No One Knows What Goes On Behind Closed Doors: Antibiotics in Healthy Livestock -- Will Congress and the White House Sell Out Public Health?

In my experience, corporations that pollute the environment and endanger public health rarely yield power, or agree to have their products and activities regulated.  In fact, a massive infrastructure of lawyers, lobbyists, “public relations” professionals and scientists-for-hire exits in Washington for most major industries to ensure that no laws are passed, and no rules are written that will require industries to take steps to protect the public.  A corollary to this rule is that a loss in one forum for industry necessitates an even stronger effort in another forum to get the unwanted result weakened, delayed or overturned.

The rise of antibiotic resistance due to the widespread use of antibiotics on healthy livestock animals (pork, poultry, and beef) is going to be a good case study for this proposition in the months ahead.  For those not already up to speed, here are the basic facts that illustrate the problem:

• The Centers for Disease Control (CDC) has reported that antibiotic-resistant infections are on the rise, including multiple-drug-resistant infections of diseases such as MRSA, food-borne illnesses involving Salmonella and Camplyobacter, and Tuberculosis;
• 80% of antibiotics in the U.S. are fed to livestock;
• 83-90% of livestock antibiotics are fed to healthy animals;
• The vast majority of antibiotics are used at low levels on healthy livestock to promote faster weight gain and to compensate for crowded, unsanitary conditions, creating antibiotic resistance;
• Low level use is especially likely to create antibiotic resistance;
• FDA has recognized that the use of antibiotics in healthy animals leads to antibiotic resistance and that it is a public health concern since the 1970s;
• Major medical and public health groups including the American Medical Association, the American Academy of Pediatrics, American Public Health Association, and the Centers for Disease Control and Prevention (CDC) agree that feeding low doses of antibiotics to healthy food animals leads to drug-resistant infections in people.

In a recent court victory by NRDC and our allies – Public Citizen, Center for Science in the Public Interest, Union of Concerned Scientists and Food Animal Concerns Trust – the Food and Drug Administration (FDA) was ordered to move forward with proceedings to withdraw approval for the use of certain antibiotics on healthy livestock that are important for human health.  Those proceedings had been stalled since the mid-1970s, when the FDA first determined that use of the antibiotics – penicillin and tetracyclines—in healthy livestock was not safe.   Another part of the case, in which the court has not yet ruled, focuses on the use of other medically important antibiotics that are also being used on healthy livestock and are also contributing to the rise in antibiotic resistance.

After we filed our lawsuit, the FDA leapt into action – not to finally withdraw approval for those unsafe uses of antibiotics, but to get rid of our lawsuit and maintain the status quo which benefits the Ag and Pharmaceutical industries at the expense of the public.   The FDA did this by repeatedly pointing to “voluntary guidance” under development recommending what the industry should do, but with no actual requirements, no deadlines, no public information, and loopholes large enough to drive a herd of hogs through.  The Court rejected FDA’s reliance on the voluntary guidelines in the context of penicillin and tetracyclines where FDA had already made findings that the use of those antibiotics in animal feed is not shown to be safe for human health (and even though FDA withdrew the documents that contained their findings, but not the findings themselves). But, the agency continues to emphasize the now-finalized voluntary guidance and has proposed other nonbinding recommendations – what my colleague Avi Kar calls a “make believe solution” to the problem – and continues to pretend that its response is sufficient.  The FDA also finally took a baby step forward in January by controlling the use of a class of antibiotics called cephalosporins -- which constitute less than 0.2 percent of antibiotic use in animal agriculture. 

While it is possible that the Ag and Pharmaceutical industries will be satisfied to rely upon FDA’s soon-to-be-patented “Go Slow, Do Nothing” approach, I think it is highly likely that those industries will seek further “relief” from Congress to ensure that FDA can’t act to protect the public –even if it wanted to.

There are a number of ways that industry could try and get their legislative “fix” including:

• Getting a provision included in the Farm Bill;
• Including a provision in one of the other FDA-related bills that are being developed in the House and Senate, the Medical Device User Fee Act or the Prescription Drug User Fee Act (two of the so-called “UFAs” – the third, the Animal Drug User Fee Act will not come up for reauthorization until next year);
• Slipping a “rider” into an appropriations bill.

Some of these changes can happen at the very last minute, behind closed doors, with no notice to the public, no public debate, and no up or down vote on an issue that pits the health of society and the continuing viability of our antibiotics for combating illness against the interests of large and powerful industries.

Of course, the industry is unlikely to announce in advance its strategy for how to subvert a victory for public health.  Unfortunately, because the FDA appears firmly committed to its current course of virtual inaction, it is equally unlikely that the Obama Administration will lead the opposition to any such effort by the Ag and Pharmaceutical lobbies, and more likely that they will support the industry efforts in the least visible manner possible.

The good news is that all of this can be prevented. Sending a strong message to members of Congress urging action from FDA to protect the public from antibiotic resistance and strong opposition to any attempt by industry to hinder the FDA’s authority to take action will make it much harder, maybe even impossible, for members of Congress, industry, and the Obama Administration to go behind closed doors and cut a deal that sells-out public health.  They could even go further and co-sponsor legislation – the Preservation of Antibiotics for Medical Treatment Act (H.R.965/S.1211) – that would actually address the problem by phasing out the unsafe use of antibiotics in livestock for non-therapeutic purposes.  Every phone call, letter, email, and, especially, in person comment directly to a Senator or Representative when they are back home during the congressional recesses, makes a difference.   Don’t delay, contact your Senators and Representatives today!