By Ezra Klein
Wednesday, September 16, 2009
When I was a kid, my mother was a bit obsessive about making sure I finished my antibiotics. Even if I was feeling better. That didn't make a lot of sense to me. You take medicine until you're not sick anymore. But when I got a bit older, she explained: If you don't kill off the bacteria, you could be left with only the strongest bits, which then multiply and mount a counterattack. That made sense. I'd watched enough slasher flicks to know that you don't turn your back just because the killer is down. You make sure he's dead.
But leaving a capsule of Zithromax behind, it seems, was the least of my problems. This column is based on a single and quite extraordinary statistic: Food animal production accounts for 70 percent -- 70 percent! -- of the antibiotics used in the United States. That doesn't even include the antibiotics used for animals that actually get sick. That figure is for "non-therapeutic use" such as growth promotion and disease prevention.
The heavy reliance on routine antibiotic use is a byproduct of the way we raise animals for food: packed into dim and dirty enclosures where they live amid their own filth, eat food that they haven't evolved to digest, and are pretty much stacked atop one another. Most human beings I know can hardly spend three hours on a plane without contracting a case of the sniffles.
When you give antibiotics to animals meant to become food, however, you're ensuring that antibiotics end up in the food in low but constant doses. That means bacteria are getting more accustomed to the antibiotics. There's good reason to think that this background exposure to antibiotics is contributing to the startling rise in antibiotic-resistant bacteria. Everything from staph to strep to salmonella is exhibiting uncommon resilience in the face of our latest drugs. A 2003 World Health Organization study (PDF) put it pretty starkly: "There is clear evidence of the human health consequences [from agricultural use of antibiotics, including] infections that would not have otherwise occurred, increased frequency of treatment failures (in some cases death) and increased severity of infections." Even stronger was the title of a 2001 New England Journal of Medicine editorial: "Antimicrobial Use in Animal Feed -- Time to Stop."
Rep. Louise Slaughter (D-N.Y.) is a former microbiologist who has a master's degree in public health. She also happens to chair the powerful House Committee on Rules. "This is terribly important," she says. "If people don't believe in evolution, they should look at staphylococcus. Your body used to be able to take care of it. But now it can kill you. It's evolved." Her answer is H.R. 1549: the Preservation of Antibiotics for Medical Treatment Act of 2009. The legislation's approach is very simple, Slaughter says: "The bill preserves the seven most effective classes of antibiotics for human use only. They can be used to treat sick animals, but they can't be used to simply raise animals."
The industry's objection to this is that it will make meat -- delicious, delicious meat -- unaffordable for the average consumer. When I pose this to Slaughter, she laughs mirthlessly. "That really is a strange defense," she says. "We keep animals in such deplorable conditions that they'll become sick as a dog if we don't dose them?"
There's also the argument that the pennies we're saving on each burger are being spent in our hospitals. A 2005 study out of Tufts University estimated that antibiotic-resistant infections add $50 billion to the annual cost of American health care. On the other side of the coin, a National Academy of Sciences study found that eliminating non-therapeutic antibiotics from animals would cost only about $5 to $10 per person per year. I'd pay that for a lower risk of super-staphylococcus.
There's also a trade angle to the issue: In 1986, Sweden banned the use of non-therapeutic antibiotics in their meat. In 1998, Denmark, the largest swine-producing nation in Europe, did the same. In 2006, the whole European Union outlawed growth-promoting antibiotics in its meat, and it's likely that other countries will follow suit. That could begin shutting down foreign markets for our livestock exports, or at least embroil us in nasty trade wars. And for what? A practice that's making us sicker, that obscures the horrible way we raise our animals and that even my mother would have warned against 20 years ago?