Antibiotic-resistant disease is a major health threat around the globe, such that illnesses once easily treatable with the drugs are now becoming deadly. The cause of the antibiotic-resistance epidemic is quite straightforward: overuse of antibiotics. “Resistant bacteria are more common in settings where antibiotics are frequently used: health care settings, the community and food animal production,” the U.S. Centers for Disease Control and Prevention (CDC) states1 — and the latter category is of utmost importance.
The majority of antibiotics in the U.S. aren’t used in health care settings for humans; they’re used in industrial agriculture, primarily in low, steady doses for purposes of “disease prevention” (which also has the “side effect” of growth promotion, making the animals get bigger, faster). Despite this, exactly how and in what numbers antibiotics are used on U.S farms is a mystery, in large part because, as Wired put it, the data “isn’t considered an obligation owed to public health … it’s a political football.”2
Agricultural Antibiotic Usage Largely Hidden in the US
In countries like the Netherlands, health and agricultural agencies release two sets of antibiotics data — one for human usage and resistance and one for livestock — every year. The data is clear and concise, in stark contrast to what is revealed in piecemeal fashion in the U.S. As reported in Wired:3
“They [the data sets] are remarkably real-time, fine-grained, and coherent across categories — so much that, in the wake of a 2005 European Union ban on one type of farm antibiotic use, the Dutch data could show that drug-resistant infections linked to food didn’t drop as expected. That gave the government the proof it needed to recruit farmers into voluntary cuts in farm drug use. Antibiotic use dropped 60 percent in three years — and that time, they saw a drop in human infections.”
In the U.S., however, there is no comprehensive collection of such data, despite the fact that knowing where and how antibiotics are being misused is necessary to stop the spread of antibiotic resistance. Data on human antibiotics usage is compiled by a private company and available only for a steep fee. Pharmaceutical manufacturers keep track of veterinary antibiotic sales, which are then reported to the U.S. Food and Drug Administration (FDA) as part of the Animal Drug User Fee Act (ADUFA).
The ADUFA requires drug companies to pay a fee to the FDA to help cover new-drug approvals and also requires them to release some agricultural data.
The FDA has released a limited summary of ADUFA data each year since 2009, but only in recent years has it been disclosed how antibiotics are dispensed on farms or how they’re used in different livestock species. Meanwhile, ADUFA is up for reauthorization in 2018, and some have tried to insert provisions that would allow drug companies latitude to use animal drugs without showing proof of their effectiveness for five years.
As Matthew Wellington, antibiotics program director for the organization U.S. PIRG, told Wired, “The lack of data is a problem because we know that antibiotics are vastly misused in agriculture, but we need more information on exactly how they are used to put in place the best stewardship practices possible … The less clear that data is, the harder time public health advocates and elected officials will have in creating best practices.”4
Antibiotics for US Pigs Prescribed at Nearly the Same Rate as for People
As an example of the kind of valuable data that could be gleaned from a comprehensive data set regarding U.S. agricultural antibiotics use is a new report from the Natural Resources Defense Council (NRDC). They found that about the same amount of antibiotics are sold for use in pigs as are used for treating humans in the U.S.
What’s more, administering these antibiotics to pigs routinely for disease prevention isn’t working, as pig diseases are on the rise.5Concerning findings from the report, “Better Bacon: Why It’s High Time the U.S. Pork Industry Stopped Pigging Out on Antibiotics,”6include:
- Of all the medically important antibiotics sold in the U.S., 27.1 percent go to pork production while 27.6 percent are for treating humans
- Compared to in 2000, many diseases on pig farms, including E. coli infections, pneumonia and meningitis, are much more prevalent
- The U.S. pig industry uses far more medically important antibiotics than other countries, including seven times more per kilogram of pig produced than Denmark and the Netherlands, and twice as many as U.K. producers
It’s an eye-opening report, but the data to create it didn’t come easy to NRDC, even though it should be publicly available. “Robust information on the use of antibiotics in livestock production, including in pigs, remains scarce in the United States,” NRDC noted. “The lack of clear data unnecessarily hampers public and government efforts to reduce antibiotic overuse.”7 Dr. David Wallinga, a physician and senior health officer at NRDC further stated:8
“We’re squandering the miracles of modern medicine on pigs that aren’t sick — and for what? The drugs aren’t working to prevent disease the way producers hope — and if we keep wasting them, they won’t work when sick people need them either. Consumers are demanding responsibly raised meat — the companies that heed their call will have the market advantage and will help save lives in the process.”
