Is feeding antibiotics to food animals contributing to the increase in resistant bacterial infections of humans?
It’s a question that has been floating precariously between the livestock agricultural industry and the medical community for years, with plenty of speculation but no definitive answers.
But a piece of legislation introduced to Congress this past summer — timed, whether intentionally or not, with talks of health care reform and, to a lesser extent, the H1N1 influenza pandemic and humane animal treatment — has suddenly pushed this issue to the forefront of public discussion, and what was once an occasionally heated debate has now turned into a full-blown fight between the people who feed us and the people who treat our illnesses.
The “Preservation of Antibiotics for Medical Treatment” Act (PAMTA) of 2009, H.R. 1549 and its companion bill S. 619, would restrict the types of antibiotics used with animals intended for the food chain to those that demonstrate no harm to human health due to resistance development caused by nontherapeutic uses. These nontherapeutic uses refer to the feeding of antibiotics to the whole herd as a preventative measure, rather than treating illnesses of specific animals as needed; nontherapeutic antibiotic use may also be referred to as “antibiotics as growth promoters.” The antibiotics in question would be those that are also used to prevent or treat human infections, which would include seven classes of antibiotic: penicillins, tetracyclines, macrolides, lincosamides, streptogramins, animoglycosides, and sulfonamides.
Not surprisingly, this bill is pitting food producer against food user in a contentious fight for control over the American food supply. Consumers, specifically led by the medical community, on one end calling for an end to nontherapeutic antibiotic use — driven by the fear created by recent reports of drug-resistant deadly infections such as strep, staph, E. coli, and salmonella; and pork, cattle, and poultry producers on the other end explaining that the very reason why they use antibiotics the way they do is because that’s what consumers demand: That in order for producers to stay economically viable and to continue to put inexpensive cuts of meat in the store, that they must feed antibiotics to prevent disease in order to promote fast growth and a quick-moving supply chain.
But not all producers say this, and therein lies a rapidly widening rift within the livestock industry itself — between the conventionally minded who see nontherapeutic antibiotic use as a vital component of their production system, and the sustainably minded who agree with the growing community of consumers that antibiotics should be used judiciously. It is that this division exists within the industry, even more so than consumer demand, that may have the biggest influence on which direction PAMTA ultimately takes, should it make it to the House vote.
Supporters: Nontherapeutic Antibiotic Use is Valid Consumer Concern
One of the leading supporters of PAMTA is the National Commission on Industrial Farm Animal Production, a partnership between the Washington, D.C.-based Pew Charitable Trusts — a community of concerned citizens, public and private organizations, and donors with interest in bettering public policy — and the John Hopkins School of Public Health. The goal of the Commission was to conduct an assessment of the impact of the conventional livestock industry on public health, the environment, animal welfare, and rural economy and then to issue recommendations on ways to mitigate the negative impacts of industrialized agriculture while continuing to provide quality, reasonably priced food to consumers. Pew’s recommendations were released approximately a year before PAMTA was introduced to Congress, and named specifically restriction of the nontherapeutic use of antibiotics in food animal production as the place to start in tackling the issue of drug resistance in bacterial infections that occur in both food animals an
d humans. The reason, the Pew report states, is because no system exists to test meat for dangerous resistant bacterial strains, and there is also little consumer oversight into how food is mass produced.
“Human antibiotics are routinely misused on factory farms to promote faster animal growth and compensate for crowded, stressful, and unsanitary conditions,” said Robert Martin, senior officer with Pew’s Environmental Group. “Medical experts agree that this practice directly contributes to a dramatic rise in antibiotic-resistant infections in people. We must reduce the use of antibiotics today to help preserve their effectiveness tomorrow.”
While not related to what’s going on in the food animal industry, the H1N1 influenza viral pandemic represents, to many people, the worst-case scenario — a potentially deadly, widespread, drug-resistant bacterial infection with no effective treatment. That bacterial infections are often more dangerous than viral infections is not lost on consumers, either. Scares of drug-resistant staph skin infections and food poisoning cases caused by E. coli and salmonella already have consumers on edge. According to the Arlington, Va.-based Infectious Diseases Society of America, 70 percent of the 90,000 people who die from hospital-acquired diseases each year have drug-resistant infections. In 2005, MRSA — a drug-resistant staph infection — caused more than 18,000 deaths in the United States. And in 1998, the Institute of Medicine in Washington, D.C., estimated that drug-resistant bacterial infections generated $4 to 5 billion per year in extra costs to the U.S. health care system.
