Public health should trump politics
How many voices shouting in the wilderness, or even writing in major publications, does it take to affect badly needed change by industrial giants? Those who control our food supply at various stages, federal regulators appointed to protect public health, congressional leaders who could pass effective legislation but don’t. Most are pretty well aware of the proliferation of drug-resistant bacteria but seem unwilling to try to stop or even curtail it.
You would have to go all the way back to 1994, when Laurie Garrett’s “The Coming Plague” became a bestseller, to find a powerful voice for controlling the overuse and misuse of antibiotics. Still, it was years before some doctors took note and began refusing to prescribe antibiotics for viral infections and other self-limiting conditions.
It was almost a decade before the first posting of notices in doctors’ offices that antibiotics would not be prescribed for the common cold, flu or children’s ear aches. At the time, some doctors feared that patients would just look for another doctor who would accede to their demands. Eventually, restrictions on antibiotic use became accepted practice.
So how long will it be before the other misuses of these drugs are effectively regulated? When I first wrote about “superbugs” in 2007, 70 percent of antibiotics in this country were used in agriculture. That figure is now at 80 percent, as reported in a recent study funded by the Pew Charitable Trusts, which opposes routine use of such drugs in animals.
A Los Angeles Times article by Jill U. Adams recently cited a study published in the journal Clinical Infectious Diseases, which found drug-resistant staphylococcus bacteria on 47 percent of samples of beef, chicken, pork and turkey from 26 grocery stores in five U.S. cities. “Of those bacteria, 96 percent were resistant to at least one type of antibiotic and more than half were resistant to at least three,” the report states.
In 2009, another study found drug-resistant staphylococcus (MRSA) in 49 percent of 299 pigs tested at two farms, as well as in nine of 20 tested farm workers there, the Times article reports. Direct transmission of the disease from pigs to the workers was suspected by the lead researcher.
The FDA issued a draft of suggested guidelines to limit the use on farm animals of antibiotics used in human medicine. Not only have the guidelines not been finalized, the FDA recommendations are just that: suggestions that are unenforceable. In fact, when the FDA identifies the source of an outbreak of food poisoning, it is powerless to force a recall. The food producer has to willingly initiate the recall.
Obviously, there has been significant pushback from industry groups, which favor the use of antibiotics to prevent infections caused by overcrowding at feedlots and to promote faster growth of animals destined for slaughter. Just how the drugs work to stimulate growth is not well understood. Nevertheless, producers cling to the practice regardless of its detrimental effects on human health.
As early as 1969, the British government sponsored a report that recommended a ban on the use of antibiotics for promoting growth in food animals. Since then, the World Health Organization, the Centers for Disease Control and Prevention, the American Medical Assn. and the Union of Concerned Scientists all have condemned this practice. So why is the U.S. food industry still supporting it?
Denmark, the largest exporter of pork products, has noted positive results since limiting drug use in pigs starting in 1992. According to a 2010 report in the American Journal of Veterinary Research, between 1992 and 2008, Denmark’s overall production increased and animal growth rates improved while death rates were unchanged.
The drugs currently studied by the National Antimicrobial Resistance Monitoring System (a cooperative effort by the CDC, FDA and USDA) include salmonella, e-coli, and Enterococcus, but not staph. Yet drug-resistant staph has become the scourge of hospitals nationwide. As early as 2007, several states (Illinois was first) were moving to pass laws to require pre-admission testing of high-risk patients for methicillin-resistant staphylococcus aureus (MRSA).
While the FDA may not have the authority to enforce its recommendations, Congress does have the ability to legislate them. But few lawmakers are willing to buck industry lobbyists and the considerable influence they have over elections. Food industry representatives have even been known to threaten the careers of young researchers who speak out against practices that threaten public health.
Under the guise of federal spending control, Congress can also pass laws decimating the budgets of the FDA, USDA and any other agency that threatens entrenched industry practices.
How many scientists publishing results of decades of research will it take to get the attention of lawmakers or their constituents? The public health threats we face are way more important than the frivolous proposals currently being debated by eager young politicians.
Brave up, guys. Let’s get to work on the serious stuff.