All blog posts are the sole opinion of the author and do not necessarily reflect the official position of Keep Antibiotics Working or Food Animal Concerns Trust.
Everyone has to eat, and we often make decisions about what to eat based on our values. For some people, this means becoming a vegetarian or buying humanely raised products. Many people also seek out meat from animals that have been raised without antibiotics both because it is healthier individually and because it also reduces the risk to the community from antibiotic resistance superbugs.
According to new data, the antibiotic resistance crisis is even worse than we thought. A study published in Lancet last week estimates 1.27 million deaths globally were caused by antibiotic resistant-superbugs in 2019. The previous widely accepted estimate from the The Review on Antimicrobial Resistance attributed 700,000 deaths to antibiotic resistant superbugs. While past data has given us a window into this growing global threat, the Lancet article provides a more comprehensive analysis that utilizes additional country specific data as well as deaths associated with a much broader group of antibiotic-resistant superbugs. Though a shocking estimate, it is likely the most accurate representation of the global burden of antimicrobial resistance (AMR) to date.
Data released by the FDA today showed a slight drop (3%) in the sales of medically important antibiotics for use in food-producing animals. This is only the third time that sales have dropped from year to year since data began being collected in 2009. Particularly good were reductions in the use of two classes of drugs, cephalosporins and macrolides. These drugs are considered critically important to human medicine because they are the go-to drugs for infections that people catch from food animals. The World Health Organization (WHO) recommends that these drugs not be used at all in animals, so having sales of them go down is important.
Antibiotic resistant superbugs threaten to dismantle our entire medical system and kill as many as 10 million people per year by 2050. A key driver of antibiotic resistance is the overuse of antibiotics in food-animal production, especially the overuse of antibiotics that are important to human medicine. In the United States, approximately two thirds of the medically important antibiotics sold in the U.S. go to meat production. In cattle, the bulk of these are given in feed not to treat illness but to prevent problems caused by unhealthy feedlot diets and by the stress of shipping baby calves across the country to unhealthy crowded feedlots. This is unacceptable and needs to change. Food animals should be raised under healthy conditions so that farms and feedlots do not routinely use these lifesaving drugs. That is where McDonald’s and other food companies come in.
Feed mills could be an important source of how antibiotics are used on farms. Sales of antibiotics for use in feed are the highest of all sales in the US, outstripping sales in human medicine. Existing Food and Drug Administration (FDA) rules require feed mills to keep records of the amount, reason for use, and the animals receiving them. The rules also require feed mills to make these records available to the agency for inspection and copying. What is lacking is a willingness by the FDA to actually go out and collect these records.
The majority of the most recent epidemic and/or pandemic illnesses which have plagued the globe, including COVID-19, Ebola, H1N1 swine flu, and SARS have emerged from animals. As experts have noted, identifying and combating both present and future pandemic threats requires a comprehensive surveillance system to monitor animal pathogens which have the potential to cause human disease.
In 2003, the Animal Drug User Fee Act (ADUFA) was signed into law. It authorizes the Food and Drug Administration (FDA) to collect fees from the animal drug industry in exchange for, “expediting the animal drug development process and the review of new and supplemental animal drug applications.” In short, the law directs the FDA to charge fees to the animal drug makers in order to speed up and streamline animal drug approvals and set targets for how quickly the FDA takes to review drugs. The program gives the drug makers significant power over the FDA because it requires the FDA to negotiate with the animal drug industry every five years on how the collected fees will be used, and the fees make up a large part of the FDA’s budget related to the regulation of animal drugs.
The overuse of antibiotics in food animals helps fuel the development and spread of antibiotic resistant superbugs. These superbugs kill someone every fifteen minutes in the United States and pose a huge threat to global public health.
The overuse of antibiotics is a large problem in the United States. By volume of sales almost two-thirds of medically important antibiotics - antibiotics that are used for treating both animal and human infections- in the U.S. are given to food animals. These drugs are often given as insurance against possible future diseases instead of being given for the treatment of diagnosed illnesses. This method represents antibiotic overuse because the amount of animals receiving drugs is much higher compared to the amount of animals that would receive drugs if farms waited for signs of disease before distributing antibiotics. If farmers can predict whether or not an animal will get sick, then they should be implementing practices to keep them healthy rather than preventatively giving them antibiotics. Food production animals require healthier homes and better food.
As the threat of antibiotic resistance (ABR) grows every day and millions of Americans suffer from infections caused by superbugs, the public is left questioning - what are federal agencies doing to protect our health? It is essential that federal agencies take action to support research on ABR. Currently, the USDA’s National Institute of Food and Agriculture (NIFA), which funds a plethora of research across all agriculture-related scientific fields, including ABR, is missing the mark.
FDA just released its annual report on sales of antibiotics for use in food producing animals. The big take away is that sales of medically important antibiotics continue to rise (3% between 2018 and 2019). This is dangerous because antibiotic overuse in animals leads to antibiotic resistant superbugs that cause difficult to treat infections in humans and animals. This is the second consecutive year that antibiotic sales have increased, following drops in 2016 and 2017. Prior to 2016, there were five years of increases in sales. In order to adequately contain the threat of superbugs we need additional drops in sales rather than increases.
So far, the U.S. response to the deadly global pandemic of drug-resistant superbugs has been flawed and feeble. This is illustrated in a recent update to the National Action Plan (NAP) to combat ‘superbug’ bacteria which covers the years 2021 to 2025. The plan does not include actions needed to reduce the tremendous overuse of critical antibiotics on farms and feedlots. This overuse of antibiotics continues to drive development of resistance by placing selective pressure on bacteria and in turn favoring the emergence of deadly drug-resistant strains. Despite goals of the Federal Task Force on Combating Antibiotic-Resistant Bacteria to “improve antibiotic use and reporting” and “enhance efforts to slow the emergence and spread of resistance,” their National Action Plan and coordinated strategy falls extremely short.
The COVID-19 pandemic has impacted millions of lives throughout the nation and across the globe and has demonstrated the importance of effective healthcare settings and coordinated government action in the midst of a crisis. At a critical time such as this it is imperative we continue addressing all of the public health threats plaguing our society including antibiotic resistance.
The misuse and overuse of antibiotics in human and veterinary medicine has contributed to the development and spread of antibiotic resistant organisms which kill at least 35,000 Americans and cause almost 3 million illnesses each year. More federal action is needed to keep the already high numbers of illnesses and deaths from going up. In order to make sure this action is taken, sixteen Keep Antibiotics Working members and colleague organization recently sent a letter to FDA Commissioner Hahn urging FDA to continue to move forward with efforts to protect the efficacy of existing antibiotics by strengthening and implementing the Center for Veterinary Medicine’s Five-Year Action Plan for Supporting Antimicrobial Stewardship in Veterinary Settings. However, key components of the plan need to be strengthened and implemented in order to promote more judicious use of antibiotics and mitigate the threat of AMR.
Keep Antibiotics Working is staffed by Food Animal Concerns Trust (FACT). Learn more at www.foodanimalconcernstrust.org.
