Time to crack our drug habit
Antibiotics in farming pose serious health problems that need to be addressed, argues Emma Rose.
Most people are now aware of the problem of antibiotic resistance, thanks to the increasingly vocal proclamations from numerous experts.
From Britain’s Chief Medical Officer, Dame Sally Davies, to the World Health Organization (WHO), health professionals are warning that the impacts of antibiotic resistance in human medicine are being felt now. This is not a prediction for the future. Resistance to ‘front-line’ antibiotics has become commonplace in our hospitals, so doctors must now cast around for alternatives. Increasingly, they are turning to ‘last-resort’ drugs in order to cure patients.
We are facing a terrifying future in which routine infections may once again kill, and operations such as hip replacements become too risky for doctors to carry out. Even cancer chemotherapy will be threatened if we lose the ability to prevent bacterial diseases from infecting vulnerable patients. Unless we act fast, our ability to treat and cure human disease and infection will be at stake.
We are enabling the emergence of antibiotic resistance through our own complacency. Bacterial resistance – a natural phenomenon – is sped up through excessive antibiotic use. Each dose administered to a sick human or animal encourages resistant bacteria to thrive, while weaker bacteria are killed off. Resistant bacteria can move between animals and humans in both directions – through the environment, through direct contact with animals or people, or through handling and consuming meat.
But while doctors are urged to curb inappropriate prescribing practices, systematic overuse of antibiotics in farming has received far less attention. Given that farm animals account for approximately 40% of total antibiotic usage within Britain, this is an inexcusable oversight, and it undermines targets directed at doctors prescribing antibiotics.
In most European Union (EU) countries, including Britain, it remains legal to routinely treat groups of healthy animals with antibiotics. This preventative measure is commonly deployed to counter the disease-inducing conditions of intensive farming systems, where outbreaks are more common and harder to control. Drugs are often administered through animals’ feed or drinking water, a form of mass medication which accounts for 85% of antibiotic use within farms in Britain.
Farmers may even treat animals using drugs classed by the WHO as ‘critically important’ for humans. Worryingly, while medical use of these drugs has declined steadily in Britain, farm-use has increased in last 4 years.
Meanwhile, the weight of scientific evidence that links farm-use and human resistance grows ever stronger. Human infections are being traced back to the farm, and resistance in the bacteria which cause them is recognized as originating in livestock. Commentators of all stripes are crunching the numbers: the costs to our National Health Service of not acting on the antibiotic crisis have been put as high as $46,000 per patient, and we may see 1 million deaths across Europe by 2025.
In some EU countries, including Denmark, Sweden and the Netherlands, significant reduction in farm antibiotic use has already been achieved, but in Britain the importance of reduction strategies is downplayed and industry practices remain unchanged.
So how can we explain the lack of action to address such indiscriminate use of drugs in farming? Why does the government’s Antimicrobial Resistance Strategy fail to include measurable targets for reductions in farm-use of drugs, despite including them for human use? Why are GPs urged to take action, while veterinary prescribing continues as usual?
Representatives of the farming industry may argue that preventative treatment of livestock is necessary to avoid the disease outbreaks which pose a huge risk to animal welfare, production efficiency and farm profitability. This holds true for more intensive systems, where animals, such as early weaning piglets, are often kept together indoors in confined spaces. Antibiotics are a prop that such practices cannot do without.
The on-farm antibiotics problem is a systemic issue, signalling that all is not well within our farming systems. Routinely treating groups of healthy animals to help them withstand disease-inducing conditions delivers an impressive double whammy: enabling the continuation of intensive farming while contributing to what some consider to be the biggest human health threat of the modern era.
Routine, purely preventative dosing of healthy animals must stop. We urgently need a coherent policy to phase out such mass-medication, and dramatically reduce use of important antibiotics. In tandem, there needs to be a shift toward systems which are able to rely more on animals’ natural immunity to disease. This means prioritizing good husbandry and hygiene, lower stocking densities, slower-growing breeds and extensive systems (where animals require far fewer antibiotics than those reared in intensive conditions).
Failure to crack down on our drug habit will have serious consequences. Let’s hope that pressure can be brought to bear on our policymakers before we see these play out in our hospitals, farms and families.
Emma Rose is Campaign, Communications and Lobbying Specialist for the Alliance to Save our Antibiotics, a coalition of health, medical, animal welfare and NGO organizations, supported by the Jeremy Coller Foundation. They can be found on Twitter @ASOAntibiotics.