Antibiotics have been one of science’s great achievements. Antibiotics are extremely useful in the fight against bacterial infections. Antibiotic medications may either kill or inhibit the growth of bacteria that can lead to infections. As a result, millions of lives have been saved.
Yet the successes of antibiotics have been increasingly undermined by their overuse. Antibiotic-resistant strains and species, sometimes referred to as "superbugs," are now contributing to the re-emergence of diseases that were previously well controlled by antibiotics. For example, tuberculosis infections are on the rise due to emergent bacterial strains that are resistant to the antibiotics that have been effective in the past. Skin infections that in the past might have been controlled by a topical antibiotic now put people in the hospital.
This has led to widespread problems, and the World Health Organization has classified antibiotic resistance as a "serious threat [that] is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country." In the United States, antibiotic-resistant bacteria infect more than 2 million people each year, causing more than 23,000 deaths. Experts predict that if antibiotic resistance is not addressed now, by 2050 there may be more than 10 million deaths per year worldwide, making antibiotic resistance a bigger killer than cancer.
The reason for the growth of bacterial strains that are resistant to antibiotics? According to the federal government, of the estimated 154 million prescriptions for antibiotics written in doctors’ offices and emergency departments each year, 30 percent are unnecessary.
But the overuse of antibiotics in humans is not the only factor driving the evolution of “superbugs” that are increasingly immune to these therapies.
There has been extensive use of antibiotics in farm animals for decades. Livestock are fed antibiotics so that they grow faster with less feed and can remain healthy in the unsanitary, disease-laden cramped conditions common on factory farms. In fact, approximately 70 percent of medically important antibiotics sold in the U.S. are intended for use in livestock.
Since humans eat livestock, antibiotic-resistant bacteria can make their way from animals to humans. That threat led the Food and Drug Administration (FDA) to call on pharmaceutical companies to voluntarily stop the sale of antibiotics to farms for animal “growth promotion.”
Unfortunately, though most pharmaceutical companies have complied with the FDA’s guidance, this is unlikely to put a serious dent in antibiotic use in factory farms since farmers are still allowed to give the same antibiotics to livestock under the guise of disease prevention. In addition, the FDA has also proposed changes to the rules regarding veterinary oversight that could allow veterinarians to prescribe antibiotics without having visited the facility or examined the animal in the recent past.
Given the stakes for public health, the nation shouldn’t allow even one large-scale farming operation to overuse antibiotics in this way.
As is too often the case, the federal government is failing to protect health and the environment, meaning that states need to act. So far, the states of California and Maryland have enacted legislation to step into the void left by the feds. What can other states do?
Since veterinarians are licensed by states and states also regulate farming, they can place restrictions on antibiotic use. As a result, California and Maryland have passed laws banning the routine use of medically important antibiotics for disease prevention on farms that operate in those states.
Some key steps include: restricting the use of antibiotics in livestock production to cases of actual animal sickness or direct disease exposure, not dispensed to all livestock as a precaution without inspection. In addition, states must require that the administration of antibiotics to animals on factory farms be overseen by a qualified veterinarian who has been to the farm or ranch and assessed the animals.
Of course, more needs to be done. Off the farm, health care professionals, health systems, and patients must take actions to limit antibiotic use.
But when it comes to our food, New York should join the growing number of states looking to protect the public’s health by tightly regulating the use of antibiotics on farms.
Blair Horner is executive director of the New York Public Interest Research Group.
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