by Ashley Colpaart, RD LD
The late Jean Mayer eloquently said, “nutrition is not a discipline, it is an agenda.” Consequently, it is not surprising to find legislation that transcends disciplines being studied at the Friedman School. The use of antibiotics in animal agriculture and its impact on human health and food begs consideration from our spectrum of specialties: public health, policy, epidemiology, bio-molecular science, agriculture and environment, and communications.
The Preservation of Antibiotics for Medical Treatment Act (PAMTA) (H.R. 1549/S. 619) has been introduced for a third time in a refined form. The latest version, introduced by the late Senator Ted Kennedy (D-MA) and Representative Louise Slaughter (D-NY)-(the only microbiologist serving in Congress) would require that the U.S. Food and Drug Administration (FDA) deny the use of any new animal antibiotic drugs unless the federal government is certain the drugs will not contribute to antimicrobial resistance. The bill would also ban the routine, or nontherapeutic*, use of antibiotics in food-producing animals–a widespread practice in animal agriculture. This article will explore the ways that the PAMTA bill contributes to the application of our studies at Friedman.
*Nontherapeutic– an estimated 70 percent of the antibiotics and other antimicrobial drugs used in the United States are fed to farm animals for nontherapeutic purposes, including–growth promotion; and compensation for crowded, unsanitary, and stressful farming and transportation conditions; and unlike human use of antibiotics, these nontherapeutic uses in animals typically do not require a prescription.
Studies by the World Health Organization (WHO) and others have shown that ending the routine use of antibiotic feed additives does not compromise food safety. Studies also show that if animals are raised using good animal-husbandry practices, they do not need to be continually dosed with antibiotics to prevent disease. Such practices include proper diet, good hygiene, and avoiding overcrowding, excessive stress, or premature weaning. Since the continuous use of antibiotics creates antibiotic-resistant bacterial strains, this practice actually threatens human health rather than protecting it – and resistant infections tend to be more virulent than susceptible ones. Experience bears this out: after Denmark ended routine use of antibiotic feed additives, levels of antibiotic-resistant bacteria in animals decreased significantly.
The Public Health Perspective
The antibiotics commonly used in animal agriculture are often the same ones used in people to treat serious diseases such as pneumonia, scarlet fever, rheumatic fever, venereal disease, skin infections, and even pandemics like malaria and plague, as well as bioterrorism agents like smallpox and anthrax. Many scientific studies are confirming that the nontherapeutic use of antibiotics in agricultural animals is contributing to the development of antibiotic-resistant bacterial infections in people like antibiotic resistant E. Coli and Methicillin-resistant Staphylococcus aureus (MRSA).
Students earning a Masters in Public Health (MPH) understand the urgency of addressing antibiotic resistance; antibiotics have been a miracle of medicine and it is the duty of the public to keep them in our arsenal against disease. The spread of this new generation of infections resistant to antibiotic treatments has serious consequences for public health.
Antibiotic-resistant bacteria can keep people sicker longer, and sometimes people are unable to recover at all. Children, the elderly, and those with weakened immune systems (including cancer, HIV/AIDS, and transplant patients) are particularly vulnerable because their immune systems are not as vigorous as those of healthy adults. The American Public Health Association has signed on in support of the PAMTA bill and strong support, action and continued education by MPH students and graduates is crucial.
The Epidemiology Aspect
The contribution of Epidemiology to understanding antibiotic resistance and its effect on public health and illness of populations is key. As the cornerstone of public health research, epidemiology can contribute evidence-based research to help minimize risk factors that effect public health and contribute to preventative approaches.
Traditionally, MRSA infections have been acquired almost exclusively in hospitals, long-term care facilities, or similar institutional settings but further evidence has shown possible community-acquired strains in people that lack the typical risk factors for MRSA infection. Although the details of the epidemiology of staphylococcal drug resistance may change, the fundamental forces driving it are similar. The question is not whether resistance will occur, but how prevalent resistance will become.
From epidemiology, we know minimizing the antibiotic pressure that favors the selection of resistant strains is essential to controlling the emergence of these strains in the hospital and the community, regardless of their origins. Furthermore, epidemiologists can be at the threshold of emerging research on antibiotic resistance.
The Food Policy Focus
The general role of policy is to provide direction and guide decisions and actions in a particular area. Had the car industries had formal rules to increase their fuel efficiency we may have avoided a bailout. Similarly, if we rely on the animal industry to do ‘what is best’, we may very well be facing bailout, or worse: a public health crisis.
