Last week was recognized in the U.S. as “Get Smart About Antibiotics Week,” and two coalitions came forward with statements about the growing problem of antimicrobial resistance.
While they delivered the same message — protecting antibiotics is a shared responsibility — they were notably different in tone.
First was an announcement that the U.S. Centers for Disease Control and Prevention is joining forces with a coalition of 25 health-care organizations to curb the rise of drug-resistant “super bugs.”
“How we use and protect these precious drugs must fundamentally change,” Dr. Arjun Srinivasan, associate director for health-care-associated infection prevention programs at the CDC, said in a conference call with reporters on Nov. 13.
These groups warn that without action, patients could soon face a time when antibiotics are powerless to treat many of the most common infections. Dr. David Relman, president of the Infectious Diseases Society of America, which is part of the effort, said doctors are already seeing patients with bacterial infections resistant to “every antibiotic we have left.”
“It will take all of us — consumers, health-care providers, researchers, policy-makers, industry, and others — to tackle this problem,” he said.
Key among their recommendations is that antibiotics used in animal agriculture be allowed on a prescription-only basis.
The U.S. Food and Drug Administration said the same thing last April when it asked companies to start phasing out antibiotic use for purposes such as promoting growth.
Then there was a message from those living in the alternative universe — a statement issued after a three-day symposium in Columbus, Ohio co-ordinated by the National Institute for Animal Agriculture (NIAA).
“Antibiotic use and antimicrobial resistance are the responsibility of all communities — human health, animal health and environmental health — and solutions will require collaboration of these health communities,” a post-conference press release tells us.
It reminds us that “antibiotics dramatically improve human, animal and plant health, and increase life expectancy.”
“Antimicrobial resistance is not going to go away. A historical look at antimicrobial resistance shows antimicrobial resistance is not a new phenomenon but existed before mankind.”
In NIAA universe, antimicrobial resistance is a “topic” that is “subtle, complex, difficult and polarizing,” rather than an urgent public health issue requiring immediate action.
“Antimicrobial resistance is not merely a consequence of use; it’s a consequence of use and misuse — and each community — animal health, human health or environmental health — is responsible for antibiotic stewardship,” said the release, which also calls for an end to finger pointing and blame on the issue.
“Finding a solution is not about compromise; it’s about reaching agreement,” stated Dr. Lonnie King, dean of The Ohio State University College of Veterinary Medicine. “We (animal health, human health and environmental health communities) need to focus on interests and not positions and initiate options for mutual gain. We need to find common ground — something we all can agree to when we disagree on other issues.”
Without pointing any fingers, we’d like to suggest a starting point. How about this for common ground?
Antibiotics should be available by prescription only, whether they are used for humans or livestock. And they should only be used to treat illness, not used as growth promoters or as an alternative to preventive management.
That is already how these important drugs are used in humans, so animal industry needs to play catch-up. You don’t buy these drugs for human use at a pharmacy unless you’ve seen a doctor first. It’s not foolproof; it is widely recognized that doctors have overprescribed in the past. But professional medical organizations are taking steps to remedy that. Right now, there is no way to bring accountability into how these drugs are used on animals, nor is there any willingness by the industry to go there.
In Canada, it’s not clear who should take responsibility. Human drugs are under federal control, veterinarians are provincially regulated. No one is even monitoring how much is used or how these drugs are used in livestock, except to check for residues in meat.
In the U.S., animal agriculture uses about 30 million pounds of antibiotics, more than four times the amount sold for human use. That fact alone suggests regulation is coming. The U.S. is moving much more quickly on this issue than Canada, despite the counter lobby from animal industry. Canada needs to pick up the pace, if for no other reason than protecting access to our biggest export market.