The U.S. FDA Fails the Public on Antibiotics Once Again
Forgive me if you don’t see me jumping for joy at the U.S. Food and Drug Administration’s (FDA) recent announcement that it intends to limit the use of a specific group of antibiotics in livestock production.
While the FDA’s decision to curb the use of cephalosporins in food animal production beginning April 2012 has been hailed as positive step in the right direction, I’d say it’s more a shuffle forwards—and a very reluctant one at that.
“We believe this is an imperative step in preserving the effectiveness of this class of important antimicrobials that takes into account the need to protect the health of both humans and animals,” said Michael R. Taylor, the FDA’s deputy commissioner for foods, in the FDA press release. Now, as regular readers of my post will already know, I am passionate about the urgent need to curb the misuse of antibiotics in intensive farming systems. So what’s my problem with the FDA’s recent actions? After all, surely this is good news?
As various commentators—including Tom Philpott and Mary McKenna—have already pointed out, I am afraid that cephalosporins are nothing but small fry when it comes to overall antibiotic use in intensive farming. During 2009 alone, the FDA revealed that 80 percent of all antibiotics produced in the U.S. were used for animals—that’s an incredible 28,820,000 pounds out of the 36,080,000 pounds produced. Yet cephalosporins amounted to just over 91,000 pounds of this total—less than half of one percent of all antibiotics used in the U.S. The FDA’s latest figures also reveal that cephalosporin use has decreased even further during 2010 to just over 51,000 pounds. To make matters even worse, the FDA’s announcement is actually a (less strict) rehash of proposals that were first announced in 2008, and which were immediately recalled after the usual uproar from the intensive farming industry lobby.
So what’s the real outcome of the FDA’s recent action? Well, certainly some positive media fluff for the FDA for appearing to take a stand by banning a minor antibiotic that was clearly already losing favor within the industry, yet a minimal impact on the day-to-day workings of the intensive farming industry. A cozy coincidence? I wish it was.
This rather insignificant move forward comes after a preemptive, giant leap backwards made Dec. 22, 2011, just as most of us were focusing on the upcoming holiday period. Notably without any accompanying press release or media fanfare in this instance, the FDA quietly announced in the Federal Register that it was withdrawing its long-standing intention to compel intensive farms to limit certain uses of the key antibiotics penicillin and tetracyclines for food-producing animals—an objective originally set in motion more than 30 years ago when government FDA scientists first began to fully appreciate the risks to human health from the laissez-faire non-therapeutic use of antibiotics in industrial farming.
We all know the story since then—over the years, the FDA has time and again cowed down to powerful political and legal pressure from the multi-billion dollar intensive farming industry lobby and its paid-up politicians, as antibiotic use in farming continued to spiral out of control in the pursuit of ever-cheaper protein and ever-increasing profit—not to mention the impact of intensification on animal welfare, our health and the environment. In its recent announcement the FDA warns that while it has not “ruled out” future regulatory action, it will instead “focus its efforts for now on the potential for voluntary reform and the promotion of the judicious use of antimicrobials in the interest of public health.” I bet Big Ag’s CEOs are quaking in their boots.
Voluntary reform? Call me a cynic, but the FDA has got to be kidding. Despite decades of mounting evidence and the emergence of a global scientific consensus that the routine non-therapeutic use of medicinally important antibiotics on industrial farms across the world is leading to the development of life-threatening multiple antibiotic-resistant bacteria, the powerful U.S. intensive farming lobby continues to aggressively dismiss the science and deny any possible risks to human health—just as the tobacco industry did in the 1970s.
While the FDA’s announcement of limitations for the use of cephalosporins in food animal production might well be a small step in the right direction, the FDA continues to show that it has no teeth when it comes to ensuring that the intensive farming industry puts human health before profit, so that these vital medicines can remain effective for as long as possible. Even the Government Accountability Office recently concluded that key government agencies—including the FDA—are simply not doing enough to combat the growing threat of antibiotic resistant bacteria to public health, and that “antibiotic use in food animals contributes to the emergence of resistant bacteria that may affect humans.” Far from being the proud industry watchdog working on behalf of U.S. citizens, the sad reality is that the FDA is happy to play the role of Big Ag’s lapdog.
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When hurricanes and other extreme storms unleash downpours like Tropical Storm Beta has been doing in the South, the floodwater doesn't always stay within the government's flood risk zones.
New research suggests that nearly twice as many properties are at risk from a 100-year flood today than the Federal Emergency Management Agency's flood maps indicate.
