), or (3).
    ``(c) Chair.--In addition to the members appointed under subsection 
(b), the Secretary shall appoint 1 individual to serve as a non-voting 
Chair of the Advisory Group. Such individual shall meet the 
qualifications specified in paragraph (1), (2), or (3) of subsection 
(b).
    ``(d) Conflicts of Interest.--In appointing members under 
subsection (b) and a Chair under subsection (c), the Secretary shall 
ensure that no member (including the Chair) receives during the 
individual's term of service with the Advisory Group compensation in 
any manner from a commercial or for-profit entity that develops or 
intends to develop antimicrobial drugs. In implementing the 
requirements of this part, the Secretary shall prohibit Advisory Group 
members (including the Chair) from participating in any particular 
Advisory Group matter that will have a direct and predictable effect on 
their financial interests.
    ``(e) Applicability of FACA.--
            ``(1) In general.--Except as otherwise provided in this 
        section, chapter 10 of title 5, United States Code (commonly 
        referred to as the `Federal Advisory Committee Act') shall 
        apply to the Advisory Group.
            ``(2) Termination.--Section 1013 of such title (relating to 
        the termination of advisory committees) shall not apply to the 
        Advisory Group.

``SEC. 399PP-2. ENCOURAGING APPROPRIATE USE OF ANTIMICROBIALS AND 
              COMBATING RESISTANCE.

    ``(a) Health Facility Grant Program.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of this part, the Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention (in 
        this subsection referred to as the `Secretary'), shall 
        establish a grant program to support hospital, skilled nursing 
        facility, and other health care facility efforts--
                    ``(A) to judiciously use antimicrobial drugs, such 
                as by establishing or implementing appropriate use 
                programs, including infectious disease telehealth 
                programs, using appropriate diagnostic tools, 
                partnering with academic hospitals, increasing health 
                care-associated infection reporting and prevention 
                efforts, and monitoring antimicrobial resistance; and
                    ``(B) to participate in the National Healthcare 
                Safety Network Antimicrobial Use and Resistance Module 
                or the Emerging Infections Program Healthcare-
                Associated Infections Community Interface activity of 
                the Centers for Disease Control and Prevention, as 
                specified by the Secretary, relating to antimicrobial 
                drugs.
            ``(2) Prioritization.--In awarding grants under paragraph 
        (1), the Secretary shall prioritize health care facilities 
        without an existing program to judiciously use antimicrobial 
        drugs, subsection (d) hospitals (as defined in section 
        1886(d)(1)(B) of the Social Security Act) that are located in 
        rural areas (as defined in section 1886(d)(2)(D) of such Act), 
        critical access hospitals (as defined in section 1861(mm)(1) of 
        such Act), hospitals serving Tribal populations, and safety-net 
        hospitals.
            ``(3) Standards for use of grant funds.--In implementing or 
        expanding an antibiotic stewardship program, an entity 
        receiving a grant under paragraph (1) shall adhere to 
        nationally recognized guidelines and best practices, including 
        adequate staffing, for improving antibiotic use.
    ``(b) Antimicrobial Stewardship Pilot Program for Outpatient 
Facilities.--
            ``(1) Antimicrobial stewardship pilot program for 
        outpatient facilities.--Not later than 2 years after the date 
        of enactment of this part, the Secretary, in consultation with 
        the Director of the Centers for Disease Control and Prevention 
        and the Administrator of the Centers for Medicare & Medicaid 
        Services (in this subsection referred to as the `Secretary'), 
        shall establish a pilot program to make grants to entities to 
        implement or expand antibiotic stewardship programs in 
        outpatient facilities.
            ``(2) Implementation.--In developing the pilot program, the 
        Secretary shall consult with professional societies with 
        expertise in antibiotic stewardship.
            ``(3) Eligible entities.--To be eligible to receive a grant 
        under paragraph (1), an entity shall be--
                    ``(A) a physician;
                    ``(B) a hospital outpatient department;
                    ``(C) an urgent care setting described in paragraph 
                (5)(A); or
                    ``(D) a retail clinic described in paragraph 
                (5)(B).
            ``(4) Standards for use of grant funds.--In implementing or 
        expanding an antibiotic stewardship program through a grant 
        under this subsection, an entity shall adhere to nationally 
        recognized guidelines and best practices, including adequate 
        staffing, for improving antibiotic use.
            ``(5) Prioritization.--In awarding grants under paragraph 
        (1), the Secretary shall prioritize--
                    ``(A) urgent care settings, such as facilities that 
                use Place of Service Code 20 for urgent care developed 
                by the Centers for Medicare & Medicaid Services (or any 
                successor code); and
                    ``(B) retail clinics, meaning facilities that are 
                co-located with a pharmacy or other retail commercial 
                establishment, such as those that use Place of Service 
                Code 17 for walk-in retail health clinics developed by 
                the Centers for Medicare & Medicaid Services (or any 
                successor code).
            ``(6) Report.--Not later than 5 years after the date of 
        enactment of this part, the Secretary shall submit to Congress 
        a report on the impacts of the pilot program, including 
        recommendations for expanding antimicrobial stewardship to 
        additional outpatient settings.
    ``(c) Surveillance and Reporting of Antimicrobial Use and 
Resistance.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall use the National Healthcare Safety Network and other 
        appropriate surveillance systems to collect data and assess 
        trends in antimicrobial resistance and antibiotic and 
        antifungal use, such as--
                    ``(A) appropriate conditions and measures causally 
                related to antimicrobial resistance, including types of 
                infections, the source or body sites of infections, the 
                demographic information of patients with infections, 
                infection onset in a community or hospital setting, 
                increased lengths of hospital stay, increased costs, 
                and rates of mortality; and
                    ``(B) changes in bacterial and fungal resistance to 
                antimicrobial drugs, including changes in percent 
                resistance, prevalence of antimicrobial-resistant 
                infections, rates of mortality, and other such changes.
            ``(2) Antimicrobial use data.--The Secretary, acting 
        through the Director of the Centers for Disease Control and 
        Prevention, shall obtain reliable and comparable human 
        antibiotic and antifungal drug consumption data (including, as 
        available and appropriate, volume antimicrobial distribution 
        data and antibiotic and antifungal use data, including 
        prescription data) by State or metropolitan areas. To 
        accomplish this, the Secretary may work with, as appropriate, 
        Federal departments and agencies (including the Department of 
        Veterans Affairs, the Department of Defense, the Department of 
        Homeland Security, the Bureau of Prisons, the Indian Health 
        Service, and the Centers for Medicare & Medicaid Services), 
        private vendors, health care organizations, pharmacy benefit 
        managers, and other entities.
            ``(3) Antimicrobial resistance trend data.--The Secretary, 
        acting through the Director of the Centers for Disease Control 
        and Prevention, shall intensify and expand efforts to collect 
        antimicrobial resistance data and encourage adoption of the 
        Antimicrobial Use and Resistance Module or other appropriate 
        module within the National Healthcare Safety Network and other 
        appropriate surveillance systems among all health care 
        facilities across the continuum of care, including, as 
        appropriate, acute care hospitals, dialysis facilities, nursing 
        homes, ambulatory surgical centers, and other ambulatory health 
        care settings in which antimicrobial drugs are routinely 
        prescribed. The Secretary shall seek to collect such data from 
        electronic medication administration reports and laboratory 
        systems to produce the reports described in paragraph (5).
            ``(4) Diagnostics data.--The Secretary shall collect data 
        on tests used to diagnose and inform the appropriate treatment 
        of infections in health care settings. This includes data on 
        the implementation of diagnostic stewardship to ensure the 
        appropriate use of a diagnostic test before a treatment is 
        prescribed, and the use of diagnostics in monitoring and 
        tracking infectious diseases. The Secretary shall collect data 
        on the use of diagnostic tests through the National Healthcare 
        Safety Network (in this paragraph referred to as the `NHSN') 
        Antimicrobial Use and Resistance Module or other appropriate 
        NHSN module. These efforts shall be implemented in 
        collaboration with external stakeholders, including infectious 
        disease professional societies, patient advocacy organizations, 
        health care systems and professionals, and the diagnostics 
        industry.
            ``(5) Public availability of data.--Beginning on the date 
        that is 2 years after the date of enactment of this part, the 
        Secretary shall, for the purposes of improving the monitoring 
        of important trends in antimicrobial use and resistance, and, 
        as appropriate, patient outcomes in relation to antimicrobial 
        resistance--
                    ``(A) make the data described in paragraphs (1) 
                through (4) publicly available through reports and web 
                updates issued on a regular basis that is not less than 
                annually; and
                    ``(B) examine opportunities to make such data 
                available in near real time.

