Working to Keep Antibiotics Working Can the Superbugs Be Stopped?

by Julie Light

What we eat and how it is produced has long been a central concern of consumers. And as agriculture has become increasingly corporatized and industrialized, making the use of chemicals more pervasive, consumer questions are mounting about everything from food safety to working conditions on farms, from animal welfare to environmental impacts of food production.

One intensifying concern for public health experts is how the routine use of antibiotics in beef cattle, hogs and chicken is diminishing the effectiveness of life-saving antibiotics in humans. Currently, almost 25 million pounds of antibiotics a year are used prophylactically in the United States to prevent the spread of infections in animals often raised in crowded, filthy conditions on factory farms and commercial feedlots or to promote growth in livestock.

In Fall 2001, a coalition of 13 public health, environmental, animal rights and other organizations joined together to end the routine agricultural use of antibiotics, under the banner "Keep Antibiotics Working" (KAW).

Antibiotic resistance is a "multifaceted and important issue that is bringing many different folks to the table," says Karen Florini, chair of Keep Antibiotics Working's steering committee and senior attorney for Environmental Defense.

Combining scientific expertise with grassroots pressure, the campaign has registered quick and impressive victories. KAW has focused its efforts not just on enacting federal legislation, but also on demanding restaurants and food service providers agree to stop using or selling meat, poultry or fish from animals produced with antibiotics for non-therapeutic purposes.

Rise of the Superbugs

When it comes to antibiotics: "the more you use ëem, the faster you lose ëem," observes Florini. She says the potential public health crisis from the emergence of antibiotic-resistant infections would be staggering.

Public health officials are concerned with the growth of 'superbugs" -- bacteria that are resistant to antibiotics and can cause serious illness, or even death, in humans. Antibiotics are used to prevent infections after surgery or organ transplants and during chemotherapy. They are also used against infectious diseases like tuberculosis and pneumonia, which are already showing resistance to several drugs.

According to the Centers for Disease Control, some two million patients a year pick up infections during their stays in U.S. hospitals. Some 90,000 die as a result. Seventy percent of the bacteria that leads to their deaths are resistant to at least one antibiotic, according to Ramanan Laxminarayan of Resources for the Future and Mark Plotkin of the Amazon Conservation Team, writing in the Washington Post.

The overuse and abuse of prescription antibiotics for mild infections is probably one of the main culprits for the rise in antibiotic resistant bacteria. But KAW charges that a steady diet of low-dose antibiotics fed to livestock, hogs and chickens is also to blame.

KAW does not object to using antibiotics to treat sick animals, but cautions against overuse of some, like fluoroquinolones, used in humans to treat serious infections, such as food poisoning from salmonella.

Holding Retailers Responsible

It's not easy to target farm practices directly. Farmers have less and less control over decisions about how they farm. They may be contractually required to employ certain practices by giant meat and poultry processors. They compete in an impersonal market, which penalizes those who disdain profitable practices that have long-term deleterious consequences. And few farmers now sell directly to the market, so it is hard for consumers to deliver clear messages with their purchasing decisions.

On the other hand, it is not easy simply to pass national legislation and create new standards for agribusiness -- especially given the power of the pharmaceutical industry that hawks the antibiotics used so widely on U.S. farms.

Recognizing these constraints, KAW has targeted large food retail and service companies, asking them to buy meat and poultry produced without antibiotics. With a vibrant grassroots advancing the campaign's demands, it has started to shake the food establishment.

KAW's highest profile victory came in June 2003, when McDonald's, the world's biggest fast food chain, announced that it would no longer use antibiotics as growth promoters in chicken and would encourage its beef and pork suppliers to follow suit.

"McDonald's is asking producers that supply over 2.5 billion pounds of chicken, beef and pork annually to take actions that will ultimately help protect public health," according to Frank Muschetto, senior vice president of worldwide supply chain management at McDonald's Corporation.

However, the policy stops short of discontinuing all antibiotic use in those 2.5 billion pounds of meat. It still allows the use of the drugs to prevent infections in overcrowded, unsanitary feedlots. Nor does it contain a timetable for halting antibiotic use, or penalties if the suppliers ignore the company's request.

The new policy brings McDonald's USA in line with the European branch of the corporation, which began phasing out the use of antibiotics in 2000. McDonald's USA stopped using fluoroquinolones in 2001.

The partial victory at McDonald's came as the campaign's grassroots started flexing their muscle. Shortly before McDonald's announced its decision to cut out antibiotics in chicken feed, local activists demonstrated outside the fast food chain and its competitors in Miami, St. Paul, Columbus, Chicago and three cities in Maine.

Activists hope that, having wrung a meaningful concession from the fast food industry leader, other corporations will fall in line.

