The Food and Drug Administration (FDA)—gingerly, gingerly—took a step on Monday towards addressing one of the most fundamental but unknown threats to public health: the overuse of antibiotics in animal food and water. The FDA said in a new policy document that the uses of antibiotics for agriculture should be limited to treated sick animals, and that veterinarians should be involved in giving out the drugs. (See the FDA document here.) The change came in part out of concerns that the use of antibiotics on animals was helping to breed resistant bacteria—an estimated 100,000 people a year now die from hospital-acquired bacterial infections that can no longer be treated with most antibiotics, thanks to resistance. (More on Time.com: See a package on who should share the blame for the oil spill)
Here’s how the Times described the policy:
While doing nothing to change the present oversight of antibiotics, the document is the first signal in years that the agency intends to rejoin the battle to crack down on agricultural uses of antibiotics that many infectious disease experts oppose.
Doesn’t sound like a big deal, right? Drugs like penicillin and tetracycline were developed to help sick people, and it might stand to reason that they should be preserved for use in sick people—not to speed the growth of pigs, chicken and cattle. And given the scale of the problem—according to the Union of Concerned Scientists (UCS), about 13 million lbs. or 70% of all antibiotics in the U.S. goes to food animal production—the FDA’s statement was just a baby step. As Deputy FDA Commissioner Joshua Sharfstein told reporters in a news conference after the recommendation was made: “We’re not expecting people to pick up this guidance and change their practice tomorrow. This is the first step in the FDA establishing the principles from which we could then move, if necessary, toward other mechanisms of oversight, which is regulation.” Sharfstein was so cautious he might as well have been wearing a flak jacket and a crash helmet while speaking. (More on Time.com: See photos of a Mexican meth gang waging a holy drug war)
But he has reason to be careful. the powerful agriculture industry has fought every attempt by federal regulators to crack down on the use of antibiotics in animals—and they’ve won every time . The meat industry argues that antibiotic use in animals is far lower than its critics say—the Animal Health Institute, a trade group, estimates that just 13% of all agricultural antibiotics are used for growth promotion, with the rest going to treat sick animals or prevent illness. And they’ll fight hard against any attempt by the government to limit their ability to dispense drugs to the millions of swine, chicken and cattle being raised for food in the U.S. “Show us the science that use of antibiotics in animal production is causing this antibiotic resistance,” Dave Warner of the National Pork Council told the Washington Post.
It is difficult to make the direct connection between an antibiotic being used on a pig in Iowa and a person dying from drug-resistant Salmonella in a hospital in New York. But there’s no disputing that doctors are increasingly worried about the rise of resistant bacteria and the threat the problem poses to each of us. The Centers for Disease Control found in its 2005 annual report that half of all Campylobacter infections are drug resistant. One in five Salmonella infections, and nearly 100,000 Salmonella infections would resist treatment with at least five antibiotics, according to Congressional testimony in 2009 by Margaret Mellon, the director of the food and environment program at the UCS. The World Health Organization has sounded the alarm of antibiotic resistance, and the Institute of Medicine has estimated that longer hospital stays because of resistant food-borne microbes cost the U.S. an additional $4 to $5 billion a year in health care costs—plus all the additional time sick people have to take off work. Superbugs like MRSA—Methicillin resistant Staphylococcus aureus—are truly scary, resistant to nearly every antibiotic we have at our disposal. We’re in an arms race with bacteria—and we’re in danger of losing, as Dr. Ken Harvey of La Trobe University’s School of Public Health in Melbourne told the Australian Broadcasting Corporation today:
“Although we’ve developed new antibiotics, the more we’ve used them the more the bacteria have become resistant. It’s sort of Darwinian selection of the species if you like.” Dr Harvey says bacteria have the edge in this evolutionary battle. “We’re grossly outnumbered by bacteria and they’ve got very efficient mechanisms of mutating, becoming resistant, passing on that mechanism of resistance to other germs.”
And a small but growing number of studies are connecting the use of antibiotics on farms to resistant bacteria in hospitals. A strain of MRSA responsible for 20% of all MRSA infections in the Netherlands has been shown to be transmitted from pigs to farmers and their families, and hospital staff. Even news organizations as mainstream as CBS have begun to raise questions about the connection between antibiotic use in our farms and resistant bacteria, as this Katie Couric investigation from February shows. (More on Time.com: See photos of the alien beauty of an island off Yemen’s coast)
The meat industry has argued that restricting antibiotics in animal feed will lead to unbearably high costs, but other countries have already taken that step without destroying their to make bacon. In Europe, Denmark led the way by banning antibiotics for growth promotion in 1998, after concerns grew about resistant bacteria. In the years since the industry has thrived—Danish swine production from 18.4 million in 1992 to 27.1 million in 2008, while total antibiotic use decline 51% from an all-time high in 1992. I had a chance to see the situation for myself when I was in Denmark last December for the UN climate change summit. Pork farmers told me that the rule was a pain when it was first put into practice, but that they’d adjusted, taking better care of their pigs because they knew that they could no longer rely as heavily on drugs. (Antibiotics were still available for sick animals, but were much more closely regulated.) And in 2006 the European Union followed suit and banned antibiotics for growth promotion. (More on Time.com: See photos of the animals of Kenya)
Given all that, what the FDA did on Monday is too weak, not too strong—as some public health groups argued. “Te FDA has proposed good steps, but they have not gone far enough or moved fast enough,” said Representative Louise Slaughter of New York, who happens to be the only microbiologist in Congress. “We cannot wait any longer.” Given how strong the farm lobby is in the U.S.—which I can tell you from experience—we might be waiting forever.
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