Add that to the fact that the newest antibiotic approved for human use by the U.S. Food and Drug Administration in 2003, meaning there are no new antibiotics being added to the human medicine arsenal.
“Doctors almost always warn their patients never to take antibiotics if they are not actually sick,” said Laura Rogers, director of Pew’s Campaign on Human Health and Industrial Farming. “Yet, this is what is happening on industrial farms today — healthy animals are fed low doses of antibiotics over long periods of time, creating the ideal breeding ground for bacteria to become resistant. Our food production practices need to change in order to keep us all safe.”
It’s a fact that bacterial infections are becoming more resistant to antibiotics. What has remained ambiguous through the years is the exact reason for this. Medical doctors stopped prescribing antibiotics in every case of infection, such as the recommendation a few years ago that sinus infections and childhood ear infections didn’t necessarily need a prescription of antibiotics. Now, the medical community is looking deeper — to the food supply and considering that what’s going into the producing of food may actually be going into the making of drug-resistant illnesses.
The Union of Concerned Scientists, headquartered in Cambridge, Mass., has long warned of the link between animal antibiotics and drug-resistant bacterial infections in humans. According to the Union, 50 million pounds of antibiotics have been used in industrialized farm animal production in the past two years — and that 70 percent of all antibiotics sold in the United States go for nontherapeutic uses in food animal production.
Even as far back as 1999, this link between food animals and drug-resistant infections in humans was speculated. The Washington, D.C.-based National Research Council released a report that year concluding that drug-resistant bacteria can be passed from food animals to people and use of antibiotics in livestock can promote this resistance, although at the time, there was not enough research available to determine the extent of the public health risks by this transmission.
A wide array of organizations have since joined the support for a nontherapeutic antibiotic ban for food animals, including the American Medical Association, the Centers for Disease Control and Prevention, the Institute of Medicine of the National Academies of Science, and the World Health Organization — the last of which had persuaded the European Union to enact a PAMTA-like ban in 2006.
Opposition: PAMTA Based on Fears, Rather Than Fact
But food animal producers say that there still is not enough evidence to warrant a ban on nontherapeutic antibiotic use. The industrialized food animal industry says PAMTA is based on a mere theory, rather than an indisputable fact.
Included in a letter to the White House, sent by the American Feed Industry Association (AFIA) on behalf of 20 food animal organizations, was the crux of the argument on nontherapeutic antibiotic use: “No conclusive scientific studies have been offered demonstrating the use of antibiotics on farms contributes significantly to an increase in human resistance. In fact, a growing body of evidence shows just the opposite, namely the responsible, professional use of these products reduces pathogens in and on foods, enhancing animal welfare while not contributing to resistance.”
The letter refers to a 2006 report by the Institute of Food Technologists, headquartered in Chicago, that concluded that there are significant human health benefits from preventative antibiotic use in food animals and that eliminating nontherapeutic antibiotic doses could actually result in more antibiotic use overall. Europe’s ban on antibiotics for growth promotion has resulted in significant increases in animal diseases, some in fact that hadn’t been seen for 20 years, and therefore an increase in the use of antibiotics by veterinarians to treat the diseases. Furthermore, 2006-2007 data from The Netherlands shows that penicillin and tetracycline resistance to Salmonella actually increased in humans since the ban, while the same resistances decreased in the United States.
The Institute requests that policymakers turn their attention to the over-prescription of antibiotics in human medicine, and to leave the food animal industry to continue to strive toward protection of the food supply from food-borne illness.
In addition, the AFIA letter brings attention to the fact that removing nontherapeutic antibiotics from mainstream food animal production is no minor change — that it will affect the entire industry, and therefore the quality and price of food that ends up on the consumer’s plate.
PAMTA and the publicity it has generated, including a Dec. 29, 2009, article by The Associated Press, has created a unified front of food animal industry representatives against the claims that nontherapeutic antibiotic use is dangerous to humans and should therefore be eliminated.
“America’s farmers, ranchers, and veterinarians are committed to ensuring the health of their animals and the safety of their products,” said Kay Johnson Smith, executive vice president of the Arlington, Va.-based Animal Agriculture Alliance, in response to The Associated Press article. “Antibiotic use in agriculture is carefully monitored to provide a healthy, plentiful food supply for all.”