One such company is Bon Appetit, which provides food services to 148 clients across the country, including major corporations and renowned universities. Bon Appetit has agreed to stop purchasing chicken that has been produced routinely using antibiotics by June 2004. It will also give preference to meat, dairy and fish that have been produced with fewer antibiotics. While the purchasing policy stops short of a complete ban on antibiotic-fed meat, it breaks new ground in the food industry. The inclusion of meat, dairy and fish makes the policy more far reaching than McDonald's. As with the fast food giant, the Bon Appetit purchasing policy was reached with assistance from Environmental Defense, part of the KAW coalition.

Going to Capitol Hill

But individual victories in the food industry will not be enough. Ultimately solving the problem of antibiotic misuse, KAW believes, will require national legislation. The coalition is a driving force behind a bill now in Congress that would phase out all non-therapeutic use of antibiotics in livestock and poultry. Bipartisan bills, now in both the Senate and the House, have been endorsed by more than 300 organizations, including the American Medical Association and the American Public Health Association.

The ban would take effect two years after it were enacted and would allow antibiotics to be used on sick animals or to prevent the spread of an actual outbreak of disease. It would ban eight specific medicines for routine use in livestock: penicillins, tetracyclines, macrolides (including erythromycin and tylosin), lincomycin, bacitracin, virginiamycin, aminoglycosides, and sulfonamides.

Senators Edward Kennedy, D-Massachusetts, and Olympia Snowe, R-Maine, and Representatives Sherrod Brown, D-Ohio, and Wayne Gilchrest, R-Maryland, introduced the bill in July 2003. Activists are predicting that it will face an uphill battle, given the anti-regulatory sentiment on Capitol Hill and the strength of the pharmaceutical and agricultural lobbies opposing the legislation.

The Industry Opposition

While restricting the use of antibiotics in livestock may seem like a no-brainer to some, it has encountered stiff opposition from the big pharmaceutical manufacturers and livestock producers. Major pharmaceutical corporations make billions of dollars manufacturing antibiotics. And the Union of Concerned Scientists estimates that 70 percent of all antibiotics in the United States are fed to beef cattle, poultry and pigs for routine purposes, not to treat sick animals.

To protect this huge market, drug companies like Bayer, Pfizer, Wyeth and Novartis have joined with agricultural giants like Monsanto and manufacturers of veterinary products to form the lobby group, Animal Health Institute.

Animal Health Institute's first line of attack has been to challenge the studies showing that the overuse of antibiotics in animal feed promotes resistance in humans.

"Experts have stated that banning antibiotics as growth promoters in animals will not solve or even impact the problem of antibiotics resistance in hospitals," states Animal Health Industry's website. "While antibiotic resistance is a public health threat around the world, it is clear that hospital- and community-acquired diseases, unrelated to animal drug use, constitute the major problem."

It is difficult to track the dollars spent on lobbying by AHI, in part because the group uses in-house lobbyists. The pharmaceutical industry, which is engaged in a number of major policy fights on Capitol Hill, is a political powerhouse, given significant credit for the Republicans strong performance in the 2002 House of Representatives elections. As a whole, the industry has donated $4.3 million to congressional and presidential candidates in the 2003-04 election cycle, according to the Center for Responsive Politics. Most -- but not all -- of it has gone to key Republicans, with the Bush campaign topping the list with nearly $400,000 in donations. Pfizer, a member of Animal Health Industries, leads the industry with more than $400,000 in contributions. AHI members Wyeth and Bayer have each given more than $70,000.

Add that to the almost $12 million spent by agribusiness, and groups like AHI find their way to Capitol Hill well lubricated.

Still, the tide is turning against the routine antibiotic use. In 2000, the World Health Organization (WHO) recommended halting or phasing out antibiotic use to promote growth in livestock. A WHO study recently found "no major disadvantages" to a 1998 ban on antibiotic growth promoters in Denmark. And the European Union is set to discontinue antibiotic use in animal feed in 2006.

Meanwhile, the U.S. Food and Drug Administration issued a new agricultural guidance for the use of antibiotics last year. The FDA is asking for specific measures showing that antibiotic use in livestock will not contribute to the emergence of resistant bacteria. The voluntary FDA guidelines are not regulations, however, and there is no timetable for their suggested implementation.

Forging Grassroots Power

The high level negotiations that have led to changes in food industry practices are backed by pressure from the grassroots. KAW is mounting campaigns in the Iowa, New Hampshire, Maine and Ohio, where consumer, health and religious groups have taken the lead.

Local activists are focusing on key officials at the federal and state levels, explains Claudia Malloy, director of grassroots advocacy for the Center for Science in the Public Interest in Washington, D.C. She says the strategy is to replicate national victories on the local level.

"We supply activists with the materials, the message and the timing and they take it from there," says Malloy.

Activists have approached state legislators in the hope of getting local bills introduced ranging from labeling antibiotic fed meat, to banning the drugs, to collecting data on antibiotic resistance.

"People in the states like to have more than national legislation to work on," explains Malloy. "They like to have more than one way to work on an issue they care about."

Julie Light is a San Francisco-based journalist who writes frequently on corporate issues.