Tuesday, May 15, 2012

Enacting PAMTA


H.R. 965: Preservation of Antibiotics for Medical Treatment Act of 2011

Sponser: Congresswoman Louise M. Slaughter

  • Although things may appear bleak with the widespread effects of the issue, affecting the environment, public health, and health care costs, there is hope for the current crisis.
  •  H.R. 965: Preservation of Antibiotics for Medical Treatment Act of 2011 (PAMTA), sponsored by Democrat Louise Slaughter, is the most ambitious solution proposed to date. The bill modifies the Federal Food, Drug, and Cosmetic Act which would obligate the Secretary of Health and Human Services to reject new applications for “critical antimicrobial animal drugs” unless the applicant establishes that it would cause no harm to the health of humans due to the development of antibiotic resistance accredited to the routine use of the medication. The amendment defines “critical antimicrobial animal drug” as an antibiotic planned for use in animals grown for food production that contains particular drugs or additional antibiotics used in humans that prevent or treat infection or disease caused by bacteria. The solution also forces the Secretary to remove the endorsement of nontherapeutic drugs in animals grown for food production two years following the date this act is enacted, unless specific safety rules are met.
  •  PAMTA was first introduced in the 110th Congress in 2007 to the House of Representatives, but was referred to Committee and died. It was re-introduced in 2009, where it also died in Committee and then again re-introduced in March of 2011, where it currently sits in Committee. It was also introduced as S. 1211 to the Senate in June of 2011 with bipartisan support by Democrat Dianne Feinstein. Slaughter, who is the only microbiologist in Congress, re-introduced the bill to the House with the hope to gain control on the growing threat of superbugs and to call an end the regular use of antibiotics on healthy animals. 
  • The bill has seventy-eight cosponsors from several different states, as well as a great deal of endorsers, with nearly 380 supporting organizations, including agricultural, health, environmental, animal protection, labor, religious, and numerous other interest groups. With all of this support being steadily built, PAMTA is the exceedingly radical answer to the problem of microorganisms withstanding pharmaceutical drugs in the U.S. today. It is the most suitable solution given that it reduces the root cause of antibiotic resistance, is extremely beneficial in long-term costs, and could potentially follow in the footsteps of the Danish and European bans of antibiotics in animal agriculture.
  • There are many arguments that critics of PAMTA often use in order to discourage its passage. Many of its opponents contest that the ban will ineffective cost wise. Dr. Liz Wagstrom, who is the National Pork Board’s Assistant Vice President of Science and Technology, told reporter Katie Couric in an interview on the issue that an antibiotic ban would greatly increase costs. Dr. Wagstrom continued with saying that, “we would likely see small producers pushed out of business, we’d have more sick and dying pigs, and none of that would result in a benefit to the U.S. consumer.”
  •  In response, Couric interviewed Duane Koch, a Pennsylvania turkey farmer, who has been raising his birds without antibiotics for over a decade. Koch told Couric that the costs to change his facility to free of antibiotics were low and since the switch, his business has been more profitable. He provides them with higher-quality feed and has improved their living quarters so that they are naturally healthier. He says that by presenting the turkeys with more space, their weight can easily be matched to those with the growth promoters. Couric also reported in the same investigation that grocery store costs did not drastically increase. She reported that turkey meat free of antibiotics will cost around $1.40 versus traditionally antibiotic fed birds for $1.20. 
  • Additionally, in 2009, extended hospital stays due to drug resistant illnesses were approximated to cost roughly $18,588 to $29,069 more per patient, which totals to billions in additional healthcare costs each year nationwide. PAMTA’s legislation would ban the use of antibiotics within CAFOs, causing a transition from factory farming to free range farming. While there may be a small increase in cost for producers to upgrade their farms and facilities, the savings in health care costs would in all likelihood offset those costs significantly, creating a long-term cost benefit.
  • Another argument that challengers of PAMTA frequently point to is the outdated Danish data that supposedly proves that a ban on antibiotics in the U.S. would damage the farm industry. Opponents often describe the ban on nontherapeutic antibiotics in animals in Denmark as a less than a success, claiming the figures illustrate an increase in both the death of piglets and the need of antibiotics for therapeutic purposes to treat sick swine.
