Still Seeking UN Leadership to End Routine Livestock Drugs

Tomorrow, the United Nations hosts a “High-Level Meeting” on the global crisis around antibiotic resistance—only the 4th time a health issue has risen to that level of engagement.[1] The meeting’s most tangible outcome will be a new UN Declaration. The latter falls short of the bold leadership we desperately need to avert the “end of the road” for antibiotics that CDC Director Tom Frieden has warned is already near.

The Declaration rehashes a lot of promises already made, for instance at last Spring’s Global Health Assembly. Those promises have mostly been of the mealy-mouthed variety: to somehow find more funding; to invest in more research; to do better education and antibiotic “stewardship”; and to create national plans of action.

Where’s the announcement of bold, global targets for reducing our enormous and often unnecessary use of antibiotics—especially in livestock production, where an OECD analysis projects it to increase 67% to more than 105,000 tonnes annually by 2030? Where, in other words, is leadership?

After all, it is antibiotic use—and overuse—that selects for and spreads resistant bacteria. And as NRDC and the World Health Organization point out, much of the overuse currently takes place in countries like the U.S. that continue to allow antibiotics to be fed routinely to flocks and herds in the absence of any disease. These antibiotics amount to a crutch allowed to livestock producers to promote faster growth, or ostensibly to “prevent” disease; their availability distracts producers from making alternative non-antibiotic investments to improve animal feed, hygiene and husbandry, in order to keep the animals healthier in the first place.

So what could the Declaration have done? Three actions come to mind:

  • First, the UN could have clearly called on member states to end the practice of routinely feeding medically important antibiotics to livestock or poultry. Period. Countries that have already taken this bold step, like Denmark and the Netherlands, reduced their total use of antibiotics quickly and hugely. Yet their food animals remain healthy; farmers continue to profit. This is a tried-and-true path the entire world can and must embrace to help us all avoid the catastrophic future that gave rise to this UN meeting in the first place. Yet this week’s Declaration is silent on the urgent need to end this routine but unnecessary use.
  • Second, the UN could have explicitly called upon member states to set concrete, numeric national targets around antibiotic use in livestock production, preferably using a common global metric. Many European countries, for example, report their use of antibiotics in terms of milligrams of antibiotic active ingredient per kilogram of biomass of meat produced. A compelling graphic (p. 19), prepared by the Global Review on Antimicrobial Resistance last year, shows that antibiotics usage in livestock in the U.S. and other developed countries like Italy and Spain may be 2 to 6 times more intensive than in low-end antibiotics users like Denmark and the Netherlands. The simple act of setting such a goal, no matter how modest, would send an important signal to the world that the necessary aim is not just better “stewardship”, but animal production that prevents the use of unnecessary antibiotics.
  • Finally, the UN should have declared that some human classes of antibiotics of last resort—like the fluoroquinolones and 3rd and 4th generation cephalosporins—be put off limits for food animal production. Their importance for treating life-threatening disease is simply too great to risk it. 

All of these action steps have been taken by individual countries, with great benefit to their public’s health. But they cannot solve antibiotic resistance on their own, since it is a global crisis. That’s why collective leadership at the UN is so desperately needed. As Earth’s citizens, we all share the threat of a future where antibiotics will no longer work to save people from even common infections.

Global consumers of meat products certainly seem to be responding to that threat. Some of the world’s biggest restaurant chains, like Subway, say they’re moving away from allowing routine antibiotic use in their meat supply. They say that’s what consumers want.

Over the last couple years, those commitments have translated into a sea change in how global suppliers like Perdue and Tyson’s raise their chickens. By our estimates, more than 40 percent of the U.S. broiler chicken industry has phased out or committed to phasing out antibiotics used routinely for growth promotion or disease prevention.

Voluntary leadership from the private sector is great, but not sufficient. Of the top two U.S. fried chicken chains, Chick-fil-A committed in 2014 to phasing out antibiotics from its chicken supply chain, and says it is on track to fully meet that goal by 2019. Industry laggard KFC, meanwhile, has yet to adopt any policy or commitment to reduce antibiotics.

Similarly the Chain Reaction II report, released today, grades the 25 top U.S. restaurant chains on how meaningfully they have acted to reduce antibiotic use in their meat supply chains. This year, twice as many companies get passing grades compared to last year. Nevertheless, 16 of the 25 companies—including giants like KFC and Burger King—receive an "F", having taken no action at all to reduce antibiotics.

This problem is so big, we all have to work together, public and private sectors alike. It's too bad the United Nations itself, as well as the individual countries that make up its leadership, couldn't have set the bar on livestock production a great deal higher.

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About the Authors

David Wallinga, MD

Senior Health Officer, Food, Agriculture and Health, Healthy People & Thriving Communities Program
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