A Plan To Reduce Antibiotic (Ab)use By The Global MeatΒ Industry

A policy proposal for addressing the rise of antibiotic-resistant bacteria that threaten human and animal health worldwide

by GrrlScientist for Forbes | @GrrlScientist

(Credit: Jack Dykinga / USDA / CC BYΒ 2.0)

Human addiction to eating meat creates antibiotic resistant β€œsuperbugs”

Although most people think of human medical uses when they think of antibiotics, 80% of all antibiotics are in fact consumed by food animals, and this is where our problems start. First, because the total global food animal biomass far exceeds the total global human biomass, there are correspondingly more opportunities for antibiotic resistant bacteria to pop up in animals.

There are noteworthy differences in how antibiotics are used in livestock compared to people, and this has several far-reaching implications. People generally use a short course of antibiotics targeted to treat a specific bacterial infection, whereas food animals are fed antimicrobials as a general sort of β€œtonic” that acts as a cheap but powerful growth promoter and, as an added benefit, also serves to reduce illnesses resulting from severe overcrowding and filthy conditions. Thus, antibiotics are typically provided to food animals consistently in their food, but in low dosesβ€Šβ€”β€Šand this is the perfect situation for driving the evolution of antibiotic resistance in microbes.

The combination of a growth promoter with disease prophylaxis are the main reasons underlying antibiotic abuse by the global meat industry, a practice that initially started in the 1950s. As use of antimicrobial-laced livestock feed becomes ever more entrenched worldwide, it portends increasingly dire health consequences for both livestock and people.

Thomas Van Boeckel and co-authors of a paper published recently in the journal, Science (ref), propose a three-pronged public policy designed to deal with runaway antibiotic abuse by the global meat industry:

  1. Enforce global β€œcaps” on antibiotic use
  2. Enact a global strategy to reduce meat consumption
  3. Implement a global user fee on veterinary antimicrobial use

In their paper, Dr. Van Boeckel and his colleagues discuss the combined economics and effectiveness of their proposed three-part policy approach.

Enforce a global cap on antibiotic use

According to the new report, enforcement of effective global limits or β€œcaps” on antibiotic use could reduce antimicrobial use between 9% and 80% by 2030 in food animals, compared with projected business-as-usual targets based upon current practices.

Dr. Van Boeckel and his colleagues based those numbers on veterinary antimicrobial sales from public records obtained from 38 countries. They estimated that global consumption of antibiotics by livestock was 131,109 tons in 2013. Just to give you an idea of what this translates into, the global meat industry’s antibiotic abuse for 2013 alone is roughly twice the mass of the US Navy’s hospital ship, the USNS Comfort, which has been mentioned often in the American news media recently because it has remained moored at Norfolk for more than a week after Hurricane Maria ravaged the US Territory of Puerto Rico. Using these records, Dr. Van Boeckel and his colleagues predicted that global antibiotic consumption will reach or surpass 200,235 tons by 2030β€Šβ€”β€Šthe equivalent of adding yet another USNS Comfort to the fleet.

Military hospital ship, USNS Comfort, with a rather large civilian boat next to it, for comparison.
(Credit: U.S. Army / Spc. Landon Stephenson / publicΒ domain)
Figure 1: Antimicrobial consumption for food animal production by country in 2013 (light red circle) and projected for 2030 (dark red outer ring).
(Credit:
Center for Disease Dynamics, Economics &Β Policy)

Not all countries bear equal responsibility for this developing global health crisis: some European countries manage highly productive meat industries despite using less than half the current global average of antimicrobials per kilogram of animal. For example, China is the largest consumer of antimicrobials, both in absolute terms (Figure 1) and in relative terms (i. e.; per kilogram of animal food product)β€Šβ€”β€Šconsuming 40 times more antibiotics than does Norway per kilogram of animal food products, which include meat, dairy and eggs. For this reason, China could potentially play a powerful leadership role in addressing this health issue.

