WASHINGTON — President Barack Obama took long-awaited action Thursday in response to rising concerns over antibiotic-resistant bacteria. But public health experts say he failed to move decisively against a key driver of this resistance: the widespread, unnecessary use of antibiotics on industrial farms.
Meanwhile, a new wave of action on the issue is taking place at lower levels of government across the country. In recent months, more than two dozen municipal bodies have passed resolutions calling for action from the federal government, particularly with regard to the agricultural use of antibiotics. A half-dozen such resolutions have been passed just over the past two weeks, including in Cincinnati, Berkeley and San Francisco.
“In the 21st century, we must not allow infections we learned how to cure in the 20th century to once again become life-threatening,” John Avalos, the San Francisco Board of Supervisors member who sponsored the resolution, said in a statement after the action was voted through on Sept. 9. “I am pleased the Board has taken this important step urging Congress to protect the effectiveness of antibiotics.”
Some 80 percent of antibiotics sold in the United States today are used for agricultural purposes, according to widespread estimates. Most of these are administered at low levels to animals that are not ill, a practice that has traditionally been used to promote growth or to combat infections resulting from the crowded conditions characteristic of modern industrial farming.
Yet public health advocates have long warned that this type of antibiotic use provides the exact conditions required to build up resistance among bacteria.
“In the medical community we’re regularly cautioned about carefully using antibiotics – not to use them in sub-therapeutic doses and not to use them unnecessarily,” Dr. Michael Martin, an assistant clinical professor with the University of California, San Francisco, told MintPress News.
“On the other hand, the agribusiness and big pharmaceutical companies are using antibiotics in precisely the wrong way, precisely the way that promotes resistance: low doses that don’t kill bacteria but allow it to develop resistance.”
Whatever the provenance, antibiotic-resistance bacteria now leads to infections in at least two million people each year in the U.S. alone, according to the Centers for Disease Control and Prevention.
In an executive order outlining new federal action on the issue, President Obama on Thursday cited data suggesting that some 23,000 people in the U.S. are dying each year as a result of antibiotic resistance – figures that were unheard of just a decade ago. White House advisors say the economic impact on the U.S. could be as much as $70 billion a year, yet the federal government this year has allotted just $450 million toward studying and combating the problem.
“The rise of antibiotic-resistant bacteria … represents a serious threat to public health and the economy,” the president stated in the order. A fact sheet from the White House warns that the problem is “worsening.”
More research needed?
The executive order directs federal agencies to coordinate in implementing a new five-year national strategy on monitoring and reacting to the rising levels of antibiotic resistance, and creates a presidential task force to oversee this work. That council is now mandated to create a national action plan by February, to be implemented over the ensuing half-decade.
The new strategy is the result of a report by a high-level advisory group called the President’s Council of Advisors on Science and Technology, or PCAST. That report was also publicly released on Thursday, and, as the scientific consensus formally informing the new policy direction, it has received the bulk of the criticism from those who worry that it doesn’t place enough emphasis on reforms within the agricultural sector.
The PCAST report does not downplay the importance of attending to the agricultural use of antibiotics, but it also doesn’t suggest significant action beyond reforms already introduced by the Food and Drug Administration. Beyond this, the report suggests, “If the FDA guidances are not effective in mitigating the risk of antibiotic resistance associated with antibiotic use in animal agriculture, FDA should take additional measures.”
The PCAST advisors also intimate that the primary cause of growing antibiotic resistance in the U.S. is due to practices within the health care system. The report notes that up to half of these drugs prescribed in the U.S. are unnecessary or “not optimally prescribed.” Meanwhile, “the extent to which antibiotic resistance in animal agriculture contributes to human infections is not known,” the report notes, though it does say such use is “a matter of very serious concern.”
Prominent lobby groups for the meat industry are supporting this cautiousness.
“In its executive order … the White House acknowledged something that the National Pork Producers Council has been saying for years: More epidemiological research is needed to understand the key drivers of increased antibiotic resistance,” the pork council’s president, Howard Hill, said in a statement.
An official with the American Meat Institute, another trade group, added: “As both the White House and CDC note, the greatest threat to public health is the overuse of antibiotics in humans, though the agriculture industry needs to ensure judicious use of antibiotics as well.”
Watchdog groups, meanwhile, are expressing frustration with the PCAST’s characterization.
“I am glad to see that the Obama Administration has recognized the urgency of the public health threat posed by antimicrobial resistance, but disappointed that the … committee didn’t urge more effective action to limit antibiotic use in animal production,” Caroline Smith DeWaal, food safety director at the Center for Science in the Public Interest, a watchdog group, said in a statement.
“The Administration can’t tackle antimicrobial resistance without tackling unnecessary uses of medically important antibiotics on the farm.”
A political problem
The federal government has been aware of rising concerns in the medical community around the systemic use of antibiotics on large farms since at least the 1970s. Yet for critics, the response by federal regulators has been agonizingly slow. The European Union, for instance, is far ahead of the U.S. in strengthening regulation around the agricultural use of antibiotics.
“Antibiotic misuse stems directly from the excessive and inappropriate influence of the meat industry over our political system. Lobbyists are spending millions of dollars to maintain the status quo,” Tia Lebherz, a California organizer with Food & Water Watch, an advocacy group, told MintPress.
“The FDA has failed to regulate this misuse for years – it sat on one petition to restrict agricultural use for 35 years. Even current legislation isn’t moving forward, despite both the World Health Organization and the American Medical Association warning that life-saving antibiotics are losing their effectiveness.”
Legislative proposals to combat antibiotic resistance are indeed sitting in the House and Senate, but neither of these has been taken up even at the committee level. Meanwhile, the most substantive federal action has come from the FDA, which announced in June that all 26 major drug manufacturers had agreed to phase out the use of antibiotics in food-producing animals by 2016. (Other uses are supposed to be overseen by a certified veterinarian.)
Yet Lebherz says that such voluntary initiatives are inadequate for a problem of this scale, and that legislation will ultimately be required to provide a comprehensive approach. So, in recent months, she and her colleagues have begun urging city and county officials to take formal positions on the issue.
Some 26 municipalities have now passed resolutions calling for federal action, according to data provided by Food & Water Watch. These include Seattle, Chicago, Cleveland, Providence, Pittsburgh, St. Paul and, most recently, Cincinnati and a string of California towns. More such announcements are expected in coming weeks.
“We’re really seeing local officials get behind this and understand that this type of action is a no-brainer,” Lebherz said. “The municipalities we’ve worked with have really latched onto this, passing resolutions unanimously. It’s weird – when you start to talk about antibiotic resistance, it seems that a lot of people have a direct connection to this issue.”
Such steps will continue to keep the issue in the public eye in coming months, as will the new federal movement announced by President Obama. And despite decades of inaction from U.S. regulators, some observers say they foresee strong steps on this issue in the medium term.
“It’s totally inevitable here in the U.S.,” the University of California’s Martin said.
“This issue is analogous to captive smoking. At one time, we thought nothing of smoking in bars, workplaces, airplanes, but now we look back and say how crazy that was. In 10 years we’ll look back in the same way and ask how we could possibly have given antibiotics in low doses to farm animals – it’s ridiculous.”