1028. Antibiotics, the Meat Industry, and Super Bugs

By David A. Kessler, The New York Times, March 27, 2013

David A. Kessler

San Francisco--Scientists at the Food and Drug Administration systematically monitor the meat and poultry sold in supermarkets around the country for the presence of disease-causing bacteria that are resistant to antibiotics. These food products are bellwethers that tell us how bad the crisis of antibiotic resistance is getting. And they’re telling us it’s getting worse.

But this is only part of the story. While the F.D.A. can see what kinds of antibiotic-resistant bacteria are coming out of livestock facilities, the agency doesn’t know enough about the antibiotics that are being fed to these animals. This is a major public health problem, because giving healthy livestock these drugs breeds superbugs that can infect people. We need to know more about the use of antibiotics in the production of our meat and poultry. The results could be a matter of life and death.

In 2011, drugmakers sold nearly 30 million pounds of antibiotics for livestock — the largest amount yet recorded and about 80 percent of all reported antibiotic sales that year. The rest was for human health care. We don’t know much more except that, rather than healing sick animals, these drugs are often fed to animals at low levels to make them grow faster and to suppress diseases that arise because they live in dangerously close quarters on top of one another’s waste.

It may sound counterintuitive, but feeding antibiotics to livestock at low levels may do the most harm. When he accepted the Nobel Prize in 1945 for his discovery of penicillin, Alexander Fleming warned that “there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant.” He probably could not have imagined that, one day, we would be doing this to billions of animals in factorylike facilities.

The F.D.A. started testing retail meat and poultry for antibiotic-resistant bacteria in 1996, shortly before my term as commissioner ended. The agency’s most recent report on superbugs in our meat, released in February and covering retail purchases in 2011, was 82 pages long and broke down its results by four different kinds of meat and poultry products and dozens of species and strains of bacteria.

It was not until 2008, however, that Congress required companies to tell the F.D.A. the quantity of antibiotics they sold for use in agriculture. The agency’s latest report, on 2011 sales and also released in February, was just four pages long — including the cover and two pages of boilerplate. There was no information on how these drugs were administered or to which animals and why.

We have more than enough scientific evidence to justify curbing the rampant use of antibiotics for livestock, yet the food and drug industries are not only fighting proposed legislation to reduce these practices, they also oppose collecting the data. Unfortunately, the Senate Committee on Health, Education, Labor and Pensions, as well as the F.D.A., is aiding and abetting them.

The Senate committee recently approved the Animal Drug User Fee Act, a bill that would authorize the F.D.A. to collect fees from veterinary-drug makers to finance the agency’s review of their products. Public health experts had urged the committee to require drug companies to provide more detailed antibiotic sales data to the agency. Yet the F.D.A. stood by silently as the committee declined to act, rejecting a modest proposal from Senators Kirsten E. Gillibrand of New York and Dianne Feinstein of California, both Democrats, that required the agency to report data it already collects but does not disclose.

In the House, Representatives Henry A. Waxman of California and Louise M. Slaughter of New York, also Democrats, have introduced a more comprehensive measure. It would not only authorize the F.D.A. to collect more detailed data from drug companies, but would also require food producers to disclose how often they fed antibiotics to animals at low levels to make them grow faster and to offset poor conditions.

This information would be particularly valuable to the F.D.A., which asked drugmakers last April to voluntarily stop selling antibiotics for these purposes. The agency has said it would mandate such action if those practices persisted, but it has no data to determine whether the voluntary policy is working. The House bill would remedy this situation, though there are no Republican sponsors.

Combating resistance requires monitoring both the prevalence of antibiotic-resistant bacteria in our food, as well as the use of antibiotics on livestock. In human medicine, hospitals increasingly track resistance rates and antibiotic prescription rates to understand how the use of these drugs affects resistance. We need to cover both sides of this equation in agriculture, too.

I appreciate that not every lawmaker is as convinced as I am that feeding low-dose antibiotics to animals is a recipe for disaster. But most, if not all of them, recognize that we are facing an antibiotic resistance crisis, as evidenced by last year’s bipartisan passage of a measure aimed at fighting superbugs by stimulating the development of new antibiotics that treat serious infections. Why are lawmakers so reluctant to find out how 80 percent of our antibiotics are used?

We cannot avoid tough questions because we’re afraid of the answers. Lawmakers must let the public know how the drugs they need to stay well are being used to produce cheaper meat.

David A. Kessler was commissioner of the Food and Drug Administration from 1990 to 1997.