As FDA Commissioner Scott Gottlieb noted Dec. 18, this is a costly public-health problem, with an estimated 2 million Americans suffering from antibiotic-resistant infections every year, leading to 23,000 deaths. Mr. Gottlieb correctly pointed out that it is impossible to outrace resistance, but efforts must be made to “slow its pace and reduce its impact on both human and animal health.” Otherwise, antibiotics, the “miracle drugs” of the 20th century, will become useless, and a foundation of modern medicine could crumble.
A large share of antibiotics, including those medically important to human health, are given to food-producing animals. While it is proper for sick animals, the industry practice for decades has also been to use antibiotics so animals will grow faster and larger on the same amount of feed, and for prevention of disease in a whole herd or flock. The agriculture industry defended these practices by saying they were not the culprit in the rising tide of resistance. But studies show key factors in resistance are overuse and abuse of antibiotics on the farm, as well as in human health. Farms and people do not exist in a world apart but in a “linked ecosystem,” as pointed out by a predecessor of Mr. Gottlieb, Commissioner Donald Kennedy, in 1977.
The Obama administration proposed that manufacturers stop selling antibiotics for growth promotion and that veterinary oversight be strengthened for other uses. The FDA data now shows the fruits of this wise step. There was a 33 percent decline between 2016 and 2017 in domestic sales and distribution of all medically important antimicrobials for use in food-producing animals — and a drop of 43 percent since 2015 . There are still some unknowns in the data, which reflects sales and distribution, not actual use. More research and data are needed. Still, the trend does seem to herald a new direction and fresh thinking about the problem.
Importantly, change is being driven by the market and consumers. Fast-food outlets such as McDonald’s are demanding meat with less use of antibiotics. Also, there are signs of greater consensus. In an impressive joint effort, major food companies, retailers, livestock producers, and trade and professional associations announced Dec. 18 a comprehensive “framework” aimed at strengthening stewardship of antibiotic use in food animals, the result of a two-year discussion moderated by the Pew Charitable Trusts and the Farm Foundation. While much more needs to be done to protect antibiotics for future generations, having so many players at the table is a great first step.