Another major player in the defense of nontherapeutic antibiotic use is the American Veterinary Medical Association (AVMA), headquartered in Schaumburg, Ill., which has formally denounced the Pew report.
“Largely, our conclusions were that the Pew report was a superficial look at animal agriculture, and the recommendations lacked deep understanding of the issues involved,” said David Smith, a University of Nebraska-Lincoln Extension dairy and beef veterinarian, who spoke on behalf of the AVMA.
Officially, the AVMA is opposed to PAMTA on the grounds that it would lead to more animal disease and death, without scientific assurance that it would improve human health. According to the AVMA, antibiotics have been used with food animals for more than 40 years, and today, more than 95 percent of antibiotics used for livestock are for nontherapeutic uses. The AVMA points to the data from Netherlands, and also similarly from Denmark, as summarized in the AFIA letter as examples that a PAMTA ban will likely backfire in the United States.
Another AVMA spokesman, Charles Hofacre of the Jacksonville, Fla.-based American Association of Avian Pathologists, said the Pew report was biased against large agribusiness and that the authors didn’t understand that a switch from industrialized food animal production to what he referred to as “idyllic farms” would simply not work for the affordable, accessible, quality food supply that America’s consumers are so accustomed to.
“If we were to turn all the chickens and pigs and cattle loose like they would like to see done, the cost would be extremely high so people would have to pay a lot more for their food,” Hofacre said. “And there would be shortages, because I don’t know where you would raise all of those animals.”
By phasing out antibiotics as growth promoters, the National Research Council estimated in 1999 that meat prices would raise an additional $4.85 to $9.72 per person per year. Likely, this estimated additional cost could be higher today.
A Rift within Agriculture
Very much the opposite of industrialized food animal production, sustainable farms fit the “idyllic farm” image that Hofacre was trying to convey. Many producers who fall into this category have certified organic operations or at least production practices that de-emphasize the use of non-essential antibiotics, meaning that animals treated with antibiotics are withheld from slaughter for human food. The basis of this decision is precisely to eliminate the passage of antibiotics and antibiotic overuse effects from reaching the food supply — which is driven by demand from a growing segment of consumers, the same “food-conscious” consumers who back PAMTA.
The National Sustainable Agriculture Coalition (NSAC) sent a letter to the White House, on behalf of 13 family farmer organizations, that plainly aligns sustainable agriculture with the supporters of PAMTA: “Non-human antibiotics are a major source of antibiotic overuse. More than 70 percent of all U.S. antimicrobials are added to animal feed not used for treating disease, but rather as feed additives for healthy beef cattle, pigs, and poultry to promote growth and to help manage the stresses on animals posed by confinement housing. Strong evidence now implicates this routine and widespread antibiotic use in livestock with rising antibiotic-resistant bacterial infections in humans.”
The letter states that PAMTA’s opposition claims the nontherapeutic antibiotic ban would compromise animal welfare but that the real threat comes from irresponsible industrial food animal production practices: Placing too many animals in too small of areas and in confinement and feeding them physiologically incompatible diets increases discomfort, stress, and therefore disease susceptibility.
Back in 1999, the Washington, D.C.-based Center for Science in the Public Interest’s Environmental Defense Fund (EDF) first petitioned the FDA to rescind approvals for nontherapeutic uses in food animals of six antibiotics.
“It’s about time that FDA stopped protecting the profit margins of agribusiness and started protecting public health,” said Rebecca Goldburg, senior scientist for the EDF, at the time.
Jean Halloran, director of the Yonkers, N.Y.-based Consumer Policy Institute, had agreed: “At this time, science cannot say that if we reduce antibiotic use in livestock by X, we will get Y fewer upset stomachs and Z fewer deaths. Even though you can’t establish that sort of relationship, you should make a leap of faith and take a very important first step of taking antibiotics out of animal feed.”
As far as the AVMA’s idea that PAMTA would put the food animal industry at a disadvantage, NSAC’s letter said that instead of putting livestock agriculture in a position where it’d be unable to keep up with consumer demand, PAMTA would instead put family farmers and industrialized agriculture more on the same playing field, promoting more responsible farming practices.
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Source: newsroom - meattradenewsdaily.co.uk
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