Reduce worldwide meat consumption

Without doubt, a global strategy to reduce meat consumption must also be put into action. Reducing worldwide meat consumption to just 40 grams per person per dayβ€Šβ€”β€Šthe equivalent of one standard sized hamburgerβ€Šβ€”β€Šwould reduce antimicrobial abuse in food animals by 66% (Figure 2; target 2A), which is comparable with what could be achieved by limiting antimicrobial use (Figure 2; targets 1A and 1B).

Figure 2.
(Credit: Thomas P. Van Boeckel et al. | doi:
10.1126/science.aao1495)

It is important to point out that, although 40 grams (1.4 ounces) of meat per day is more than adequate for good health and nutrition, Americans are the champion meat consumers, currently devouring an average of 260 grams (9.2 ounces) of meat per person per day (ref).

Ok, I can already hear the anguished howls of devoted carnivores (and devoted carnivore wannabes living in emerging economies) as they contemplate the horrors of a daily meat portion consisting of just 40 grams. To appease these people, let’s consider a less drasticβ€Šβ€”β€Šand probably more realistic albeit far less healthy dietary option: a reduction in daily meat consumption to 165 grams per person. Even such a small reduction could still lower global antimicrobial abuse by 22% (Figure 2; target 2B). Besides substantial reductions in antibiotic resistant microbes, other perks of a reduced meat diet include improvements in people’s overall health, and many, significant, environmental benefits (ref), as well as a meaningful reduction in global animal cruelty that accompanies intensive meat, dairy and egg production.

Implement and enforce a global user fee on veterinary antimicrobial use

Third and last, the authors propose implementing a global user fee on veterinary antimicrobials so it suddenly becomes much more expensive to provide antimicrobial-laced feeds to livestock. A fee of, say, 50% of the current price paid for veterinary antimicrobials could reduce global consumption by 31% (Figure 2; target 3C).

If such a fee is implemented, enforcement is always an issue, especially in emerging economies. So to avoid additional burdens of surveillance and enforcement costs along with other issues, this user fee could be levied at the point of manufacture or on wholesale purchases, since there are only a handful of antibiotics manufacturers and their sales are easier to track.

These user fees could be dedicated to providing essential funding for research and development of desperately needed new antibiotics. If that proposed 50% user fee was enacted, for example, it would generate annual revenues between US$ 1.7–4.6 billion. Since it costs an estimated US$ 1 billion to develop just one new antimicrobial drug (ref), this user fee could be an essential shot in the arm for the development of new antimicrobials.

Will our meat addiction allow β€œsuperbugs” to make our decisions forΒ us?

It’s plain to any thinking person that global antibiotic abuse by the meat industry will decline and probably stop in the near future. The question is whether this will occur due to enactment of thoughtful international policies that address this problem or because bacteria will evolve resistance to everything that we could possibly throw at them. Hopefully, policymakers are reading this paper and will use it as a guide for action to solve this growing crisisβ€Šβ€”β€Šbefore β€œsuperbugs” take away all our choices.

Source:

Thomas P. Van Boeckel, Emma E. Glennon, Dora Chen, Marius Gilbert, Timothy P. Robinson, Bryan T Grenfell, Simon A. Levin, Sebastian Bonhoeffer, and Ramanan Laxminarayan (2017). Reducing global antimicrobial use in food animals, Science, 357(6358):1350–1352 | doi:10.1126/science.aao1495

Also cited:

David Tilman and Michael Clark (2014). Global diets link environmental sustainability and human health, Nature 515:518–522 | doi:10.1038/nature13959

Ramanan Laxminarayan (2014). Antibiotic effectiveness: Balancing conservation against innovation, Science 345(6202):1299–1301 | doi:10.1126/science.1254163


Enjoy my writing? Please give me a few handclaps to recommend this piece. Follow me on Medium for more like this.

..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..Β ..

GrrlScientist is very active on twitter @GrrlScientist and you can follow all her writing by subscribing to her TinyLetter


Originally published at Forbes on 29 September 2017.