Antibiotics Have Been Tied to Industrial Agriculture From the Beginning
In her book “Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World,” journalist Maryn McKenna uncovered how chickens became big business, highlighting the instrumental role antibiotics played in turning chickens from primarily egg layers into a meat source. According to Gastropod:9
“In 1948, a British scientist, Thomas Jukes, was experimenting with adding vitamins and other supplements to poultry feed. Jukes worked for a company that also synthesized antibiotics, a new genre of wonder drugs that had just begun to transform human health, and so he decided to add a tiny amount of his company’s antibiotic to the feed of one of the groups of chickens in his studies.
His results were astonishing: the chickens on drugs grew 2.5 times faster than the hens kept on a standard diet. News spread fast, and only a few years later, American farmers were feeding their animals nearly half a million pounds of antibiotics a year.”
Today we’re seeing the catastrophic consequences of this practice.Seventy percent of the antibiotics used in the U.S. are used by industrial agriculture for purposes of growth promotion and preventing diseases that would otherwise make their concentrated animal feeding operations (CAFOs) unviable. Low doses of antibiotics are added to feed as a matter of course, not only to stave off inevitable infectious diseases but also because they cause the animals to grow faster on less food.
“But there is a terrifying downside to this practice,” Scientific American reported. “Antibiotics seem to be transforming innocent farm animals into disease factories.”10 The antibiotics may kill most of the bacteria in the animal, but remaining resistant bacteria is allowed to survive and multiply. When the FDA tests raw supermarket chicken, they routinely find antibiotic-resistant bacteria to be present.11
FDA Allows Big Ag to Continue Using Antibiotics Virtually Unrestricted
The FDA issued voluntary guidance on agricultural antibiotics in 2013, asking drug companies to remove indications for “feed efficiency” and “weight gain” from the labels of their antibiotic products. They also required veterinarians to oversee any addition of these drugs to animal feed and water. Most companies agreed to comply with the guidelines and state they no longer use antibiotics for growth promotion purposes, but there’s a major loophole being exploited.
Instead of saying the drugs are being used to promote growth, they simply state they use the antibiotics for disease prevention and control, a use that is still allowed under the FDA’s guidance. In 2017, the FDA officially banned the use of antibiotics on CAFOs for the purpose of growth promotion and now requires a veterinary prescription for antibiotics on the farms. Yet, CAFOs saw little ramifications from the ban, which allows them to continue dispensing antibiotics as usual.
Meanwhile, in November 2017 the World Health Organization (WHO) called on farmers and the food industry to stop the use of antibiotics for growth promotion and disease prevention in healthy animals. WHO explained, “The new … recommendations aim to help preserve the effectiveness of antibiotics that are important for human medicine by reducing their unnecessary use in animals.”12
They cited a 2017 study published in The Lancet Planetary Health, which found reducing antibiotic use in food-producing animals reduced antibiotic-resistant bacteria in the animals by up to 39 percent and may similarly reduce such bacteria in humans, particularly those who are directly exposed to food-producing animals.13
According to WHO, use of all classes of medically important antibiotics should be reduced in food-producing animals, while their use for growth promotion and disease prevention without diagnosed illness should be completely restricted.
