What scientists warned would happen decades ago is coming to pass.1 Antibiotic resistance has become a major threat worldwide and the primary cause of this man-made epidemic is the misuse of antibiotics.2 Pharmaceutical drugs are used to combat bacterial infections in humans and animals, but over the past decades have been widely overprescribed.3
For example, viral infections cannot be treated with antibiotics,4 yet many have been prescribed antibiotics for a cold or the flu — both of which are viral.5 According to the U.S. Centers for Disease Control and Prevention, at least 30% of the 269 million antibiotic prescriptions written in 2017 were unnecessary.
Antibiotics are also routinely used for growth promotion in livestock and are promoted by pharmaceutical companies as a means of preventing disease in concentrated animal feeding operations (CAFOs) where illnesses spread quickly.6 Unfortunately, fear is a powerful way to sway and distort reality and ultimately limit the freedom to make choices based on truth.
According to the CDC,7 “Resistant bacteria are more common in settings where antibiotics are frequently used: health care settings, the community and food animal production.” Despite the number of prescriptions written each year, the majority of antibiotics used in the U.S. are found in industrial agriculture.
In the U.S. alone, antibiotic-resistant pathogens conservatively cause 2 million infections annually and lead to 23,000 deaths each year.8 The rise in pan-resistance (resistance to multiple drugs) has increased use of carbapenems, an antibiotic of last resort. Alarmingly, carbapenem-resistant Enterobacteriaceae are rapidly becoming more common in hospitals.9
Despite these statistics, and the knowledge that overuse of antibiotics in animal production is one of the largest driving forces behind antibiotic-resistant bacteria, pharmaceutical companies continue to push livestock production facilities to use antibiotics to prevent “Pig Zero.”10
Farmers swayed by threat of ‘Pig Zero’
Recognizing that overuse and misuse of antibiotics contributes to the rising threat in drug-resistant infections, in 2017 the World Health Organization issued recommendations to farmers and the food industry to:11
“[S]top using antibiotics routinely to promote growth and prevent disease in healthy animals. The new WHO recommendations aim to help preserve the effectiveness of antibiotics that are important for human medicine by reducing their unnecessary use in animals.
In some countries, approximately 80% of total consumption of medically important antibiotics is in the animal sector, largely for growth promotion in healthy animals.”
In the pork Industries trade show held in Des Moines, Iowa, one of the largest pharmaceutical companies producing drugs for livestock was promoting the opposite message. Posters and brochures warned farmers, “Don’t wait for Pig Zero,”12 referencing a commonly used term in human medicine — “Patient Zero” — the person identified as the first carrier of an infectious disease.
The drugmaker Elanco encouraged farmers to use antibiotics for their herd as a preventative measure, rather than treating a disease outbreak. For industrial farmers, fearful of losing an entire herd in crowded, germ-prone conditions, it’s an appealing idea. The pamphlets detailed how a daily regimen of antibiotics may increase profit as pigs grew heavier and farmers had more meat to sell.13
Elanco is a small spin-off from the larger parent company, Eli Lilly.14 The company is in the midst of developing antibiotic alternatives for animals, such as vaccines and enzymes.15 However, they continue to promote antibiotics in exactly the way global health officials are trying to curb.
Aggressive use of antibiotics in livestock is a primary driving force of antibiotic-resistance. However, Elanco is not alone. For example, rival Zoetis promotes the use of antibiotics to boost weight gain in cattle.16
Dr. Gail Hansen, former state health veterinarian and epidemiologist, equated the problem to climate change, commenting to The New York Times,17 “The reality is that antibiotics and large-scale industrial farming really grew up together. By the time people understand and believe it, it may be too late.”
CAFOs breed antibiotic resistance in livestock
Once The New York Times began asking questions, Elanco decided to switch gears and stop marketing Pig Zero. Shabbir Simjee, Elanco’s chief medical officer told The New York Times18 the antibiotics in the Pig Zero campaign would not be administered without animals showing clinical signs of illness.
He compared the program to a child at a day care center and said, “If one child gets sniffles, you usually find that the whole class ends up with a cold, and this is exactly the same principle.” However, as The New York Times19 so aptly pointed out, the children almost certainly would not be treated with preventive antibiotics and many scientists believe livestock should not be treated this way either.
Gastropod reports that, historically, antibiotics use began in poultry in 1948 when experiments showed the addition increased the growth of chickens 2.5 times faster than those eating a standard diet.20
The news quickly spread, and within a few short years, American farmers were feeding half a million pounds of antibiotics a year to their animals. Scientific American reported one terrifying downside to this practice:21
“Antibiotics seem to be transforming innocent farm animals into disease factories. Recent research shows that segments of DNA conferring drug resistance can jump between different species and strains of bacteria with disturbing ease, an alarming discovery. By simply driving behind chicken transport trucks, scientists collected drug-resistant microbes from the air within their cars.”22
In 2013, 131,000 tons of antibiotics were used worldwide in livestock and it is anticipated this number will rise to 200,000 tons in 2030.23 A study24 found proximity to pig manure increased the chance of becoming infected with methicillin-resistant Staphylococcus aureus (MRSA), and 45% of those working with pigs were colonized with MRSA, 30 times greater than the national average.
