By Avinash Kar and Eili Klein
The world's leading authorities on public health—from the Centers for Disease Control and Prevention (CDC) to the World Health Organization (WHO)—have been warning us loud and clear: we must stop taking life-saving antibiotics for granted or else they will continue to fail us when sick people and animals need them. A new report from the U.S. Food and Drug Administration (FDA) shows that consumer demand for better practices might finally be having an effect.
In 2015, more than 75 percent of U.S. sales of antibiotics important to human medicine were sold for use on livestock, not for the treatment of sick people. Sales of those drugs increased 26 percent from 2009 to 2015. Often, these drugs are not used to treat sick animals, but are distributed en masse to animals, a practice closely linked to use of antibiotics to promote faster growth and compensate for stressful and unsanitary living conditions on industrial farms.
For the first time in many years, livestock sales of antibiotics important to human medicine have dropped—down 14 percent from 2015 to 2016 according to new data released today by the FDA.
These developments are encouraging, showing that meat can be produced with fewer antibiotics in the U.S. But more work remains if we are to make a real dent in the problem. Though an improvement, the 2016 sales figures remain significantly above 2009 levels.
This welcome news follows a series of food industry commitments to reduce antibiotic use in chicken production, which started with an announcement by Perdue Foods in the fall of 2014. Since then fourteen of the top 25 U.S. restaurant chains (and approximately 50 percent of the chicken industry) have made some level of commitment to curb unnecessary antibiotics used in chicken—following increasing demand from customers and advocacy and research from groups like ours. (Note that while an FDA ban on the use of medically important antibiotics for growth promotion went into effect earlier this year, the most recent data precedes the ban).
But further change can't come soon enough. Each year in the U.S., at least 2 million people become sick and at least 23,000 people die from antibiotic-resistant infections. This crisis is fueled by the overuse of these drugs when they are not needed to treat sick people or animals. It threatens the health of every single one of us by making once manageable infections much harder or even impossible to treat. It also means that procedures we have come to rely upon—such as joint replacements, transplants, caesarian sections, or dialysis—may soon become untenable, due to the elevated risk of untreatable infection.
A. FDA, Center for Veterinary Medicine, FDA Annual Summary Reports on Antimicrobials Sold or Distributed for Use in Food-Producing Animals. B. Center for Disease Dynamics, Economic & Policy, IQVIA MIDAS. * Data on human use in 2016 is not yet available
Unfortunately, federal policy to date has fallen short in addressing the problem. While FDA finally enacted a ban on the sales of medically important antibiotics for growth promotion in January 2017, the regulations allow these drugs to continue to be used on animals that are not sick to compensate for the crowded, unsanitary, or stressful conditions found on many livestock operations, under the guise of "disease prevention." As a result, representatives of the animal drug industry have estimated that the ban on growth promotion affects no more than 10-15 percent of antibiotic use in the livestock sector. The WHO recently released recommendations that medically important antibiotics should not be used for disease prevention in healthy animals—and the FDA should heed that call and close this loophole.
In the meantime, industry, states, cities and consumers must keep leading the way. The chicken industry has reached a tipping point. And giants of the industry—from Tyson and Perdue on the producer side, to McDonald's and Subway on the restaurant side—are responding to consumer demand and helping lead the way. But we need to see the same kind of action in the pork and beef industries, which lag far behind. FDA's reported estimates of the breakdown of the sales of these drugs by animal species show beef and pork accounting for about 43 percent and 37 percent of the total, respectively, whereas chicken only accounts for 6 percent. Similarly, based on the 2016 FDA estimates and USDA production data, the beef industry used 314 milligrams of medically important antibiotics per kilogram of meat produced (mg/kg), the pork industry 273 mg/kg and chicken 27 mg/kg.
States and cities too can help fill the gaps in federal action. States can follow the lead of California and Maryland, which have fully banned the routine use of antibiotics in healthy livestock and poultry. Cities, meanwhile, can look to San Francisco's new antibiotics use disclosure ordinance, which requires large grocery chains to report the antibiotic use associated with the raw meat and poultry sold in their stores, empowering customers to make informed decisions on the meat they buy.
The growing spread of drug-resistant bacteria and infections affects anyone who may ever need antibiotics—or cares about someone who might. That's all of us. And so action is needed from all of us—consumers, companies, states, cities and especially FDA—to extend this progress and help save these miracle drugs before it's too late.
Dr. David Wallinga and Abby Zlotnick of NRDC contributed to this blog.
Avinash Kar is a senior attorney for the Health & Environment Program at the Natural Resources Defense Council.
Eili Klein has been associated with the Center for Disease Dynamics, Economics & Policy since its founding and is currently a fellow. Dr. Klein is a mathematical ecologist and epidemiologist whose research focuses on the role of behavior in the spread of infectious diseases.
This blog provides general information, not legal advice. If you need legal help, please consult a lawyer in your state.