Antibiotic Resistance May Kill 100 Million by 2030
In the U.S., according to CDC data, every year at least 2 million Americans acquire drug-resistant infections and 23,000 die as a result. Many others die from conditions that were complicated by antibiotic-resistant infections.14 Worldwide, 700,000 people die every year due to antibiotic-resistant disease, and it’s estimated that more people will be affected by it than cancer by 2050.15 What’s more, the problem is slated to get worse.
A 2015 report commissioned by U.K. Prime Minister David Cameron estimated that by 2050 antibiotic resistance will have killed 300 million people, with the annual global death toll reaching 10 million, and the global cost for treatment reaching $100 trillion.
Less than 15 years from now, in the year 2030, antibiotic-resistant disease — if left to spiral out of control — is expected to have killed 100 million.16 One of the most common, and formidable, antibiotic-resistant pathogens in the U.S. is MRSA (methicillin-resistant Staphylococcus aureus).
MRSA is a cause of skin infections that can spiral out of control, leading to bloodstream infections, pneumonia, infections at surgical sites and even death. In the U.S., more than 80,000 invasive infections and 11,000 deaths are caused by MRSA each year. Tens of thousands of Americans may also be vulnerable to life-threatening infections following surgery or chemotherapy.
One study estimated that up to 50 percent of pathogens that cause surgical site infections, and 25 percent of those that cause infections following chemotherapy, are already resistant to common antibiotics.17 If antibiotic effectiveness drops by even another 10 percent, it could result in 40,000 more infections and 2,100 additional deaths following surgery and chemotherapy each year.
A 30 percent drop in effectiveness could mean another 120,000 infections and 6,300 deaths annually, the researchers concluded.18Worse still, if antibiotic effectiveness declines by 70 percent, the U.S. could see 280,000 more infections and 15,000 more deaths as a result. Meanwhile, the U.S. is not taking even the basic steps of preventing worsening antibiotic resistance by restricting the drugs’ unnecessary use in animal feed.
Fight Antibiotic Resistance by Avoiding CAFO Meat
Even if the U.S. government chooses to stay silent on the issue of antibiotics overuse in agriculture, that doesn’t mean you have to go along with it. Increasingly, consumers are demanding sustainably sourced, antibiotic-free meat and other animal products, and by choosing foods from farmers doing it the right way, you can help prompt real change industrywide.
I encourage you to either buy direct from a trusted farm or look for the American Grassfed Association (AGA) logo, a much-needed grass fed standards and certification for American-grown grass fed meat and dairy.19 The standard allows for greater transparency and conformity20 and is intended to ensure the humane treatment of animals and meet consumer expectations about grass fed meat, including beef and pork, and dairy, while being feasible for small farmers to achieve.
An AGA logo on a product lets you know the animals were fed a lifetime diet of 100 percent forage, were raised on pasture (not in confinement) and were not treated with hormones or antibiotics.21 In addition, the AGA logo on your meat and dairy ensures the animals were born and raised on American family farms.22 As antibiotic resistance continues to worsen, and with CAFOs representing ground zero for their overuse, avoiding CAFO animal products is perhaps now more important than ever.
– Sources and References
- 1 U.S. CDC, Antibiotic Resistance and Food Safety
- 2, 3, 4 Wired June 11, 2018
- 5, 8 NRDC June 6, 2018
- 6, 7 NRDC May 2018
- 9 Gastropod August 15, 2017
- 10 Scientific American December 2016
- 11 NRDC June 1, 2017
- 12 World Health Organization November 7, 2017
- 13 The Lancet Planetary Health November 6, 2017
- 14 U.S. CDC, Antibiotic Resistance Threats in the United States, 2013
- 15 PBS March 28, 2018
- 16 Review on Antimicrobial Resistance
- 17 Lancet Infectious Diseases October 15, 2015
- 18 Reuters November 5, 2015
- 19 American Grassfed December 21, 2016
- 20 Civil Eats January 4, 2017
- 21 American Grassfed, Become an Approved AGA Producer
- 22 American Grassfed Association, Our Standards