When it comes to antibiotics, it’s time to change how the sausage gets made

With the country still grappling with COVID-19, it’s hard to be concerned about much else. Regardless, we need to reckon with other looming public health threats to forestall future pandemics, and antibiotic resistance tops that list. A new Lancet report shows more than 1.2 million people died in 2019 from drug-resistant bacterial infections, a higher death toll than from HIV/AIDS or malaria.

One of the key ways to keep our infection-fighting medicines effective is to stop overusing them.

While doctors may overprescribe antibiotics to human patients, two-thirds of the antibiotics sold in the United States that are considered important to human medicine actually go to meat producers. So, we should all be concerned that efforts to reduce antibiotic use in meat production have largely stalled.

In December, the U.S. Food and Drug Administration (FDA) released its annual report that tracks sales of medically important antibiotics to food animal production. The latest report showed those sales dropped by 3 percent between 2019 and 2020. Any decrease is welcome news, but this change is a drop in the bucket compared to the reductions we need.

The American beef and pork industries swallow up antibiotics. That’s because conventional meat producers routinely use antibiotics to prevent infections in cattle and swine they raise in unsanitary, overcrowded and stressful living conditions — not just to treat sick animals.

Routine antibiotic use may cut production costs short-term, but it imposes long-term costs on public health by breeding drug-resistant bacteria — “superbugs” — that can escape from farms and make people sick.

Thankfully, interventions work. A recent study in Canada highlighted how eliminating prophylactic use of antibiotics can reduce the development of some antibiotic-resistant bacteria in food animals.

The FDA report did include one undeniably positive statistic — a continued shift away from antibiotic use in the U.S. chicken industry. Out of all medically important antibiotics sold for agricultural use, chicken production has dropped to just a fraction, with sales to chicken producers down 27 percent between 2019-2020. According to a poultry industry survey, only 1 percent of broiler chickens in the U.S. in 2020 were raised in programs that allow the use of the full array of antibiotics available to them, and more than half of the birds were raised without any antibiotics at all.

Consumer demand drove the chicken industry to change its ways. Perdue Farms, one of the top chicken producers in the country, heard from its customers that reducing antibiotic use was important to them, so it responded. Not long after that, PIRG and other consumer groups urged fast food chains to buy only chicken raised without overusing the drugs, and a domino effect took hold. 

The beef and pork industries can reduce antibiotic use, too. American companies such as Niman Ranch and countries such as Denmark already have. But this change will be more difficult than it was for poultry producers. Cows and pigs live longer than chickens, so they’re at risk of disease for a longer period of time. To achieve meaningful antibiotic reductions, beef and pork producers have to change the way they raise the animals, incorporating longer weaning times, better diets and more hygienic conditions.

Making that happen requires a dual approach: Major buyers have to signal to producers that they want meat raised without overusing antibiotics, and policymakers need to pass legislation that eliminates the routine, preventative use of antibiotics in the long term.

The first initiative is underway. Several fast food chains are already committed to reducing antibiotic use in their beef supplies. But when it comes to public policy, the FDA has done little. The incoming FDA commissioner should have one thing at the top of his to-do list: eliminate preventative use of medically important antibiotics in food animal production, just as the European Union recently did. The drugs should only be used to treat sick animals.

Antibiotic-resistant bacteria may claim more than a million lives now, but without bold action the toll could be up to 10 million annually across the world by 2050. Consumers, companies and government agencies can all agree we don’t want that to happen, so we need to work together. Let’s change how the sausage gets made.

Matthew Wellington directs PIRG’s public health campaigns. Lydia Palumbo contributed.