lives, eased the suffering of millions of people, and contributed to major gains in life expectancy. However, the emergence of resistance in bacteria, viruses, parasites, and fungi is undermining those gains, eliminating the availability of effective treatments for many infectious diseases. In the United States, antibiotic‐resistant infections are responsible for an estimated $20 billion in excess healthcare costs, $35 billion in societal costs, and 8 million additional hospital days (36,37). Current issues that underscore the dangers of drug‐resistant diseases include - Emergence in healthcare settings of gram‐negative bacteria like E. coli and K. pneumoniae that are resistant to antibiotics of last resort (carbapenams) - International spread of extremely drug‐resistant TB - Increasing gonococcal resistance to available antibiotics - Increases in drug‐resistant Acinetobacter baumannii infections among U.S. military personnel (38) - Increasing number of hospital outbreaks involving drug‐resistant C. difficile (39). Combating antimicrobial resistance requires a multi-pronged, multi-sector approach that includes developing and advancing policies and programs designed to - Reduce the prevalence of resistant infections - Improve surveillance for emerging antimicrobial resistance problems in human and animal settings, such as through efforts to enhance laboratory sharing of resistance patterns - Prolong the useful life of antimicrobial drugs through judicious use, taking into account both human and veterinary use - Encourage development of new antimicrobial drugs - Promote development and optimal use of vaccines - Improve laboratory capacities and diagnostics aimed at detecting and characterizing new or emerging organisms resistant to antimicrobials. Domestic partners in these efforts include state and local health departments, other federal agencies, universities, the Infectious Diseases Society of America (IDSA) and other professional organizations, pharmaceutical and biotechnology companies, healthcare delivery organizations, insurers, agricultural producers, consumer groups, and members of the public. International partners include WHO and the EU‐US Trans Atlantic Task Force on Antimicrobial Resistance. • Promote One Health approaches to prevent emergence and spread of zoonotic diseases The recognition that most new human pathogens emerge from animal reservoirs (40,41) has given rise to a One Health approach to disease prevention that links human, animal, and environmental health. One Health approaches typically aim to prevent or control zoonotic diseases—diseases caused by microbes that infect both humans and animals. 24 | CDC ID Framework The elimination of canine rabies in the United States in 2004 after decades of intensive surveillance, laboratory advancements, and vaccination efforts on the part of human and veterinary science communities is a prime example of successful One Health collaborations, providing a model for improved understanding and control of emerging zoonoses and offering potential for developing countries, where canine rabies continues to cause tens of thousands of deaths each year. One Health policies and actions can facilitate early detection of new diseases that emerge from animal and insect reservoirs and also offer potential means for improving food safety and preventing the emergence of antimicrobial resistance. Examples include policies that support interdisciplinary collaborations and communications on all aspects of healthcare for humans and animals, in accordance with the goals of the One Health Initiative. Other One Health policy goals include - Active participation of agricultural and veterinary partners in integrated analysis of animal health and human health data to identify new threats - Improved linkages between veterinary experts and state and local epidemiologists (e.g., via the Environmental Health Specialist Network - Strategies that reduce the risk of importing infectious diseases into the United States via animals and cargo. In addition to domestic partners in these efforts, CDC also works with USAID, the Food and Agricultural Organization (FAO), the World Organization for Animal Health (OIE), and other international partners to promote worldwide One Health planning and cooperation. CONCLUSION CDC’s ID Framework seeks to mobilize partners and actions to sustain and advance the fundamental infectious disease surveillance, laboratory, and epidemiologic capacities that support our nation’s public health system, recognizing current challenges facing federal, state, and local agencies while realizing vast opportunities for innovative work. Effective and expansive partnerships working to implement proven practices and to identify and evaluate new public health strategies remain our best means of achieving these goals—protecting health and saving lives. October 2011 | 25 REFERENCES 1. CDC. Preventing emerging infectious diseases: A strategy for the 21st century. U.S. Department of Health and Human Services, Public Health Service, 1998. 2. National Prevention Council. National prevention strategy. U.S. Department of Health and Human Services, Office of the Surgeon General, 2011. Available at http://www.healthcare.gov/center/councils/nphpphc/strategy/report.pdf. 3. CDC. A strategic plan for the elimination