Flooding Outside the Zones<p>About <a href="https://furmancenter.org/files/Floodplain_PopulationBrief_12DEC2017.pdf" target="_blank">15 million</a> Americans live in FEMA's current 100-year flood zones. The designation warns them that their properties face a 1% risk of flooding in any given year. They must obtain flood insurance if they want a federally ensured loan – insurance that helps them recover from flooding.</p><p>In Greater Houston, however, <a href="https://doi.org/10.1111/j.1539-6924.2012.01840.x" target="_blank">47% of claims</a> made to FEMA across three decades before Hurricane Harvey were outside of the 100-year flood zones. Harris County, recognizing that FEMA flood maps don't capture the full risk, now <a href="https://www.hcfcd.org/floodinsurance" target="_blank" rel="noopener noreferrer">recommends that every household</a> in Houston and the rest of the county have flood insurance.</p><p>New risk models point to a similar conclusion: Flood risk in these areas outstrips expectations in the current FEMA flood maps.</p><p>One of those models, from the <a href="https://firststreet.org/flood-lab/research/2020-national-flood-risk-assessment-highlights/" target="_blank">First Street Foundation</a>, estimates that the number of properties at risk in a 100-year storm is 1.7 times higher than the FEMA maps suggest. Other <a href="https://doi.org/10.1088/1748-9326/aaac65" target="_blank" rel="noopener noreferrer">researchers</a> find an even higher margin, with 2.6 to 3.1 times more people exposed to serious flooding in a 100-year storm than FEMA estimates.</p>
What FEMA’s Flood Maps Miss<p>Understanding why areas outside the 100-year flood zones are flooding more often than the FEMA maps suggest involves larger social and environmental issues. Three reasons stand out.</p><p>First, some places rely on relatively old FEMA maps that don't account for recent urbanization.</p><p>Urbanization matters because impervious surfaces – think pavement and buildings – are not effective sponges like natural landscapes can be. Moreover, the process for updating floodplain maps is locally variable and can take years to complete. Famously, New York City was updating its maps when Hurricane Sandy hit in 2012 but hadn't finished, meaning flood maps in effect <a href="https://projects.propublica.org/nyc-flood/" target="_blank">were from 1983</a>. FEMA is required to assess whether updates are needed every five years, but the <a href="https://www.fema.gov/cis/nation.html" target="_blank" rel="noopener noreferrer">majority of maps</a> <a href="https://www.oig.dhs.gov/sites/default/files/assets/2017/OIG-17-110-Sep17.pdf" target="_blank" rel="noopener noreferrer">are older</a>.</p><p>Second, binary thinking can lead people to an underaccounting of risk, and that can mean communities fail to take steps that could protect a neighborhood from flooding. The logic goes: if I'm not in the 100-year floodplain, then I'm not at risk. Risk perception <a href="https://doi.org/10.1088/1748-9326/ab195a" target="_blank" rel="noopener noreferrer">research</a> backs this up. FEMA-delineated flood zones are the major factor shaping flood mitigation behaviors.</p><p>Third, the era of climate change scuttles conventional assumptions.</p><p>As the planet warms, extreme storms are becoming <a href="https://nca2018.globalchange.gov/" target="_blank">more common and severe</a>. If greenhouse gas emissions continue to increase at a high rate, computer models suggest that the chances of a severe storm dropping 20 inches of rain on Texas in any given year will increase from about 1% at the end of the last century to 18% at the end of this one, a chance of <a href="https://doi.org/10.1073/pnas.1716222114" target="_blank" rel="noopener noreferrer">once every 5.5 years</a>. So far, <a href="https://www.rstreet.org/wp-content/uploads/2020/02/195.pdf" target="_blank" rel="noopener noreferrer">FEMA hasn't taken into account the impact climate change is having</a> on extreme weather and sea level rise.</p>
Racial Disparities in Flooding Outside the Zones<p>So, who is at risk?</p><p>Years of research and evidence from storms have highlighted social inequalities in areas with a high risk of flooding. But most local governments have less understanding of the social and demographic composition of communities that experience flood impacts outside of flood zones.</p><p>In analyzing the damage from Hurricane Harvey in the Houston area, I found that <a href="https://doi.org/10.1088/1748-9326/aba0fe" target="_blank">Black and Hispanic residents disproportionately experienced flooding</a> in areas beyond FEMA's 100-year flood zones.</p><p>With the majority of flooding from Hurricane Harvey occurring outside of 100-year flood zones, this meant that the overall impact of Harvey was racially unequal too.</p><p>Research into where flooding occurs in Baltimore, Chicago and Phoenix points to some of the potential causes. <a href="https://www.nap.edu/read/25381/chapter/4#16" target="_blank" rel="noopener noreferrer">In Baltimore and Chicago</a>, for example, aging storm and sewer infrastructure, poor construction and insufficient efforts to mitigate flooding are part of the flooding problem in some predominantly Black neighborhoods.</p>
What Can Be Done About It<p>Better accounting for those three reasons could substantively improve risk assessments and help cities prioritize infrastructure improvements and flood mitigation projects in these at-risk neighborhoods.</p><p>For example, First Street Foundation's risk maps account for <a href="https://firststreet.org/flood-lab/research/flood-model-methodology_overview/" target="_blank">climate change</a> and present <a href="https://floodfactor.com/" target="_blank" rel="noopener noreferrer">ratings</a> on a scale from 1 to 10. FEMA, which works with communities to update flood maps, is <a href="https://www.fema.gov/media-library-data/1521054297905-ca85d066dddb84c975b165db653c9049/TMAC_2017_Annual_Report_Final508(v8)_03-12-2018.pdf" target="_blank" rel="noopener noreferrer">exploring rating systems</a>. And the National Academies of Sciences, Engineering and Medicine recently <a href="https://www.nationalacademies.org/news/2019/03/new-report-calls-for-different-approaches-to-predict-and-understand-urban-flooding" target="_blank" rel="noopener noreferrer">called for a new generation of flood maps</a> that takes climate change into account.</p><p>Including recent urbanization in those assessments will matter too, especially in fast-growing cities like Houston, where <a href="https://authors.elsevier.com/a/1boBRyDvMFW6W" target="_blank" rel="noopener noreferrer">386 new square miles</a> of impervious surfaces were created in the last 20 years. That's greater than the land area of New York City. New construction in one area can also <a href="https://scalawagmagazine.org/2018/01/city-in-a-swamp-as-houston-booms-its-flood-problems-are-only-getting-worse/" target="_blank" rel="noopener noreferrer">impact older neighborhoods downhill</a> during a flood, as some Houston communities discovered in Hurricane Harvey.</p><p>Improving risk assessments is needed not just to better prepare communities for major flood events, but also to prevent racial inequalities – in housing and beyond – from <a href="https://www.npr.org/2019/03/05/688786177/how-federal-disaster-money-favors-the-rich" target="_blank" rel="noopener noreferrer">growing</a> after the unequal impacts of disasters.</p>
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