March 2, 2012
The good news is that the journal Public Health Reports has published a review article acknowledging (not in so few words) that agriculture is one of the major drivers of the antibiotic resistance crisis that is unfolding.
That’s good news because Public Health Reports is both the official journal of the U.S. Public Health Service and is published by the Association of Schools of Public Health. So, it wields some credibility from two angles, government and academia. It’s also a welcome development because in the public health community there is often much more attention paid to overuse of antibiotics in the health care field as a driver of increased antibiotic resistance.
The bad news is that the realizations and recommendations in this article are a day late and a dollar short. They’re a day late because other weighty organizations began acknowledging the key role of agriculture in driving antibiotic resistance many years ago, including the American Public Health Association, and a dollar short because key aspects of this issue are conspicuous by their absence from the article. To wit:
- The need for precaution: There is an emphasis on promoting a more robust research agenda related to resistance, while the policy recommendations are restricted to calling for better monitoring of the unfolding crisis. But we should not be postponing action on this critical issue while we wait for a research agenda to be developed and implemented, or for monitoring programs to be improved. Our delays invite the dawning of a “post-antibiotic era,” as a World Health Organization official has warned.
If we put all of our emphasis on research, we are at least tacitly agreeing that the burden falls on the research community to prove that routine and widespread use of growth-promoting antibiotics (at sub-therapeutic doses) in food animals is unsafe, as opposed to shifting the burden of proof to industry to prove it’s safe. Meanwhile, we are losing more and more of the antibiotic effectiveness that should be considered a natural resource and something not to be squandered.
Industry would argue that changing their practices would sink them economically, but that brings us to another piece missing from the article, namely:
- The international experience: There is no mention of the fact that other countries have banned growth-promoting antibiotics and experienced positive impacts. For example, Denmark banned all growth promoters in 2000, yet its “swine and poultry production continues to thrive following the ban,’’ according to scientists writing last year in Microbe magazine. They report that Denmark is still exporting 90 percent of its pork production, while cutting its antibiotic use in half in that industry. In poultry, there has been a slight increase in production and 90 percent decline in antibiotic use.
- Existing policy proposals: There is no mention of the Preservation of Antibiotics for Medical Treatment Act, or PAMTA, which would phase out growth promoters that are important to human medicine, and toughen standards for the approval of new antibiotics for use in food animal production. The legislation has been endorsed by nearly 400 organizations.
The time for studying this issue is not past, but research alone would be a weak response to such an urgent crisis.