For decades, farmers have given livestock low doses of antibiotics in their feed to speed growth and prevent infection. And, for decades, scientists and public health officials have warned that this practice, known as “subtherapeutic use,” leads to the creation and spread of antibiotic-resistant bacteria. Antibiotic-resistant bacteria have grown more common both in people and in meat at the grocery store. Doctors encounter patients with infections that are harder to treat and last year, we saw a massive food recall—the third-largest recall of meat in USDA’s records—thanks to antibiotic-resistant Salmonella in ground turkey.
The FDA acknowledges there’s a problem, but has done little to actually rein it in. The agency tracks antibiotic resistance in bacteria in meat and has created regulations to limit subtherapeutic uses in two classes of antibiotics, but has mostly focused on voluntary initiatives, citing lack of resources to implement enforceable rules.
Finally, the warnings from a vast chorus of science, health and consumer experts and the evidence that subtherapeutic use is a serious health concern could no longer be ignored. The last three weeks have brought about promising movement towards curtailing the dangerous practice, but we still have a long way to go.
First, on March 23, the FDA lost a lawsuit. A federal judge ruled that the agency must act on a proposal it made in 1977 to prevent two antibiotics important to human medicine – tetracyclines and penicillins – from being given routinely to healthy livestock. After citizen petitions in 1999 and 2005 and a lawsuit filed last year, FDA finally took action—quietly withdrawing the proposal just before Christmas—but the federal judge ruled that FDA actually had to address the concerns it identified over thirty years ago. The drug manufacturers will have a chance to make their case that the drugs are safe to feed to livestock routinely. But if they aren’t able to (and science indicates they won’t), the FDA must withdraw its approval of subtherapeutic uses of the drugs.
Then, on April 6, the FDA banned most subtherapeutic uses of one class of antibiotics, cephalosporins. Cephalosporins play an important role in treating food-borne illnesses in humans, especially children, as well as pneumonia and skin and soft tissue infections. Salmonella resistant to cephalosporin drugs is on the rise, putting the public at risk. Food & Water Watch helped gather public comments earlier this year to encourage this ban and we’re glad to see this move forward to protect cephalosporins from overuse in agriculture.
Finally, this week (April 11), the FDA announced a major voluntary initiative to promote the “judicious use” of antibiotics in livestock. The agency released the final Guidance 209, The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals, along with yet more guidance about how make it work—if (and this a key “if”)—the pharmaceutical industry and livestock producers agree to go along with it. The FDA has set forth how to transition over-the-counter antibiotics in feed to a system requiring oversight by veterinarians, but still missing is the regulatory heft to actually make it happen.
With all the talk about antibiotics recently, the FDA seems to be sending mixed signals. On one hand, it banned subtherapeutic uses of two major classes of antibiotics, but it has taken a lawsuit to make it address a proposal to ban the same uses in two other major classes. And the FDA currently insists that industry voluntary efforts will address this public health issue, while new scientific evidence calls into question whether producers are even following the legal bans.
Can we trust the FDA to take strong action as they promised to this week, or must we rely on lawsuits to force the agency to protect consumers? Is it naïve or complicit for the FDA to expect voluntary measures to force the industrial meat industry to do the right thing? The answers to these questions are yet to be known, but one thing is certain. To truly protect consumers, anything less than a complete ban on the subtherapeutic uses of antibiotics in livestock is insufficient.
The FDA should use every tool in its regulatory toolbox to reduce subtherapeutic uses of antibiotics in livestock and not rely on voluntary measures. But to wipe out this practice once and for all, we urge Congress to make a ban on subtherapeutic use of antibiotics law by passing the Preservation of Antibiotics for Medical Treatment Act (PAMTA).