A week ago, I spent two days outside Washington, D.C. at the sprawling campus of the U.S. Food and Drug Administration.
The occasion was the first public meeting in three years of a government effort known as NARMS, the National Antimicrobial Resistance Monitoring System, a multi-agency project that keeps track of antibiotic resistance in livestock, retail meat and people.
NARMS has been going since 1996, but the questions that underlie are it more urgent now than at any time since the effort began. Basically, they are: Does the use of antibiotics in livestock raising prompt the emergence of resistant bacteria? Do those bacteria move off the farm via the meat those animals become? Do those bacteria attack humans and cause drug-resistant illness?
And, most urgent of all: Can we do anything to stop them?
If you keep track of the issue of antibiotic use in agriculture, you might know that the answers to the first questions are Yes, Yes, and Yes—but the answer to the last one may be, Ask Again Later.
Routine giving of antibiotics to meat animals commenced at the very beginning of the antibiotic era, with the accidental late-1940s recognition that animals receiving small doses of drugs in their feed put on weight more quickly than ones that got no drugs. That finding allowed meat production to raise animals either more quickly, or at the same rate but while spending less money on food. This was right after World War II, when there was deep concern that war-ravaged societies lacked the capacity to feed themselves; the prospect of raising more meat more cheaply, to feed more of the world, must have seemed like a gift.
Meet Gerbert Oosterlaken, a Dutch pig farmer who has reduced his use of antibiotics.
Of course, it quickly became a vast industry. Today, according to numbers tendered to the FDA by veterinary drug manufacturers, livestock raised in the United States receive 29.9 million pounds of antibiotics per year.
The unintended consequences of giving meat animals antibiotics emerged surprisingly quickly—in the old accounts I’ve been reading, scientists raised concerns about superbugs almost immediately—and yet this practice of routine antibiotic dosing has never really been successfully curtailed. In the US, that is. In Europe, using antibiotics for “growth promotion” has been banned since 2006. Some countries have gone further, also restricting “therapeutic” doses that prevent animals from become sick in crowded spaces, and allowing antibiotic use only when animals are actually sick.
The FDA attempted as far back as 1977 to revoke the licenses it granted in the 1950s for growth-promoter antibiotics, but was stymied for decades by Congressional interference. Finally, last year, it gave up trying to re-regulate the drugs, and instead asked the veterinary drug manufacturers to sign onto a voluntary program to restrict growth-promoter use. That decision has come under a lot of criticism because, in Europe, the growth-promoter ban triggered a shell game in which the same amount of antibiotics were sold as before, only under different labels—making the ban ineffective until further crackdowns caught up. Researchers have pointed out that, without the force of law behind the US ban, the same thing is likely to happen here.
The meeting last week, though, revealed what the FDA is up against. At the end of the second day, there was a public comment period, in which anyone not part of the federal process—scientists, activists, lobbyists—can put a statement into the written record. One of the speakers was Dr. Richard Carnevale, a veterinarian who is vice president and spokesman at the Animal Health Institute, which represents the major veterinary drug companies. He said:
“This is how this is going to happen, with industry cooperation. FDA will not be able to do this on their own, regardless of how many regulations, or guidelines, or legislation they enact. That is the honest truth.” He added, a few moments later: “I hear an awful lot of handwringing and claims of a crisis. I’m not sure there is a crisis.”
That comment gives a flavor of what the FDA has come up against in trying to control animal-antibiotic use. So is this effectively a stalemate? Or, at best, a painfully slow curve down to more reasonable amounts of use?
Well, perhaps, in the regulatory arena. But far outside that tortured process, interesting things are happening. Consumer buying patterns are shifting, and local political movements are increasing the pressure. They may force change on the issue of antibiotic use in meat production more quickly that the political process has ever managed.
Consider these: Just about every major poultry company now sells “antibiotics-free” chicken as part of their arrays of products. The fast-food chain Chipotle Mexican Grill, which built its reputation selling antibiotic-free meat, enjoys so much demand for its dishes that it is purchasing meat from outside the US. And Chipotle has new company in the market: Chick-fil-A, the Georgia-based chain known almost as much for its founder’s Southern Baptist beliefs as for its cult chicken sandwiches, has vowed to go antibiotic-free in 5 years.
Listen to celebrity chef Tom Colicchio discuss the effectiveness of the food movement.
There is political pressure alongside the consumer pressure. Celebrity chefs such as Tom Colicchio, best known to most of the country for being a “Top Chef” judge, have begun testifying in front of Congress and using their social-media clout to educate consumers. The James Beard Foundation supports a “Boot Camp for Policy and Change” that trains chefs to be advocates. And the environment in which those chefs work, and in which their customers spend dining dollars, is shifting. So far this year, according to the nonprofit group Food and Water Watch, 14 cities have passed resolutions calling for an end to antibiotic overuse in meat production. They include places as large as Seattle, Madison and Chicago—and larger cities, including New York City, are still considering similar bans.
When I count up all those changes—and though I’d been aware of each of them for a while, I didn’t add them up until I started to write this piece—they feel to me like significant change is happening, not at the fought-over federal level, but down where people live and eat.
The long FDA process of restricting farm antibiotic overuse has two more years to run; the success of the voluntary program won’t be assessed until 2016. But when I look at what is happening outside Washington, I wonder whether regulators and industry will emerge at some point from their stalemate and discover that, while they were arguing, the market made up its mind.