Two years ago, the international community came together to take on the Ebola crisis, a public health threat that at the time seemed almost unimaginable.
But another international crisis is brewing, and this one hits even closer to home. It could turn what today are just common infections into potentially life-threatening illnesses, and reverse decades of progress made in cancer treatments, surgical procedures, and even childbirth.
Antibiotic resistance has emerged as a critical threat to our health, and it took the world’s stage this month at a high-level United Nations meeting in New York. International leaders passed a political declaration to combat antibiotic resistance globally, and now the real work of making that promise a reality begins.
The widespread overuse of antibiotics in both human and agricultural settings is fueling the development and spread of antibiotic-resistant bacteria. According to the U.S. Centers for Disease Control and Prevention, at least 2 million Americans get sick from antibiotic-resistant infections each year, and 23,000 die as a direct result. Some estimates predict that by 2050, drug resistant infections could kill more people worldwide than cancer does today per year.
One of the most negligent uses of antibiotics that contributes to antibiotic resistance in the United States occurs not in hospitals or doctors’ offices, but on farms.
Of the antibiotics considered important to human medicine, approximately 70 percent in the U.S. are sold for use on livestock and poultry. These drugs are typically given on a routine basis to animals that aren’t sick in order to make them grow faster and to compensate for unsanitary conditions. This practice fuels the spread of drug-resistant bacteria that can make their way off farms and into our communities through contaminated food, direct human-to-animal contact, and environmental factors like air-borne dust and water runoff.
In fact, in its 2013 report titled Antibiotic Resistance Threats in the United States, the CDC reported, “much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe.”
Despite increasingly urgent calls from public health and medical experts like the World Health Organization and the American Academy of Pediatrics, the Food and Drug Administration has not gone further than implementing voluntary guidelines that will likely have little to no impact on ending the misuse of antibiotics in agriculture.
Although government has been slow to act, the American marketplace is moving. As consumers become more aware of the problem, they are starting to look for meat raised without routine antibiotics. In the past two years, food industry giants like McDonald’s, Subway, Taco Bell, and Wendy’s have made various commitments to stop serving meat raised on routine antibiotics in their U.S. operations. Just last month, McDonald’s announced it has met its promise to serve chicken raised without medically important antibiotics eight months ahead of schedule.
In addition to fast food chains, major meat producers like Perdue and Tyson Foods are responding to market changes by gradually moving away from routine antibiotic use.
These marketplace actions are significant and result in major changes in the meat industry, but we need government action to fully address the problem.
The passage of this political declaration puts an international spotlight on the role that governments around the world can play to address antibiotic resistance. Now is the time for the United States Food and Drug Administration to act and join international leaders like Denmark, the Netherlands, and South Korea in phasing out the routine, non-therapeutic use of antibiotics on livestock and poultry. Future generations depend on it.
Matthew Wellington is campaign director of the Antibiotics Program for the Massachusetts Public Interest Research Group. Sujit Suchindran, MD, MPH, is medical director of Antibiotic Stewardship in the Department of Infections Diseases at the Lahey Hospital and Medical Center.