Last year, the World Health Organization announced that the world is nearing a “post-antibiotic era” in which the available drugs are no longer effective against common infections. This growing fear over antibiotic resistance is prompting long overdue discussions at the highest levels of government, but the actions these discussions have spurred are simply not enough to stem the tide of antibiotic resistance.
In September 2014—more than 40 years after the U.S. Food and Drug Administration (FDA) first expressed concerns about antibiotic resistance and animal agriculture—President Obama issued an Executive Order on Combatting Antibiotic-Resistant Bacteria, labeling the issue “a national security priority.” At the time, Center for Food Safety applauded the President for addressing the crisis, but challenged the weaknesses of the order regarding animal agriculture. However, the Executive Order established a Task Force charged with developing a 5-year National Action Plan, providing an opportunity for the government to remedy its past failings. On March 27, 2015, the National Action Plan on Combatting Antibiotic-Resistant Bacteria was released. And yet again, the government failed to offer sufficient action to curb the overuse of antibiotics in agriculture in the face of a public health crisis.
Despite conclusive evidence nationally and internationally that administering routine, non-therapeutic antibiotics to food animals is contributing to a public health crisis, the government refuses to take strong action against the industry. The Action Plan’s strategy for reducing antibiotic use in agriculture relies exclusively on weak, voluntary guidance issued by FDA and continues to permit the routine use of medically-important drugs to promote growth or prevent disease in squalid conditions.
Antibiotics are currently used routinely in food animal production for growth promotion and disease prevention, both of which are considered non-therapeutic uses because the purpose is not to treat a sick animal. According to FDA, over 80 percent of antibiotics sold for use in the U.S. are marketed for food-producing animals.[i] Roughly 300mg of antibiotics are used to produce every kilogram of meat and eggs.[ii] Exposing organisms to sub"‘lethal concentrations of antimicrobial agents at such a high rate drives the selection of resistant genes, a growing concern for health professionals.[iii]
Of primary concern is the use of antibiotics that are also commonly used in human medicine (“dual use antibiotics”). Bacteria originating in large animal factories frequently develop resistance to these antibiotics, diminishing their effectiveness when used to treat even common infections in people. These bacteria may reach consumers through multiple pathways. Multi-drug resistant Salmonella is increasingly found in the poultry we buy at the grocery store.[iv] Livestock manure from large feedlots can introduce resistant bacteria into local waterways, and wastewater from intensive farming facilities in particular is a major source of pathogenic and antibiotic-resistant organisms that are released into the environment.[v]
Instead of taking the needed steps to address antibiotics overuse in animal factories, the President’s Action Plan relies exclusively on implementation of FDA’s Guidance 213 for eliminating the use of antibiotics for growth promotion. This guidance, however, is voluntary, and leaves wiggle room for producers to comply and still continue to administer antibiotics at non-therapeutic dosage levels. The guidance still allows producers to administer antibiotics for disease prevention. As Pew recently revealed, the lines between growth promotion and disease prevention are not always clear, and many antibiotic products have disease prevention doses that overlap with doses designed to promote weight gain or feed efficiency. Many of these products have no duration limit, meaning producers can use antibiotics at low levels throughout the life of an animal without any signs of bacterial infection or illness.
Center for Food Safety and others have consistently called for USDA and FDA to collect data on the amount of antibiotics used in animal agriculture. However, while the Action Plan mentions the need for collecting data on agricultural use of antibiotics, it only requests data on sales and the prevalence of antibiotic-resistant isolates on retail meats. Supply and end-point data will not present the full picture of antibiotic use. Information on how producers are using antibiotics in their animals, at what rates, and for how long is critical in a successful strategy to combat the threat of antibiotic-resistance. As recently reported in The New York Times, Denmark provides a model for this.
Despite the clear urgency, the National Action Plan on Combatting Antibiotic-Resistant Bacteria represents another opportunity missed in 40 years of inaction. In order to preserve the effectiveness of important human medicines, their routine use in food animals for growth promotion and disease prevention must be eliminated.
[i] US Food and Drug Administration. 2012 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals. FDA Center for Veterinary Medicine: Rockville, MD. (September, 2014); Pham, T. Drug Use Review. FDA Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology. (April 5, 2012).
[ii] Aarestrup, Frank. “Get pigs off antibiotics.” Nature vol. 486, 465-466. (28 June 2012).
[iii] Slibergeld, Ellen K., Jay Graham, & Lance B. Price. “Industrial Food Animal Production, Antimicrobial Resistance, and Human Health.” Annu. Rev. Public Health, 29. 151-169. (2008).
[iv] National Antimicrobial Resistance Monitoring System (NARMS). Executive Report. (2011).
[v] Baquero, Fernando, Jose-Luis Martinez, & Rafael Canton. “Antibiotics and antibiotic resistance in water environments.” Current Opinions in Biotechnology, 19. 260-265. (2008). pp. 262.