A study funded by WHO and published in The Lancet25 found if antibiotic use was reduced in food-producing animals, it would reduce the antibiotic-resistant bacteria found in animals by up to 39% and may similarly reduce the bacteria in humans.
FDA rule professes to limit drugs in livestock
In 2013, the U.S. Food and Drug Administration (FDA)26 began a voluntary plan recommending industrial farms phase out the use of certain antibiotics in animal feed or drinking water.
The FDA cited the use of antibiotic drugs contributing to the development of antimicrobial resistance and stated they would be issuing a final guidance document. Four years later, in 2017,27 they issued a final rule for their Veterinary Feed Directive, stating they were taking important steps toward fundamental change in how medicinally important antibiotics could be used.
The agency announced it would be moving toward eliminating the use of drugs for production purposes and recommended antibiotics only be used under the supervision of licensed veterinarians. However, the FDA left a very large loophole in place. The FDA wrote:28
“The rule facilitates veterinary oversight in a way that allows for the flexibility needed to accommodate the diversity of circumstances that veterinarians encounter, while at the same time ensuring that veterinarians in all states are conducting such oversight in accordance with nationally consistent principles.”
Federal rule doesn’t go far enough
The New York Times29 reported that former Rep. Louise M. Slaughter, NY-D, who was the only microbiologist serving in Congress before her death, regretted that the FDA’s rules were riddled with loopholes. “It’s useless,” she said of the regulations. “That’s why the industry’s supporting it.”
One year after their final rule, the FDA released data showing a reduction in the amount of medically important antibiotics sold for use in livestock.30 They reported domestic sales had declined by 28% since the first year the FDA started collecting data in 2009. However, the data only represented sales and distribution and not how the drugs were used.
The Natural Resources Defense Council, which advocates for restrictions on the use of medically important antibiotics in food production, reports beef and pork Industries continue to be high users.31
The beef industry racked up 2.3 million kilograms (kg) in antibiotic sales in 2017, while pork producers had 2 million kg, compared to 268,000 kg for poultry. Senior attorney at NRDC, Avinash Kar, said in a press release:32
“We are seeing real progress, but the American meat industry continues to have a drug problem and the clock is ticking to solve it. Far more antibiotics important to humans still go to cows and pigs — usually when they’re not sick — than to people, putting the health of every single one of us in jeopardy.
The good news is, the data shows change is possible and can happen quickly. To keep these life-saving drugs working for treating sick patients who need them most, the beef and pork industries have to step up.”
Undersecretary wants focus on promoting Big Pharma
Ellen Silbergeld, Ph.D., a leading American expert in the field of environmental health and professor at Johns Hopkins University, has worked with WHO on drug resistance. She succinctly told The New York Times33 the reason pharmaceutical companies are promoting drugs is simply “money, honey.”34 “That’s what it’s all about. That’s what it’s always been about.”
Big companies always do well when they have an ally in Washington, and now President Trump has appointed Ted McKinney, one of Elanco’s past executives, as the undersecretary of agriculture.
According to The New York Times, in a meeting in Rome, summer 2018, McKinney told food safety regulators that too much energy was focused on consumers and called for food safety regulators to rededicate their focus on pharmaceutical companies and research scientists as their customers.35
Jeffrey Simmons, Elanco’s chief executive, was invited to a White House summit meeting where he pledged to find antibiotic alternatives. However, while microbiologists, WHO and others emphasize the urgency of fighting antibiotic resistance, Simmons says it must be balanced against food supply.
In an interview, The New York Times36 reports, Simmons said he’s “not doing it for a paycheck or profits. Purpose has to override that.” Yet, in 2018, Simmons’ paycheck was $5.4 million from Elanco in salary and benefits, including a base salary of $775,185, annual equity grant of $1.2 million, $907,450 in bonuses, 1% shareholder payouts, plus shares and options.37,38
What are your options?
The antibiotics fed to livestock and the antibiotic resistant bacteria they create are an antibiotic disaster pharmaceutical companies have a financial incentive to hide. Worldwide, 700,000 people die every year from antibiotic-resistant disease39 and it’s estimated more will be affected by antibiotic-resistant infection than by cancer by 2050.40
You may reduce your own exposure and vote with your pocketbook by avoiding meat produced in CAFOs. Increasingly, consumers are demanding sustainably-sourced, antibiotic-free meat and other animal products. When you choose foods from farmers who are doing it the right way, you may help prompt a real change in the industry.
The NRDC is fighting to reduce the use of antibiotics in factory farms where it is giving rise to numerous antibiotic-resistant bacteria. They report seeing significant progress in the chicken industry but are working hard to reduce use in beef and pork by placing pressure to provide more transparent information about antibiotic practices. You may join the fight by signing their most current petition.
I encourage you to either buy directly from a trusted farmer or look for the American Grassfed Association (AGA) logo,41 which provides grass fed standards and certification for meat and dairy grown in the U.S.42 The greater transparency and conformity was prompted by the growth of the industry and a lack of government oversight.43
The AGA logo means the animals were fed a lifetime diet of 100% forage and raised on pasture, not in confinement.44 They were not treated with hormones or antibiotics45 and all of the animals were born and raised in America.46 With growing antibiotic resistance, and as CAFOs represent ground zero for their overuse, avoiding these animal products is likely more important now than ever.