For years the critical question of antibiotic resistant bacteria and it’s relationship to the health and welfare of the general population has been debated and discussed at a variety of levels. Now the question has reached the highest level of government prompting President Barak Obama to issue an Executive Order to thoroughly study the problem. This order would appear to signal a significant shift in the thinking of those who have long been involved in studying the problem. For decades the addition of antibiotics to animal feed has been an accepted practice defended by animal scientists as having little or no impact on the possibility of antibiotic resistance.
In recent years a mounting body of evidence would suggest that this line of reasoning is no longer valid. Of the total volume of antibiotics produced annually in the United States the great percentage of that production has been added to animal feed to promote more efficient feed utilization and provide a low level of antibiotic to control possible intestinal infections.
Bacteria are remarkable resourceful organisms able to adapt to a wide variety of adverse conditions that man and nature have developed to greatly modify or halt their activities. These changes have not always occurred quickly but given enough time the bad bugs will usually find a way to survive. This period of adaptation has led in many instances to the development of the so-called super bugs which now plague physicians and hospitals throughout the world. It was this serious public health problem that led to an Executive Order issued in Sept. 2014 entitled, “Combating Antibiotic-Resistant Bacteria”. This act created a five year, $1.2 billion overview that would bring together experts in both human and veterinary medicine to develop a plan that would resolve the problem.
To oversee this ambitious project the President created an interagency task force with the Secretaries of Agriculture, Defense and Health and Human Services providing the necessary leadership and direction. Five goals were outlined in the plan which included slowing the emergence of resistant bacteria and preventing the spread of resistant infections; strengthening the One Health surveillance effort; developing rapid diagnostic tests; accelerate the research and development of new antibiotics, vaccines and other therapies; and improve international collaboration on prevention, surveillance control and research.
The Executive Order is far reaching in its outline but the matter of funding has yet to be resolved so until Congress gives its authorization very little is going to happen. Assuming that the funding is approved those involved in animal agriculture, especially in the beef industry, are going to be required to make some significant changes in their management practices. Under FDA Guidelines the use of medically important antibiotics presently used for growth promotion in food producing animals will be eliminated and there will be veterinary oversight of such antibiotics when used for treatment, control or prevention of disease. This change in a long standing practice will require that all of those involved at any level be informed of the changes.
This will not be a quick fix. Some farmers, veterinarians and feed dealers may not stay abreast of what is going on in the cutting edge of the industry. To address this potential concern the FDA will be developing a plan to insure that all potentially involved parties are informed of the mandated changes.
Another issue that must be addressed is the need to bring livestock producers and veterinarians up to speed on that which now constitutes the acceptable use of antibiotics. This new usage has been given the name, “stewardship of antibiotics in animals”. Veterinary colleges may be required to revise some of their course materials in order that future graduates are fully in tune with new treatment protocols. Both the FDA and the USDA will be developing new guidelines to insure that all involved are fully aware of their new responsibilities. Many will find themselves somewhat confused as they work their way through regulations that are crystal clear to the bureaucrats who wrote them but murky to those in the trenches.
A program will be developed to monitor the use of antibiotics in animal agriculture. Within five years the FDA, the USDA and the industry will evaluate and report on the total sales of antibiotics in animal agriculture and the types and prevalence of antibiotic-resistance among selected foodborne pathogens and commensals isolated from retail meat and farm animals. The latter group are those organisms which exist in a given environment without doing harm. A baseline for the use of antibiotics will be developed using the sales of antibiotics from 2009 through 2013. The present plan calls for a study to look at production practices at selected points in the food chain to determine whether certain antibiotic use practices in food production facilitate the development of resistance. At this time the National Animal Health Monitoring System collects voluntary on-farm use information but there is need for increased on-farm antibiotic use data so the USDA will be developing a plan to increase monitoring. On farm sampling will continue to be voluntary.
In the face of increased antibiotic resistance there is an urgent need for new antibiotics, vaccines and other therapeutic measure to combat disease. For reasons that remain somewhat unclear the development of new antibiotics has slowed to a snail’s pace in recent years. The large pharmaceutical companies have scaled back on their research and development creating a huge void in the creation of new antibiotics. It has fallen on smaller companies to take up the slack and their research activities are often limited by inadequate funding and facilities. The Federal Government has stepped into the picture offering grants and support to assist these smaller innovators. The great likelihood is that one or more of these innovators will come up with a new class of yet to be defined antimicrobials that will supplement or replace antibiotics as we now know them. At this time there are so-called biopharmaceutical incubators that allow academics and independent start-ups the opportunity to brainstorm among themselves to hopefully come up with ideas that may change current treatment and preventative programs.
At this time there is an increasing movement towards the “One Medicine’ concept where all health care providers interact and move towards a common goal. All animals, two legged and four legged, often interact at some level and sharing of information becomes increasingly important as the planet continues to shrink and especially in the face of a disease that many species share in common. Response times, isolation protocols and treatment programs need to be in place to insure maximum effectiveness in times of extreme urgency. Data collection in all aspects of a disease outbreak needs to be complete, accurate and swift making it critical that all members of the health care network are working together. In this era of instant communication a major obstacle has been overcome.There are in place a number of systems that monitor bacterial resistance and they can provide almost instant information about a suspect case anywhere in the world. Knowing what not to do becomes almost as important as what to do.
Today there are few, if any, disease outbreaks in which one country can stand alone in resolving problems that are of universal importance. Effectively combating antibiotic resistance throughout the globe will require government, industry, academia and the human and animal health sectors working together. The global community has limited tools to address this global threat due to the critical lack of data on the magnitude, epidemiology and economic impact of antibiotic resistance, as well as the lack of diagnostic and therapeutic options. It is important that in the face of an outbreak in one part of the world that it be rapidly detected, diagnosed and contained at the point of emergence. Many organizations exist worldwide that are focused on this problem.
Everyone involved in animal agriculture at any level should be aware of this emerging problem and the threat it poses to both humans and animals. Funding to support all of the many levels of research will be necessary to find all of the answers lies in the hands of our representatives in Washington. If this problem affects you in any way contact your person in Washington and let him/her know of your concerns.