Given current concern about the Ebola virus, it's surprising that the public isn't more alarmed about "superbugs." Superbugs are infectious bacteria that have mutated to adapt to antibiotics that were designed to kill them, making the drugs ineffective. According to the Centers for Disease Control and Prevention (CDC), at least 2 million people become infected with antibiotic-resistant bacteria in the U.S. annually, resulting in at least 23,000 deaths -- the equivalent of 46 jumbo jets crashing, with no survivors. Many others die from conditions complicated by antibiotic-resistant infections. Superbugs cause an estimated 8 million days in U.S. hospitals each year, costing between $21 and $34 billion. My friend, in her 50s, recently died in the hospital of an antibiotic-resistant Staphylococcus infection. After five days in the hospital, a friend of a friend -- even younger -- conquered a staph infection, but he suffered gastrointestinal problems because the powerful antibiotics that killed the staph also killed his healthy gut bacteria.
These statistics can scare us, or they can empower us to demand safer agricultural practices. The recent Frontline episode "The Trouble With Antibiotics" investigates a major cause of the resistance problem: antibiotics administered to farm animals. With the discovery of antibiotics in 1929 and the rise of industrial agriculture in the 1940s, many of the large farms that replaced smaller family farms began the practice of confining the animals in crowded spaces. Antibiotics were routinely administered to the animals to prevent infectious diseases, with the fortuitous side effect that animals also grew faster. The use of antibiotics enhanced growers' profits -- they enabled the animals to grow faster in crowded and filthy conditions. As farm animals developed antibiotic resistance over time, they required more antibiotics, boosting drug makers' profits. Between 2009 and 2012, agricultural antibiotics sales in the U.S. jumped by 16 percent. As much as 70 percent of antibiotics sold in the U.S. go to farms.
What is the fate of these antibiotics? Some end up in meat, milk, and eggs, but around 90 percent end up in manure, the vast majority of which is spread on agricultural land, including land for growing organic crops. Then what? Antibiotics in soil are taken up by plants, end up in groundwater or surface water, or stay in the soil. In the soil, they kill "good" bacteria that are critical for soil fertility and high crop yields -- while promoting harmful bacteria.
Though the Frontline story focused on antibiotics dosed to farm animals, the drugs are also sprayed on crops. They are increasingly used in antibacterial soaps, toys, furniture, clothing, and other products. Originally, antibiotics were available to humans only for fighting infections -- with a doctor's prescription. Now many Americans unwittingly take antibiotics every day.
Antibiotics kill essential beneficial bacteria that help us fight pathogens, produce vitamins, and bolster immune response. Martin Blaser, M.D., writes in Missing Microbes that overuse of antibiotics has disrupted the bacterial cells in our body (mostly in the gut) that outnumber human cells 10 to one -- fueling our "modern plagues" of obesity, asthma, allergies, diabetes, and cancer. Since agricultural antibiotics are proven growth promoters, it's no wonder that antibiotics might drive our obesity epidemic.
Superbugs reach humans through food, water, soil, air, and direct contact with animals. In 2001, the World Health Organization (WHO) urged governments to take action against this "threat to global stability and national security." This year, WHO issued a report concluding that antibiotic resistance is happening now in every region of the world, with the potential to affect anyone, of any age, in any country.
Yet the U.S. government merely fiddles. Why? Using their enormous political clout, agribusiness trumps public health. Frontline interviewed former Food and Drug Administration (FDA) commissioner Donald Kennedy, who in the 1970s proposed restrictions on penicillin and tetracycline, two of the most widely used farm antibiotics. Agribusiness attacked the proposal, claiming the FDA had not proven human health impacts. Warning of financial ruin, they turned to their congressional buddies, including the chair of the committee controlling the FDA's budget, Jamie Whitten. Representative Whitten threatened that unless the agency provided more scientific evidence supporting the call for restrictions, he would "cut the heck out of the FDA budget" if the proposal went forward. Kennedy had little choice but to back down.
The FDA has dithered ever since. Last December, the FDA rolled out a new approach, calling for the pharmaceutical industry to voluntarily phase out antibiotics used solely for growth promotion, combined with increased veterinarian supervision of antibiotic use. Because the pharmaceutical industry claims that only 12 percent of agricultural antibiotics are used for growth promotion, however, the phaseout will likely have minimal impact. This baby-step approach also does not include data collection for evaluating progress.
Government failure to address the deadly problem of antibiotic resistance illustrates that when there is a concern about the safety of industrial practices, the burden of proof falls on government or ordinary citizens to show harm, rather than on industry to show safety. Tom Chiller, M.D., associate director of the CDC, told Frontline that the use of antibiotics in animals is breeding resistance. "We see resistance pretty much everywhere and in everything we test," he said. "[I]n cattle, in pigs, in chickens, in humans, in the retail meat that we buy in stores. Anywhere you use antibiotics, you're going to have resistance and propagate resistance." He added, "It's very challenging to link the use of a particular antibiotic in a particular herd of animals to a particular human illness." But why should he have to? Agribusiness employs practices that create antibiotic resistance, and we are witnessing the effects. Shouldn't agribusiness be required to prove that their practices are safe?
Industrial farm operations raise animals in buildings without windows and in which cameras are prohibited. Frontline was granted access only to several facilities that remained unidentified. It is time to bring animal farming operations into the light of day, not unlike in medieval London, where -- in response to the sales of putrid and disease-ridden meat -- butchers were ordered to sell their products only during daylight hours, not by candlelight. The current practice of denying farm animals' basic needs -- for adequate living space and sanitation, for example -- and then compensating by dosing them with antibiotics has backfired, creating superbugs. We, and the species upon which we depend for food, would benefit from a more humane and considered approach. Denmark, for example, banned the use of growth-promoting antibiotics and cut antibiotic use in half without a loss in productivity -- thanks to more frequent cleaning of enclosures, increased ventilation, additional space for animal movement, and other improvements.
U.S. Representative and microbiologist Louise Slaughter is spearheading H.R. 1150, the Preservation of Antibiotics for Medical Treatment Act (PAMTA), which would prohibit nontherapeutic use of eight classes of antibiotics in food animal production. PAMTA is supported by more than 450 medical, science, and consumer organizations -- including WHO and the American Medical Association -- and more than 30 city councils across the U.S. Agribusiness fiercely opposes it.
"Real change requires a large public outcry," writes Slaughter, "including voting with your wallet by purchasing meat raised without unnecessary antibiotics -- to prevent a nightmarish future in which antibiotics are obsolete."
Agribusiness's practice of chemical warfare -- causing disease, driving up health care costs, and killing people -- is a losing battle. "Without urgent, coordinated action by many stakeholders," says Keiji Fukuda, M.D., WHO's assistant director-general for health security, "the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill."
Ellen Moyer, Ph.D., P.E., is an independent consultant dedicated to remediating environmental problems and promoting green practices to prevent new problems. You can connect with her on LinkedIn and Facebook or find more information on her website.