“One Health” Needs Clear Livestock Antibiotic Rules

Are you celebrating International One Health Day tomorrow? We’re not ready to hang the streamers yet.

For those new to the term, One Health is a buzzword spreading rapidly in academic, public health, government, and livestock industry circles.^[1] A key focus is on antibiotic resistance, and the link to antibiotic use in livestock, so we’re paying close attention.

But what exactly is One Health? That is a surprisingly hard question to answer. An “initiative,” a “movement,” an “approach,” a “strategy,” a “platform”? An umbrella??

Jargon aside, One Health seems to be a general approach for talking about the rather obvious fact—obvious to us, at least—that the health of animals, people, and the environment is interconnected. Importantly, One Health has become the home of various initiatives meant to advance antibiotic stewardship in health care and livestock settings. Note the mission statement of the One Health Initiative:

"Recognizing that human health…, animal health, and ecosystem health are inextricably linked, One Health seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals."

But the devil’s in the details. University and public institution efforts to combat antibiotic resistance are increasingly framed as One Health initiatives. If these initiatives don’t identify concrete, verifiable goals for reductions in antibiotic use, they may create confusion or give the appearance of progress without actually leading to reductions. In the worst case scenario, we are concerned that they could serve as cover to maintain business-as-usual antibiotic use in the livestock industry (and beyond)—especially in light of rumblings about a “One Health” consumer label.

Mountaire Farms, one of the nation’s biggest poultry producers, recently proposed a One Health label^[2] in response to the Centers for Disease Control and Prevention’s Antimicrobial Resistance (AMR) Challenge. While Mountaire Farms hasn’t released details about how the label might limit livestock antibiotic use, we worry that it could follow in the footsteps of other industry-led initiatives, like the Beef Quality Assurance and Pork Checkoff antibiotic use programs, that do not meaningfully restrict routine antibiotic use on farms. While those programs encourage some good stewardship practices, they are not likely to drive major reductions in antibiotic resistance because they do not prohibit routine preventative use or set concrete reduction targets.

We have global consensus that antibiotic resistance cannot be addressed successfully without ending overuse of antibiotics in food animal production. To meaningfully reduce resistance, any labeling standard that addresses livestock antibiotic use, as well as the One Health movement more broadly, should:

• State unequivocally that a major goal is to reduce the intensity of antibiotic use in livestock production. While this may sound basic, the U.S. Department of Agriculture and Food and Drug Administration have never set a national goal of reducing antibiotic overuse in livestock production.
• Set measurable antibiotic reduction targets or place enforceable restrictions on routine antibiotic use. Concrete goals for reducing antibiotic use would be a major step in the right direction. Across 30 European countries, for example, we know the intensity of antibiotic consumption in livestock production is 125 mg/kg (mg of antibiotic active ingredient per kg of animal), across all livestock sectors. A comparable figure for the U.S. has been calculated at 180 mg/kg.^[3] Specific and enforceable limits on routine use of antibiotics, like the Certified Responsible Antibiotic Use standard, can also contribute to meaningful reductions.
• Require transparency in antibiotic use. A significant portion of livestock antibiotic use is now subject to veterinarian oversight and documented on a Veterinary Feed Directive (VFD) (essentially a prescription). These oversight and prescription requirements should extend to all livestock antibiotic use, and use should be audited by a third party on a regular basis to ensure conformity with restrictions and reduction targets.

Given the pervasiveness of the One Health concept, both in our public institutions and in the private sector, we’ll be watching One Health developments closely. Consumers almost certainly would benefit from labels that contain more information about how animals are raised. But a One Health (or any other) label without strong and enforceable reductions of antibiotic use will do little to support human health, animal health, and ecosystem health.

This blog provides general information, not legal advice. If you need legal help, please consult a lawyer in your state.