Getting Our Global Act Together on Antibiotics

Next month's G7 Summit may deal with many of the usual topics: the global economy, energy, security and foreign policy. But new on the agenda will be antibiotic resistance. In April, the science academies of the G7 countries (the U.S., Japan, Germany, United Kingdom, France, Italy, and Canada) singled out antibiotic resistance as one of three priorities for worldwide leadership and action.

What's moved resistance from solely a medical issue to a global political and economic crisis of the top rank? Urgency, for one. And numbers.

Bacterial infections that resist treatment with just about any available antibiotic, and their worldwide spread, is a true crisis. The superbugs responsible don't respect borders; they hitch rides on the bodies of global citizens who easily fly from one country to the next. Superbugs also spread by way of livestock or meat products that can travel the same routes. Life-threatening microbes have globalized along with the 21st century economy.

The rising number of victims is staggering. At least 50,000 people per year die of antibiotic resistant bacterial infections, just in the U.S. and Europe; millions more suffer illness, severe pain and disfigurement. The global toll is several-fold higher, and exploding. A few months ago, UK experts warned the annual global losses from resistant infections could reach 10 million dead - as many as from cancer.

Finally, this is a slow-motion economic shock in the making; the same UK report, for instance, estimates antibiotic resistance may lower global GDP by a whopping 7% by 2050.

Even prudent antibiotic use can trigger resistance to develop. But widespread overuse of antibiotics has hastened the onslaught of resistance, and worsened today's crisis. One vital way forward is to make sure antibiotics are used much more sparingly, only when absolutely necessary. To date, G7 action has not met that challenge, including in the United States.

The Centers for Disease Control and Prevention estimates half of all antibiotics prescribed in human medicine are unnecessary. But even confronting human overuse is insufficient to tackle the problem, because enormous use and overuse of antibiotics has been a hallmark of the dominant industrial model of meat production in recent decades. FDA data indicate that 70% of all antibiotics of human importance ("medically important") sold in the U.S. are for use in livestock and poultry. Just 30% of all the penicillins, tetracyclines, erythromycins and other human drug classes, in other words, are sold to treat sick people.

Market change in the U.S. has come recently in the form of announcements from McDonald's and Tyson Foods, the world's largest chicken producer. Tyson just announced the goal of completely ending its use of human (medically important) antibiotics in chicken operations by September 2017. Earlier Perdue, the 3rd largest U.S. producer, also pledged to stop use of human antibiotics in its flocks. Taken together, it means nearly 40% of the huge U.S. chicken market is heading in a healthier direction.

Last year, Perdue announced that 95% of is flocks receive no antibiotics at all; Tyson states that is has already reduced antibiotic use in flocks by 80% over the last four years.

Compare the private sector momentum with the U.S. Government's weak actions to date to stem the livestock overuse of antibiotics. The Obama White House in February announced a new National Action Plan for Combating Antibiotic-Resistant Bacteria. The most concrete elements of the Plan, however, focus on antibiotics used and overused in human medicine. Beyond a passing mention, action to curb livestock overuse is only intimated, and much more vague.

The White House Plan defers to the Food and Drug Administration to curb livestock use of antibiotics, and the latter's current approach carries an enormous loophole, as NRDC attorney Avinash Kar has previously noted. FDA predicts an end to the marketing of antibiotics in livestock feed for 'growth promotion' by the end of 2016, but has thus far refused to take steps that would stop drug makers from continuing to sell and market the same livestock antibiotics, and often for use at identical dosages, but simply call it 'disease prevention' instead. The bacteria won't appreciate any difference between the two uses, that's for sure.

Finally, unlike some of its European counterparts, in Denmark and the Netherlands for example, the FDA has never set clear targets for how much to reduce sales and use of livestock antibiotics, and how quickly. What we do know from the FDA's own data, is that sales of these drugs have kept increasing, by a total of 16% since 2009.

Some company and national leaders have shown the world there is a better way to safeguard antibiotics, and reduce their overuse in livestock, with very little downside, if any. Shouldn't the rest follow suit?