In December, as COVID-19 cases were spiking again, the U.S. Food and Drug Administration (FDA) released its annual report on the volume of “medically important” antibiotics sold for use in animal agriculture. Despite the distraction of a pandemic, experts and advocates who track a different public health threat—antibiotic resistance—took note. Although ag sales of antibiotics had been steadily dropping since a peak in 2015, the report showed that for the second year in a row, the trend had reversed. Overall sales were ticking up, driven by the pork and beef industries.
“I wasn’t surprised, but I was disappointed,” said Lena Brook, the director of food campaigns at the Natural Resources Defense Council (NRDC). “The beef and pork sectors have been the highest users since the FDA started releasing species-level data . . . and we haven’t seen any new commitments [to reducing use] from producers in either of those sectors.”
In response, in January, a coalition of organizations including the NRDC issued a call for “urgent action” from the incoming Biden administration, “to act on the antibiotic resistance crisis as swiftly as it will surely act on the COVID-19 crisis” by setting a national target to reduce medically important antibiotic use in livestock and establishing a system to track it.
The call turns up the flame on an issue that’s been simmering for years, with health experts and agencies warning that the overuse of antibiotics in agriculture is a leading cause of resistant bacteria. (For the purposes of this story, all references to “antibiotics” are to “medically important antibiotics” only.)
The danger is obvious: If antibiotic-resistant bacteria infects humans more often, once-minor health issues could become life-threatening. The World Health Organization (WHO) identifies antibiotic resistance as “one of the biggest threats to global health” today, and a 2019 Centers for Disease Control (CDC) report found antibiotic-resistant bacteria cause 2.8 million infections and 35,000 deaths annually in the U.S. The CDC’s numbers did show an 18 percent decrease in deaths over the six years since its initial 2013 report, as a result of actions that have been taken to curb overuse in both healthcare and agriculture. But other estimates of deaths attributable to antibiotic-resistant bacteria are much higher.
A 2015 National Action Plan to combat antibiotic resistance produced by the Obama White House identified curbing “misuse and overuse” of antibiotics in food production as a primary goal, and policies since have strengthened veterinary oversight and outlawed the use of antibiotics strictly for growth promotion. But agencies have not banned their use for disease prevention, so the majority of pork and beef producers continue to administer them to all of their animals regularly in food and water. “It just so happened that many of the medically important antibiotics that were approved for growth promotion are still approved for prevention in very much the same way, on a routine basis,” said Matthew Wellington, public health campaigns director for U.S. PIRG, a public interest advocacy group. “It’s basically like plugging one leak in a very leaky tub.”
To be clear, the FDA’s data shows sales of medically important antibiotics for use in animal agriculture have dropped 25 percent overall since 2010. But NRDC calculates that 65 percent of the antibiotics sold in the U.S. are still for use in animal agriculture. And while tracking has been vastly improved in healthcare, data on how livestock producers are using antibiotics is spotty and incomplete.
Industry representatives say meat producers only use antibiotics strategically for animal health and that overuse is a problem manufactured by anti-meat advocates. But the slight uptick in the last two years mirrors trends seen in European countries that banned growth promotion earlier, and other data clearly shows routine use in feed and water is still the norm in pork and beef production. According to public health experts, any widespread, routine antibiotic use presents a public health threat, and current levels are not sustainable. “The pace of change is too slow given how scary the antibiotic resistance health threat is,” Brook said. “It’s another global health pandemic that we’re living through . . . it’s just unfolding at a much slower pace than the tsunami that hit us with COVID.”
Antibiotic Use in Pork and Beef Production
Accurate, consistent data on medically important antibiotic use in animal agriculture does not exist, so the only option is to piece together numbers that add up to a partial picture. The FDA tracks sales data, and what we know is that overall sales rose between 2010 and 2015 and then dropped considerably in 2016 and 2017. Experts attribute that change to a confluence of two factors: a massive reduction in antibiotic use in poultry and the FDA’s prohibition of antibiotics used solely for growth promotion overall, which was in the works in collaboration with industry throughout 2016. While numbers did tick up in 2018 and 2019—3 percent compared to 2018 and 11 percent compared to 2017—they are still significantly below 2010 levels.
The sales increases were primarily caused by a 9 percent increase in pork production and a 1 percent increase in beef production. During that time, sales to the poultry industry continued to fall drastically, as companies responded to consumer demand for antibiotic-free chicken. In 2019, industry data showed nearly 60 percent of chickens raised for meat were raised without antibiotics.
And since the FDA started collecting species-specific data in 2016, antibiotic sales for cattle and pigs have dropped by 30 and 18 percent, respectively. In an email response to Civil Eats, Anne Norris, a representative from the FDA’s Center for Veterinary Medicine, said the more recent increase is “not necessarily noteworthy on its own,” in the context of the larger downward trends, and that it’s the third lowest number on record, after 2017 and 2018. “FDA’s actions over the last several years . . . have fundamentally changed the way animal producers obtain and use medically important antimicrobials in food-producing animals,” Norris said.
Lance Price, a professor at George Washington University, has been studying antibiotic resistance since 2003 and co-founded the Antibiotic Resistance Action Center. He said that, over the last several decades, the FDA has “made steady, incremental progress in terms of limiting which drugs can be used in animal production in an attempt to control resistant infections in people,” such as drastically limiting the use of cephalosporins, drugs critical to treating pneumonia, strep throat, and other common infections, in 2012.
On the industry side, Liz Wagstrom, chief veterinarian for the National Pork Producers Council (NPPC) also pointed to the longer-term decreases in pork since the “high point of 2015” and attributed the recent uptick to overall industry growth. “From 2018 to 2019, the number of hogs marketed in the United States grew by 4.5 percent and weights also increased,” Wagstrom said.
Neither the North American Meat Institute nor the National Cattlemen’s Beef Association agreed to comment for this article.
Wagstrom pointed to the fact that the FDA data only shows sales estimates, but producers are not required to track actual use. The FDA has worked with the U.S. Department of Agriculture (USDA) on limited studies using voluntary data. The USDA chose a sampling of cattle feedlots and hog farms and conducted surveys on those operations’ antibiotic use during 2016, and results from these two different projects provide some insights, although they were completed before the rules prohibiting use for growth promotion went into effect.
Overall, the reports show widespread routine antibiotic use in feed and and/or water. In its report on cattle, the agency found 56 percent of feedlots administered medically important antibiotics in feed; among large feedlots, 78 percent did. Drugs were used primarily for growth promotion, respiratory disease, and liver abscesses (which form because cattle are not meant to eat grain). The most commonly used drugs were tetracyclines, characterized as highly important for human medicine by WHO, and tylosin, which is in a class deemed critically important. The USDA also found that 41 percent of the feedlots that reported using antibiotics in feed never recorded the use. In its survey of pork production, the USDA found 94 percent of farms gave their pigs medically important antibiotics in their feed and/or water. Tetracyclines, penicillin, and other drugs were most often administered for growth promotion, respiratory disease, and/or diarrhea. In the pork industry, the agency found record-keeping was much better.
Separate FDA studies, published last year as a package of research looking at antibiotic use in agriculture, looked at 2016 and 2017 records from feedlots and large hog operations and found similar trends. Nearly all of the drugs were given in food and water, suggesting that treating individual sick animals accounts for a tiny fraction of use.