Government operations and workforce

Executive Order 13676: Combating Antibiotic-Resistant Bacteria

President: Barack Obama

Directed a national action plan, interagency task force and outside advisory council to slow antibiotic resistance.

Status: In effect.

Is Executive Order 13676 still in effect? Yes. Its continuing coordination and stewardship directions did not expire when the 2020–2025 action-plan period ended. HHS’s July 15, 2026 notice confirms that the advisory council continues under section 505 of the June 24, 2019 law; a charter approved August 27, 2026 documents its continuing advisory role. 2026 Federal Register notice; Dated HHS charter.

What does Executive Order 13676 do?

EO 13676 directed agencies to improve antibiotic stewardship, surveillance, diagnostics, therapeutics, vaccines and international cooperation. It established an interagency task force to prepare a national action plan and directed HHS to establish an outside advisory council, PACCARB. The task force’s planning role and the council’s advice are different functions; the order is not a nationwide prescribing rule for individual patients. Signed order, sections 2–9.

Administration position: The order coordinates public-health policy; it does not ban medically necessary antibiotics or replace FDA, veterinary and professional prescribing rules.

The practical aim was to align human healthcare, animal health and research rather than treat resistance as one agency’s problem. Hospitals were a focus, but the instructions also covered agriculture, laboratory networks, new treatments and international partnerships. The FDA direction targeted medically important antibiotics used for growth promotion in food-producing animals; it was not an instruction to stop every veterinary use. Sections 5–9.

SignedSeptember 18, 2014
Co-chairsHHS Defense and Agriculture
Advisory bodyPACCARB

Before and after

Before the order

Agencies addressed resistance through separate surveillance, research and stewardship programs.

After the order

A national strategy aligned human health, animal health, research and international action.

The immediate change was an executive-branch work program with named coordinating bodies and deadlines. Private facilities became subject to specific requirements through separate legal measures: CMS’s 2019 final rule required participating hospitals and critical access hospitals to implement antibiotic stewardship programs by March 30, 2020. That implementation date differs from the rule’s general November 29, 2019 effective date and the order’s earlier deadline for reviewing and proposing appropriate measures. Final rule, dates and 42 CFR 482.42(b)/485.640(b).

Who had to do what

Original assignments and timing; not verified completion claims
Agency or officialDirectionTiming
National Security Council staff, with OSTP, Domestic Policy Council and OMBCoordinate government policy and task-force activities, reports and recommendations.Continuing; section 2.
Defense, Agriculture and HHS SecretariesCo-chair the task force and coordinate the national strategy.Continuing; section 3.
State, Justice, Veterans Affairs, Homeland Security, EPA, USAID, OMB, Domestic Policy Council, NSC staff, OSTP and NSFDesignate federal employees to represent their offices on the task force; participate in its work.No fixed designation deadline; section 3(a).
Federal task forceSubmit a five-year action plan with goals, milestones and metrics; assess progress with PACCARB and provide presidential updates.Plan by February 15, 2015; first update within 180 days of release, then annually; section 3(c).
HHS SecretaryEstablish PACCARB after consulting Defense and Agriculture, appoint its members and chair, support its work and send its written reports to the President. Review regulations and propose appropriate stewardship measures; encourage other facilities.No fixed council-creation date; regulatory review/proposals by the end of 2016; sections 4 and 5(a).
PACCARBAdvise HHS on antibiotic effectiveness, research, surveillance, prevention, diagnostics, alternatives, education and international coordination.Original section 4; continuing advisory work now also rests on the 2019 statute and later charter.
Defense and Veterans AffairsReview and propose appropriate stewardship measures for their hospitals and long-term care facilities; encourage other settings. With HHS, review data-sharing rules and infection protocols.Stewardship review/proposals by the end of 2016; other reviews have no fixed date; sections 5(c), 5(g), 7(c).
FDA, coordinating with AgricultureContinue steps to eliminate medically important antibiotics for food-animal growth promotion.Continuing; section 5(e).
Agriculture, EPA and FDACoordinate surveillance, research and animal-health information; monitor and report agricultural antibiotic-use changes and environmental effects with stakeholders.No fixed deadline; sections 5(f), 6(c).
Task-force agenciesSupport the council with lawful information sharing; implement appropriate stewardship, integrated surveillance and outbreak response; pursue relevant research cooperation.Continuing, as appropriate and within authority; sections 4(d), 5–9.
Biomedical Advanced Research and Development Authority, HHSDevelop countermeasures targeting resistant bacteria posing serious or urgent public-health threats.No fixed deadline; section 8(b).
Public Health Emergency Medical Countermeasures Enterprise, HHSCoordinate relevant next-generation countermeasure efforts with task-force agencies.As appropriate; section 8(c).
State, Agriculture and HHS SecretariesDesignate international-action representatives; review collaborations and pursue improved prevention, surveillance, research and policy engagement.Representatives within 30 days of signing; no fixed partnership-review date; section 9.

Signed order, sections 2–9. CDC best practices inform the stewardship directions; the order did not give every named HHS component a separate dated report. A required deadline is not proof that the deliverable was completed.

What happened next

EO 13676 was signed; Federal Register publication followed on September 23. Official source.

The administration publicly released the first action plan. Public release does not establish when a nonpublic submission to the President occurred. Official source.

CDC established the Antimicrobial Resistance Laboratory Network, a documented surveillance implementation step. Official source.

Public Law 116-22, section 505 permitted HHS to continue PACCARB and set out advisory duties and FACA requirements. Official source.

CMS published its hospital and critical-access-hospital stewardship rule, with specific implementation due March 30, 2020. Official source.

A second national action plan covered 2020–2025. That planning period was not a whole-order sunset. Official source.

HHS published a notice confirming the council’s statutory continuation and its solely advisory role. Official source.

HHS approved the council charter identifying continued authority and advisory functions. Official source.