Obama's Plan to Save Antibiotics Has a Big Loophole

The plan missing one of the biggest contributors to antibiotic resistance: routine use of antibiotics for disease prevention in farm animals.

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Mar 27 2015, 4:00pm

​Image: ​free photos/Flickr

​Antibiotics are one of the greatest medical advancements in human history. But over the last few decades our zeal for antibiotics has contributed to the growth of antibiotic-resistant superbugs. That's why, on Friday, President Barack Obama released a long-awaited National Action​ Plan to respond to antibiotic resistance (AR), setting goals to be met by 2020.

The World Health Organization warned ​us all last year that if we didn't start to seriously curb our antibiotic use, we would be heading towards "a post-antibiotic era," in which bacterial infections from E. coli to gonorrhea would no longer be treated as they are now. Already, the Center for Disease Control and Prevention estimates 2 million illnesses and 23,000 d​eaths in the US each year are caused by drug-resistant bacteria.

The action plan is a fairly thorough document that implements a many of the necessary steps that WHO and others have recommended to slow the growth of antibiotic-resistant bugs. It calls for more judicious use of antibiotics and more rigorous, standardized testing to prevent people from taking antibiotics unnecessarily. It will also require each state to introduce AR prevention program to monitor AR bugs, and prioritize research into both drug-resistant microbes and new kinds of antibiotics.

But while attacking the problem in both the lab and doctor's office is an important part of the strategy, many argue that the larger issue still lies on the farm. Right now, 80 percent of all of the antibiotics sold in the US are sold to livestock producers, according​ to the Natural Resources Defense Council. Farmers started using antibiotics to prevent disease in their livestock, but soon discovered the antibiotics also promoted growth. Over the past few decades, antibiotic use on farm animals has surged and is now standard practice, creating a dangerous breeding ground for antibiotic-resistant bugs in the process.

While the action plan calls for the "elimination of the use of medically-important antibiotics for growth promotion in food-producing animals," a loophole would still allow farmers to use antibiotics to prevent disease. But since antibiotics provide both growth and disease-prevention benefits at the same time, it's pretty hard to distinguish the two uses, leaving the door wide open for livestock producers to continue routinely using the drugs on their animals.

"This stance ignores clear evidence that the use of medically important antibiotics for routine disease prevention creates a public health risk that is identical to those posed by routine use for growth promotion," said Steve Roach, a lawyer and senior analyst for Keeping Antibiotics Working, a nonprofit that advocates for the prevention of antibiotic resistance.

"The plan also fails to set any targets for reductions in antibiotic use in food animals," Roach said in a press release. "All the other actions in the National Action Plan—including research, outreach to producers and veterinarians, and improved monitoring—will be wasted as long as the target to be reached falls so short of what needs to be done."

Many chicken producers, for example, have alrea​dy decided to eliminate the use of medically-important antibiotics (i.e. ones that we use for human drugs) and chain restaurants from Chipotle to McDonald's have committed to only sourcing chicken from these producers.

The chickens still receive antibiotics, called ionophores, that aren't used in human medicine, so it's more or less a win-win. The trouble is that not all chicken producers are on board and even fewer beef and pork producers have curbed their antibiotic use. Without any legal obligations to do so under the new action plan, it will continue to be an uphill battle to convince livestock producers to change common practice.

The action plan has some other, softer commitments, like a plan to "develop, implement, and measure the effectiveness of evidence based educational outreach to veterinarians and animal producers to advance antibiotic stewardship and judicious use of antibiotics in agricultural settings." But there's already p​lenty of evidence that routine use of human antibiotics in farm animals puts us at serious risk for AR bugs, particularly because animals are carriers. Roach said the plan missed an opportunity to finally lay down the law and seriously curb the use of human antibiotics on livestock.

"We have been waiting for FDA to take decisive action for over 40 years," he said. "How much worse must things get before they get better?"