The annual number of deaths from antimicrobial resistance could reach 10 million by 2050 – more than those currently dying from cancer. The overuse and misuse of antibiotics has allowed infections to mutate and resist the drugs needed to treat a myriad of life-threatening conditions. A recent report from the Centers for Disease Control and Prevention shows that the United States has lost progress in combating antimicrobial resistance since 2020 largely due to the COVID-19 pandemic. The report stresses that “this setback can and must be temporary.”
The United States and other governments are taking steps to reduce the use of antibiotics in animal husbandry. Paradoxically, the Food and Drug Administration appears to be working against public health by refusing to set targets for reducing antibiotics in agriculture. How can the United States successfully combat antibiotic resistance when its federal agencies are incompatible with the problem of antibiotic misuse, let alone the solution?
Approximately two-thirds of medically important antibiotics sold in the United States go to industrial agriculture, particularly to raising pigs and livestock. Factory farms raise these animals in unsanitary, overcrowded and poorly ventilated conditions and give them antibiotics to mitigate the consequences. This inevitably leads to the development of antibiotic-resistant superbugs that spread to humans through contaminated food and the environment. To put this number in context, humanely raised animals rarely, if any, need any antibiotics at all.
The continued use of antibiotics in large numbers of farm animals presents the United States with a health catastrophe. The federal government needs to set national targets now to reduce the overuse of antibiotics in food animal production, but the USDA and FDA have not yet clearly recognized this need. Instead, the FDA put together a “plan” full of sub-goals that were constantly deferred, watered down, left unfulfilled, and rejected calls to set reduction goals in several meetings with members of the Keep Antibiotics Working coalition, with which I am affiliated. And a USDA official said in an email she accidentally sent me that limiting antibiotic use in agriculture is “against US government policy,” part of which is promoting agriculture — and protecting the profits of industrial farming companies.
The CDC is clear about the need to reduce antibiotic use. The USDA and Food and Drug Administration should follow suit by limiting the use of antibiotics in animal agriculture.
Earlier this week, the Presidential Advisory Board on Antibiotic-Resistant Bacteria, the leading body that advises federal agencies on combating antibiotic-resistant bacteria, met in person for the first time since the start of the pandemic. She spent two days discussing how to integrate the fight against antibiotic resistance into the nation’s response to future pandemics. The meeting illustrated the huge gap between the nation’s willingness to tackle antibiotic resistance in the human health sector versus agriculture.
The meeting highlighted the tremendous progress in monitoring antibiotic use and antibiotic resistance in humans since the beginning of the pandemic. In contrast, little has been done to improve surveillance on the agricultural side, with the entire federal response reliant on large meat companies doing such a poor job of protecting their workers early on in the pandemic.
The gap extends to prevention, too. On the animal side, consumers are being asked to trust meat producers, who see the problem in terms of preventing pathogens from spreading among farms rather than finding ways to raise healthier animals that need fewer antibiotics in the first place.
This advisory board has spent six years advising federal agencies on ways to combat antibiotic resistance, but it has never made clear the need to reduce antibiotic use in agriculture.
I was one of the advocates who wrote to the board before the meeting, and made comments during the meeting, asking that it be made clear that preventing the spread of resistant pathogens means using fewer antibiotics. During the meeting, the board never acknowledged the need to reduce the use of antibiotics in raising animals for food. The board will release a report in the near future that advises federal agencies based on this meeting.
I and others hope that the council will call for federal agencies to set national targets to reduce antibiotic use in animal agriculture. If it does not support limiting use, it is like the Climate Change Committee which does not believe there is a need to reduce greenhouse gases, and its advice should be ignored. Acknowledging the need to reduce the use of antibiotics in farm animal husbandry will certainly ruffle the feathers of some members of the agricultural industry on the Council, but tackling the problem of antibiotic resistance cannot be done without challenging the status quo.
Since at least the 1960s, experts have recognized the threats to human health associated with the overuse of antibiotics in food-producing animals. However, today, nearly 3 million Americans have fallen ill and as many as 160,000 have died from antibiotic-resistant infections. Reduction goals for agriculture must be set to match those in human health care and solutions must be implemented that align federal agencies in taking the urgent steps required to protect public health. Not recognizing this and acting on it will threaten the health of Americans.
Now we play the chicken game with nature, the odds are not on our side.
Stephen Roach is director of the Safe and Healthy Food Program at the Food Animal Concerns Trust and senior analyst at Keep Antibiotics Working, a coalition of advocacy organizations working to combat the inappropriate use of antibiotics in animal food.