``SEC. 399PP-3. DEFINITIONS.

    ``In this part:
            ``(1) Antimicrobial drug.--The term `antimicrobial drug'--
                    ``(A) means--
                            ``(i) a drug that directly inhibits 
                        replication of or kills bacteria or fungi, or 
                        acts on the substances produced by such 
                        bacteria or fungi, relevant to the proposed 
                        indication at concentrations likely to be 
                        attainable in humans to achieve the intended 
                        therapeutic effect; and
                            ``(ii) a biological product that acts 
                        directly on bacteria or fungi or on the 
                        substances produced by such bacteria or fungi; 
                        and
                    ``(B) does not include--
                            ``(i) a drug that achieves the effect 
                        described in subparagraph (A)(i) only at a 
                        concentration that cannot reasonably be studied 
                        in humans because of its anticipated toxicity; 
                        or
                            ``(ii) a vaccine.
            ``(2) Contract.--The term `contract' means a transaction 
        other than a procurement contract, grant, or a cooperative 
        agreement.
            ``(3) Contract antimicrobial.--The term `contract 
        antimicrobial' means an antimicrobial drug or biological 
        product for which a contract under this part is in effect.
            ``(4) Eligible antimicrobial.--The term `eligible 
        antimicrobial' means an antimicrobial drug or biological 
        product that satisfies the eligibility criteria described in 
        section 399PP(b).

``SEC. 399PP-4. APPROPRIATIONS.

    ``(a) In General.--To carry out this part, there is authorized to 
be appropriated, and appropriated, to the Secretary, out of amounts in 
the Treasury not otherwise appropriated, $6,000,000,000 for fiscal year 
2026, to remain available until expended.
    ``(b) Allocation.--The Secretary may use not more than 6.5 percent 
of the amounts appropriated under subsection (a) to carry out section 
399PP-2.
    ``(c) Emergency Designation.--
            ``(1) In general.--The amounts provided by this section are 
        designated as an emergency requirement pursuant to section 4(g) 
        of the Statutory Pay-As-You-Go Act of 2010.
            ``(2) Designation in senate.--In the Senate, this section 
        is designated as an emergency requirement pursuant to section 
        4112(a) of H. Con. Res. 71 (115th Congress), the concurrent 
        resolution on the budget for fiscal year 2018.''.
                                 <all>