Antibiotics in Agriculture: Science, Public Policy, and the Marketplace Rebecca Goldburg, Senior Scientist,Environmental Defense November, 2004.

Antibiotics in Agriculture: Science, Antibiotics in Agriculture: Science, Public Policy, and the MarketplacePublic Policy, and the Marketplace

Rebecca Goldburg, Senior Scientist,Environmental Defense

November, 2004

The Antibiotic Resistance CrisisThe Antibiotic Resistance Crisis

Federal Interagency Task Force, 2001:Antimicrobial resistance is “a growing menace

to all people” Without effective action, treatments for

common infections “will become increasingly limited and expensive – and, in some cases, nonexistent.“

Relative CausationRelative Causation• Medical overuse is a major factor• But, massive agricultural use of

antibiotics likely also plays a large role in generating and distributing resistance genes

• Precise quantification of relative contributions probably impossible…

• ... but simultaneous action on medical and agricultural fronts is not!

Key terminology

Non-therapeutic Generally added to feedFor “growth promotion”For “routine prophylaxis” – compensate for crowded conditions

Therapeutic Treat sick animals or those likely to get sick

because of illness in the herd or flock

Livestock Therapy

Human Therapy

Other LivestockNon-Therapeutic

%

6 8 15

70

U.S. antimicrobial use

Half from classes used in human

medicine

UCS estimatesUCS estimates

HUMANS(General Populace)

Routes of ExposureRoutes of Exposure

Antibiotics

WORKERS

ENVIRONMENT

Resistant Bacteria

Animals FOOD

Transfer of Resistance GenesTransfer of Resistance Genes

Bacteria “teach” each other to outwit

antibiotics

Plasmids and moreReadily transferredEven to distantlyrelated bacteriaConfirmed in human gut, mouth

Via FOODhandling, consumption

HUMANS(General Populace)

Routes of ExposureRoutes of Exposure

Antibiotics

Via WORKERSHandling of feed, manure; transfer to family, community

Via ENVIRONMENTContamination of water, soil, air by bacteria and antibiotics

Resistant Bacteria

Animals

“AR genes … once evolved in bacteria of any kind anywhere, can spread indirectly through the world’s interconnecting commensal, environmental and pathogenic bacterial populations to other kinds of bacteria anywhere else.”

-- O’Brien, 2002

The Role of Residues• Antibiotic residues NOT major

focus of concern – Testing finds occasional

violations of residue standards

• But, even if residue standards fully met, antibiotic resistance problem remains!

Public-health consensusPublic-health consensusNational Academies Institute of Medicine,

2003:

"Clearly, a decrease in antimicrobial use in human medicine alone will have little effect on the current situation. Substantial efforts must be made to decrease inappropriate overuse in animals and agriculture as well."

Government Policy and Government Policy and Marketplace InitiativesMarketplace Initiatives

Government policyPhaseouts of antibiotic feed additives in

Sweden, Denmark, and then EU US – FDA, Congress

MarketplaceRestaurant chains, suppliersMarket opportunities

Environmental Defense’s roleEnvironmental Defense’s role

• Coalition to Keep Antibiotics Working Coalition to Keep Antibiotics Working (KAW)(KAW) – members include Union of Concerned Scientists Humane Society of the United States National Catholic Rural Life Conference Environmental Defense

• Alliance for Environmental InnovationAlliance for Environmental Innovation – arm of Environmental Defense that works with businesses to voluntarily adopt policies and practices that protect the environment

FDA’s Draft Guidance 152FDA’s Draft Guidance 152• New FDA policy

• Mostly guidance to industry for assessing NEW antimicrobial drugs for animals

• Acknowledges FDA needs to review existing approvals, but no timetable for doing so

Fluoroquinolones in poultryFluoroquinolones in poultryOct. 2000: FDA proposed to ban

fluoroquinolones for therapeutic use in poultry

Bayer contesting FDA administrative law judge ruled

against Bayer in 2003Multi-year process of appeals ensuesMeanwhile, poultry drug remains on

market

Citizen Petition to FDA, Citizen Petition to FDA, March 1999March 1999

FDA “tentative” response Feb. 01: “The Agency’s FDA “tentative” response Feb. 01: “The Agency’s experience with contested, formal with- drawal experience with contested, formal with- drawal proceedings is that the process can consume proceedings is that the process can consume extensive periods of time and Agency resources.” extensive periods of time and Agency resources.”

Asked FDA to issue rules phasing out non-therapeutic Asked FDA to issue rules phasing out non-therapeutic use of 7 classes of medically important antibiotics.use of 7 classes of medically important antibiotics.

FDA cited as examples:FDA cited as examples: DES - 6 yearsDES - 6 years Nitrofurans - 20 yearsNitrofurans - 20 years

““Preservation of Antibiotics for Preservation of Antibiotics for Medical Treatment Act” Medical Treatment Act”

(Sen. Kennedy/Snowe; Rep. Brown/Gilchrest)(Sen. Kennedy/Snowe; Rep. Brown/Gilchrest)

Phases out nontherapeutic use of 8 classes of human-use antibiotics

Unless FDA concludes ‘safe’

Ag-use data Transition

support

EndorsersEndorsers• About 375 endorsers, including:

– American Medical Association– American Academy of Pediatrics– Alabama State Nurses Association– Iowa Farmers Union– American Grassfed Association– Consumer Federation of America

Marketplace: Private sector Marketplace: Private sector actionsactions

Major poultry producers -- Perdue, Tyson Foods, Foster Farms, ConAgra, Gold Kist, Claxton, and Wayne Farms – say they have reduced or eliminated routine uses of medically important antibiotics or the use of fluoroquinolones in sick birds

McDonald’s PolicyMcDonald’s Policy

• Bans growth promoters after 2004 for “direct suppliers,” i.e. poultry

• Creates purchasing preference for other suppliers

• Establishes guidelines for “sustainable use” – e.g. preventative use of antibiotics

• Applies globally

• Developed with Environmental Defense

Economic Opportunity

Consumer interest in products from animals raised– Without routine/ any antibiotics– Without hormones– Under standards for humane treatment– By independent ”family” farmers

““Family Farm Foods”Family Farm Foods”

New initiative:

• Marketing alliance to be based in Louisiana

• National scope with regional subunits

• Link producers to retailers

• Clear, consistent production protocols

National Brand using Visa ModelNational Brand using Visa Model

Family Farm FoodsFamily Farm FoodsKey organizations:• Agriculture of the Middle • The Association of Family Farms, Inc. • Family Farm Foods of MississippiOther supporters:• Land grants• Foundations• Nongovernment organizations• SYSCO, Winn Dixie

ConclusionsConclusions• Strong scientific case for reducing

antibiotic use in animal agriculture• Federal government is beginning to

address the issue• Some major food companies are reducing

antibiotic use, particularly in poultry• Coupling reduced antibiotic use with

other production attributes may offer an opportunity for independent farmers