Overuse of our most precious medicines is killing us. And much of that overuse has been and continues to be in industrialized agriculture. That’s one upshot of this weekend’s “Deadly Germs, Lost Cures” series in The New York Times on a worsening, global crisis due to drug-resistant, aka “superbug,” infections.
It’s a crisis claiming tens of thousands of American deaths each year—at least. New estimates put the figure at up to 162,044 people who die from these antibiotic-resistant infections alone—more than seven times CDC’s previous estimates—which would make it the third leading cause of death in the U.S., behind heart disease and cancer. But researchers warn even that figure is likely conservative. And this doesn't even take into account the risks posed by fungal infections resistant to antifungal drugs.
As the Times reports, one particularly nasty kind of yeast infection has emerged, caused by Candida auris, that sometimes resists treatment with all three major classes of anti-fungal drugs. In Chicago, half of the residents at some nursing homes have tested positive for it. Based on its limited experience to date, the CDC reports that 30% to 60% of patients with C. auris infections may die.
We have always lived in a world surrounded by bacteria and fungi. What’s different about today’s world is that we also have flooded our common environment with anti-bacterial and anti-fungal drugs. Generally speaking, this practice creates a microscopic ecosystem where the most drug-resistant strains of bacteria and fungus are the ones best-equipped to thrive, multiply and out compete their microbial competitors. Superbugs like these don’t necessarily affect healthy people in their prime, but can be deadly for infants, the elderly and others with immature or compromised immune systems.
For decades, the United States has promoted an industrial form of agriculture that routinely uses pharmaceuticals, like antifungals and antibiotics, on crops and in fed to livestock. As mentioned in the New York Times story, azoles are one class of antifungals widely applied to food crops, including potatoes, beans, wheat, tomatoes, onions, and many more, and are a virtual copy of front line medicines used to treat human fungal infections, such as itraconazole. And more antibiotics are sold for use in raising pigs and cattle in the U.S. than are sold for treating sick people (nearly 50% more, actually). These precious medicines are routinely and intensively fed to herds of pigs and cows that aren’t sick, ostensibly to ward off problems created by the crowded, often unsanitary, conditions under which those animals are being raised.
Secrecy is one feature of the superbug epidemic we can no longer afford. The Times quotes numerous physicians bemoaning hospitals that place their own reputation above the public interest in making people more aware of the human toll that superbugs are wreaking within their walls.
Similarly, neither U.S. farm producers, the USDA or the FDA have shown any inclination towards leadership by divulging specifics about how often and in what amounts antibiotics and antifungals are actually being used at the farm level. Arguably, the lack of transparency is as much a driver of the ongoing crisis in superbug infections.
Together, the U.S. beef and pork industries account for 78% of all medically important antibiotics sold for use in livestock—and about 50% more of these precious medicines than are used in humans. As the largest users, we call on the beef and pork industries to change course. Their actions impact the health of their consumers, and they have a responsibility to respond to a public concerned about the growing spread of drug-resistant infections resistance. This means beef and pork producers—as well as the restaurants, supermarkets and other businesses that profit of their product—need to be transparent about antibiotics use in their supply chain, and commit to ending the routine overuse of these drugs that’s helping to fuel the superbug crisis.
We have seen that the marketplace has the power to make positive change. In just a few short years, the chicken industry—under pressure from consumers and groups like ours—has made great strides in cleaning up its act. More than half the chicken industry is now under commitments to discontinue the routine use of antibiotics.
To keep our miracle drugs working when sick people and animals need them, however, we need the beef and pork industries to join them.
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New estimates are for 162,000 annual deaths from infections due to multi-drug resistant bacteria—seven times higher than previous estimates. However, this doesn't change the importance of reducing unnecessary uses of antibiotics, especially in producing U.S. pork and beef.
Here's something to chew on at your next holiday meal.