Tamar F. Barlam , a physician, is
an Assistant Professor of Medicine at Harvard Medical School. Currently on
leave, she directs the Project on Antibiotic Resistance at the Center
for Science in the Public Interest.
Because of routine antibiotic use in agriculture, bacteria like Salmonella and
Campylobacter that cause food poisoning are becoming increasingly resistant to
antibiotics. Resistant infections can result in more severe illnesses and more
deaths than infections that can be treated with antibiotics. The American
Medical Association (AMA) recently added its authoritative voice to an
increasingly global call for an end to the routine use of antibiotics in
agriculture. With the Food and Drug Administration (FDA) unwilling, or unable,
to act, our medical arsenal is rapidly being depleted of one of its chief
weapons in the fight against food-borne illness.
Farmers started feeding low levels of penicillin and other common antibiotics to
livestock decades ago because the drugs appeared to help animals kept in
crowded, dirty "factory farms" grow faster. But when animals are given
low doses of antibiotics, only some of the bacteria are killed. The stronger,
more resistant bacteria survive, multiply, and pass on their strength and
resistance to future generations. A recent report by the Union
of Concerned Scientists estimates that 70 percent of antibiotics used in
this country are given to animals for growth promotion and other non-medical
uses. That's a lot of pigs, chicken, and cattle eating the antibiotics you might
need one day to treat your children.
Last month, the AMA adopted a resolution urging that the non-medical use in
animals of antibiotics should be terminated or phased out. The AMA's position
aligned it with the World Health Organization, American
Public Health Association, and a growing list of physicians, scientists,
veterinarians, and -- importantly -- parents who want that use to stop. But the
AMA's reward for issuing responsible advice was to be blasted by the Animal
Health Institute (AHI), which represents companies that produce animal
drugs. Belittling the evidence for the AMA's action as "simply not
true," AHI ignores compelling scientific studies that have accumulated over
the past 30 years.
A multi-agency task force, led by the Centers for
Disease Control, recently developed an action plan to combat anti-microbial
(antibiotic) resistance. Several measures addressed the agricultural uses of
antibiotics, including implementation of the FDA's framework for reevaluating
currently approved veterinary anti-microbial drugs. Unfortunately, the
government's action plan, which has been widely recognized as a
near-comprehensive plan for reducing resistance, has yet to receive any funding.
Current laws make it almost impossible for the FDA to prove that using
antibiotics as growth promoters can endanger the health of people. That is why
new legislation is needed to shift that burden of proof where it belongs -- to
the drug and agricultural industries. Instead of forcing the FDA to prove that
agricultural uses of antibiotics are unsafe, a new law is needed to ban the
drugs unless the manufacturer can prove they are safe. Attacking the problem
from a different direction, Congress also should provide financial incentives to
poultry, hog, and cattle operations that use fewer antibiotics.
Further information gathering and research is important. But we should not
endanger patients' health as we slowly amass more data. There is overwhelming
research to justify serious concern -- and decisive action -- now.
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