America's largest producers of meat and poultry have an antibiotics consumption problem, and it is contributing to a public health crisis. Earlier this month, the Food and Drug Administration (FDA) reported that drugmakers sold about 30 million pounds of antibiotics in 2011 for use in food animals such as pigs, chickens, and cows. This was a record high and nearly four times the amount sold to treat sick people.
Using antibiotics to make food animals grow faster and to compensate for the overcrowded conditions in which they are raised breeds drug-resistant bacteria. These "superbugs" can end up in our air and water, in our meat and poultry and, ultimately, in us. If they cause infections, the diseases can be more difficult and costly to treat and more likely to result in death.
That's why a Feb. 27 Senate hearing was so important. Lawmakers discussed the Animal Drug User Fee Act, which authorizes the FDA to collect fees from veterinary drugmakers whose products the agency reviews for safety. The bill could also empower the FDA to collect more data about how antibiotics are being used on industrial farms. Rep. Henry Waxman (D-Calif.) and Rep. Louise Slaughter (D-N.Y.) recently introduced the Delivering Antimicrobial Transparency in Animals Act (H.R. 820) to accomplish this goal.
The information that the FDA already collects on antibiotic sales is valuable, but it is not nearly detailed enough. We need to know a lot more if we want to improve the way meat and poultry are produced in the United States.
So what don't we know?
First, we don't know which animals are getting antibiotics. Congress' watchdog, the Government Accountability Office, has said that such information is vital for understanding how this practice is producing superbugs. A task force chaired by the Centers for Disease Control and Prevention (CDC), the FDA, and the National Institutes of Health echoed these sentiments in a 2012 report, recommending that government agencies work together to collect the data and come up with policies that better protect human health.
Second, we don't know what proportion of animal antibiotics are sold and administered without veterinary oversight. These medications are available by prescription for people, but they are commonly sold over the counter for use on industrial farms. The FDA has taken steps to change this, but it may be years before veterinarians are meaningfully involved in all on-farm antibiotics use, and the agency will need this sales information to ensure that its goals have been met.
Third, we don't know how often these drugs are given to sick animals to save them from infection (a practice worth preserving) and how often they are given to healthy animals to compensate for crowded and unsanitary conditions and to make the animals grow faster (practices that should be replaced by better husbandry and hygiene). In April last year, the FDA proposed to eliminate some of these harmful practices, but it has not clearly explained how it will verify that its policies are actually working. It should -- and it needs more data to do so.
What we do not need is more proof that use of antibiotics on industrial farms must be curbed. The FDA, CDC and U.S. Department of Agriculture have testified before Congress that there is a definitive link between the use of these drugs in food animal production and the crisis of drug-resistant infections in humans. The American Medical Association, the American Academy of Pediatrics, and other leading scientists and medical experts, including four Nobel laureates, warn that use of these drugs in food animals creates new strains of dangerous, antibiotic-resistant bacteria that threaten human health. These experts are supported by hundreds of studies conducted over the past four decades, including new research indicating that these practices are contributing to diseases not traditionally associated with food, such as drug-resistant urinary tract infections and virulent and contagious strains of methicillin-resistant Staphylococcus aureus, also known as MRSA.
A lot is at stake. Each year, antibiotic-resistant infections are responsible for tens of thousands of deaths, hundreds of thousands of hospitalizations, and up to $26 billion in extra health care costs.
We must do everything we can to stem the superbug tide. Although industrial farms are using more antibiotics each year, doctors are reducing their use in human medicine. They have been successful in large part because of the effective data collection and analysis that the CDC and others have done to identify when and where people are using antibiotics appropriately or inappropriately. As a result, the CDC reports that doctors are prescribing the drugs 13 percent less frequently to their patients compared with 15 years ago. If sick people can go without these medications, surely healthy animals can, too.
As our lawmakers in the Senate discuss the fees that companies will pay to help the FDA expedite drug reviews, they should also require those companies to provide information that helps the agency protect people from drug-resistant superbugs.
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