Protecting the Efficacy of Antibiotics: This is What Real Leadership (and Change) Looks Like
Posted March 14, 2013 in Health and the Environment
Today, Rep. Louise Slaughter, Congress’s lone microbiologist and a long-time leader on the issue of antibiotic resistance, reintroduced an updated version of the Preservation of Antibiotics for Medical Treatment Act, or PAMTA as it is better known.
This is an important piece of legislation concerning one of the most pressing public health issues of our time—antibiotic resistance. The Director General of the World Health Organization has warned, bacteria are becoming so resistant to common antibiotics that it could mean “the end of modern medicine as we know it,” and “[t]hings as common as strep throat or a child’s scratched knee could once again kill.” Just this January, the UK’s top medical official described an “apocalyptic scenario” in 20 years’ time, in which simple operations could lead to death from routine infections “because we have run out of antibiotics.” CDC counts antibiotic resistance among its “top concerns.”
The abuse of antibiotics in animal agriculture is contributing to the growing public health crisis of antibiotic resistance. The science overwhelmingly supports the conclusion that the use of antibiotics in livestock production poses a risk to human health. An honor roll of medical and scientific groups agrees that “[o]veruse and misuse of important antibiotics in food animals must end, in order to protect human health.”
PAMTA is aimed at doing exactly what its name suggests, preserving the effectiveness of antibiotics, with a focus on stopping the indiscriminate use of antibiotics on cattle, swine, poultry, and other livestock animals when the animals are not sick. Eighty percent of all antibiotics sold in the US are for use in animals. The vast majority of that use is to speed up animal growth and to compensate for the dangers of crowded, unsanitary conditions. Such use is contributing to the rise of antibiotic resistant bacteria which threatens the continued effectiveness of these essential medicines.
Sure, human use is part of the problem, and must be addressed. But doctors have been making progress on that front. Prescriptions for antibiotics in the US declined by 13% between 1997-98 and 2005-06. And sales of antibiotics for human use has held pretty steady between 2000 and 2011, hovering below the 8 million pound mark. Not so with the sale of antibiotics for use in livestock, which has grown from about 22 million pounds in 2001 to nearly 30 million pounds in 2011. (Click on the image below to see the great graphic from our colleagues at Pew, for more on that comparison). The use of antibiotics in livestock has gone virtually unchecked in the US in the last half century, exploding from about 7 million pounds in sales in 1970 to about 30 million pounds in 2011.
PAMTA represents a welcome check on that use. It would require the Food and Drug Administration to phase out the use of antibiotics on animals that are not sick and don’t need the antibiotics, i.e. non-therapeutic uses, unless there is a reasonable certainty that such use will not harm human health. It would continue to allow the use of antibiotics to treat sick animals.
This is only common sense. We need antibiotics to work for sick children and other people who need them, and we shouldn’t be squandering them on animals that are not sick to compensate for crowded, dirty conditions at factory farms that could be addressed with better management practices.
PAMTA is needed because, so far, the basic response to the problem from the FDA, the agency responsible for controlling the use of antibiotics in livestock, has been to stall and shrug, even while acknowledging the problem. FDA first proposed to stop the use of penicillin and tetracyclines in animal feed in 1977 because of the risks to human health from antibiotic resistance associated with such use. It then largely sat on its hands for the next 35 years, even as citizen groups petitioned FDA for action. In 2011, NRDC and our partners sued FDA to compel it to act, and last year a federal court directed FDA to take action on the problem in two separate decisions. So far FDA’s primary response has been to push voluntary measures which make flawed recommendations and require no action from industry. FDA has also appealed the court decisions. FDA must be required to do more. PAMTA would require FDA to take meaningful, timely action to address this problem.
That is why NRDC has joined over 400 organizations, including the American Medical Association, the American Academy of Pediatrics, the Infectious Diseases Society of America, the American Public Health Association, the National Association of County and City Health Officials, and the National Sustainable Agriculture Coalition, in supporting PAMTA.