The decision to support the PAMTA bill is not an easy one and getting legislation to pass is even trickier. According to Professor Parke Wilde, PhD, of the Food Policy and Applied Nutrition program at Friedman, building an effective advocacy coalition is crucial. The bill has support from 300 organizations including the American Medical Association, American Public Health Association, American Academy of Pediatrics and American College of Preventive Medicine. Under the Obama administration the Food and Drug Administration exhibits a stronger public health bent. Unfortunately, advocates and environmentalist are up against one of the strongest lobbies on the hill- Big Ag. The crucial vote may be the American Veterinary Medical Association (AVMA), who “opposes this legislation because it would increase animal disease and death – an unfortunate and unintended consequence – without assurance of improving human health.” When framing the issue we must ask: do preventative steps today factor into a cost/benefit analysis?
The Agricultural & Environmental Angle
While some uses of antibiotics in livestock operations are a matter of animal health, the issue of nontheraputic use of antibiotics is fueled by an economic motive. Antibiotics are being used to promote “feed efficiency,” that is, to increase the animal’s weight gain per unit of feed. These drugs are also regularly added to the feed and water of animals that are not sick in order to prevent diseases caused by overcrowded and unsanitary CAFO conditions. These nontherapeutic uses translate into relatively cheap meat prices at the grocery store.
People can become infected with antibiotic resistant bugs by eating undercooked contaminated meat, or by eating other foods or using utensils that have come in contact with raw meat juices. In addition, farmers, farm families, and slaughterhouse workers are routinely exposed to antibiotics, antibiotic-resistant bacteria, or both. Finally, significant quantities of antibiotics and antibiotic-resistant bacteria enter the environment through the nearly two trillion pounds of animal wastes produced annually in the U.S. by animal agriculture operations. Farm waste run-off can enter rivers, lakes, and ground water, and these wastes are sometimes spread on agricultural fields as fertilizer as well. Unfortunately, the way industrial agriculture produces meat can also have an effect on consumers who do not purchase the products: the multistate E coli 0157:H7 outbreak of 2006 has been attributed to animal waste runoff.
Studies by WHO and others have shown that ending the routine use of antibiotic feed additives does not compromise food safety. Studies also show that if animals are raised using good animal-husbandry practices, they do not need to be continually dosed with antibiotics to prevent disease. Such practices include proper diet, good hygiene, and avoiding overcrowding, excessive stress, or premature weaning.
How do these findings bode for animal producers? It depends on who you ask. As we have seen, industrial livestock producers, the Farm Bureau, and the AVMA, are not happy with the recent coverage and are not supporting this legislation. Their main concern is a loss of animals and therefore, profit. But not all producers agree. “I don’t use antibiotic[s] and I don’t believe in it. Sick animals should be treated, but I don’t see how it is necessary to use sub-therapeutic antibiotics in a healthy and ecologically appropriate system,” says Jennifer Hashley, Program Director of New Entry Sustainable Farm. “If we look at our production practices and how we produce food, we may realize it is not necessary [to use antibiotics sub-theraputically].”
The Communications Context
In early February, CBS news with Katie Couric hosted a two-part segment on the concern about the misuse of antibiotics in animal agriculture. Other main-stream news outlets have covered the issue of antibiotic resistance, animal agriculture and the role of the consumer.
Wary consumers are beginning to ask more questions about where their food comes from and how their purchases can affect public health, especially in meat and dairy production. Tyson Foods recently settled a class-action suit that accused the company of claiming its chickens were raised without antibiotics. They have agreed to pay $50 to each consumer who bought their falsely labeled product. Consumers are looking towards alternative systems for acquiring food and need reliable information to make informed decision and know there are options.
Currently, there is no labeling standard in the United States to alert consumers about an animal’s antibiotic intake, either for growth or medicinal reasons. However, there are organic and antibiotic-free meats on the market, which come from animals that have never received such medicines. The USDA has approved the use of the term “No Antibiotics Used” for the label of any meat product that is antibiotic-free. Nutrition Communication graduates need to clearly understand the issue of antibiotic resistance to communicate sound nutrition information.
Professionals from various fields of study across the Friedman School have a stake in understanding the implications of the Preservation of Antibiotics for Medical Treatment Act. To effectively solve public health issues, we need well-developed and intentioned science, effective policy, and communication. We also need the ability to reach across to solve problems through a muliti-disciplinary approach. Together, our various disciplines can and will drive polices and outcomes towards a healthier food system and ultimately, population. Our ability to understand this strength is the ultimate agenda.
For more information about PAMTA, antibiotic resistance or to get involved see: