The bill aims to stimulate the research, development, and market access of innovative antimicrobial drugs to combat drug-resistant infections, ensuring their availability and appropriate use. It establishes a program allowing the Secretary of Health and Human Services to enter into subscription-style contracts with sponsors of eligible antimicrobial drugs. These contracts provide annual payments, ranging from $75 million to $300 million, adjusted by net revenue, to incentivize the development of drugs that address urgent or serious threats identified by the CDC and meet unmet medical needs.

To qualify for a contract, an antimicrobial must be approved by the FDA and scored based on its contributions to patient care, innovative characteristics, and benefits to public health. Contract requirements for sponsors include ensuring commercial availability, tracking and reporting resistance data, developing appropriate use strategies, maintaining a reliable supply chain, and adhering to manufacturing best practices. The contract term is generally 10 years or until a generic equivalent is marketed.

The legislation also creates a Critical Need Antimicrobial Advisory Group composed of infectious disease experts, health economists, and patient advocates to guide the program. Furthermore, it establishes grant programs to promote antimicrobial stewardship in hospitals, skilled nursing facilities, and outpatient settings, prioritizing facilities without existing programs and those in underserved areas.

Finally, the bill mandates the expansion of surveillance and reporting of antimicrobial use and resistance data through the CDC's National Healthcare Safety Network and other systems. This data, including consumption and resistance trends, will be made publicly available to improve monitoring and inform public health efforts. The bill authorizes an appropriation of $6 billion for fiscal year 2026 to fund these initiatives, with a portion allocated for stewardship and surveillance activities.