  •  Conversely, in the same investigation presented by Couric, she makes a different claim. In an interview with Soren Helmer, the Danish pig farmer says that since the ban, the pork industry in Denmark has increased by forty-three percent, making it a top exporter of pork internationally. Danish scientists from the National Food Institute at the Technical University of Denmark, Drs. Frank Moller Aarestrup and Henrik Wegener, also rebut opponent’s evidence and in July of 2009 submitted a written testimony to a U.S. House Committees Rules hearing on PAMTA. They declared that government organizations financed by the U.S. agri-business have misrepresented and criticized the details on the ban of antibiotics in Denmark since its establishment. The scientists discovered that the antibiotic use for pigs decreased by fifty percent and that piglet mortality initially increased, but after upgrading and enhancing animal living conditions, those statistics have since dropped below pre-ban stats. 
  • The same results can be seen in Europe, where antibiotics valuable to human medicine and used for growth promotional purposes were banned in 2006. Once Sweden and Finland, two countries with extremely strong policies on the use of antibiotics, entered the European Union, the other European countries followed suit and eliminated more drugs from livestock feed additives, as well as changed their farm practices. 
  • Furthermore, according to Dr. Ellen Silbergeld, an environmental health professor at Johns Hopkins Bloomberg School of Public Health, both the Danish and European experience demonstrate that there will be noticeable health benefits if the ban is accomplished in the U.S. Not only will it improve food safety, but also drastically diminish antibiotic-resistance. The success displayed by these countries in providing quality meats under these policies depict that the responsible use of antibiotics does not have to come at the expense of the livestock or the consumer.
  • Support for the bill is very broad with most of its backing stemming from health, environmental, and agricultural sectors. Several organizations including the Organic Trade Association, Union of Concerned Scientists, American Medical Association, Animal Welfare Institute, Environmental Defense Fund, and United States Environmental endorse the legislation. These groups recognize the link between the prevalence of antibiotic resistance in humans and the widespread nontherapeutic use of antibiotics in animals used for food production. They are also concerned with the public health, environmental, and socioeconomic issues associated with drug resistance. Anxiety over growing health care costs and escalating tension with trade partners that have powerful food safety laws are at their basis for economic considerations of antibiotic resistance. Rather than continuing to squander billions of dollars to care for antibiotic-resistant diseases and infections, advocates promote preventing the illnesses through the reduction of the resistance. 
  • Unsurprisingly, the meat industry is greatly opposed to an increase in regulation of its antibiotic use. Organized opposition has come from the National Meat Association, National Cattlemen’s Beef Association, National Chicken Council, National Pork Producers Council, National Milk Producers Federation, National Turkey Federation, and American Meat Institute. These groups disagree with the passing of PAMTA for a number of reasons, for example, the idea that the price of meat production will rise, leading to higher costs for consumers.
  •  Pharmaceutical manufacturers are also opposed to the increase in regulation. The pharmaceutical industry believes that the existing rules and regulations regarding antibiotic use and drug approval in farming are adequate. A large amount of pharmaceutical companies including Bayer, Pfizer, Novartis, and Eli Lily and Company are affiliated with the Animal Health Institute, which lobbies against legislation to limit antibiotic use. The overall amount of lobbying expenditures of the Animal Health Institute over the past decade varies from $30,000 to $200,000 annually. While it is hard to measure political power, quite a few groups opposing the legislation have large financial resources that are being used with regard to the use of antibiotics in food production within the U.S. The advancement of new drugs by pharmaceutical companies could mitigate the danger of antibiotic resistance, but the research and development is a costly procedure that takes several years to complete. It is also not a feasible solution to tackle increasing antibiotic resistance.
  • More than one strategy is needed to alleviate this public health threat, which PAMTA aptly accomplishes. The act includes the enforcement of appropriate application of antibiotics in animals used for food production and addresses farming practices that rely upon the nontherapeutic use of antibiotics. 
  • For the last fourteen months, the bill has been waiting in Committee. Unfortunately, though the proposal has numerous endorsers, it is lacking bipartisan support, and given its previous track record, will most likely die in Committee. It is not a feasible solution with all of the lobbying from both meat and pharmaceutical companies, which is an extremely disheartening since the problem is growing at such a fast pace. According to a study done in 2005 by the Journal of the American Medical Association, an internationally peer-reviewed medical journal, it was estimated that almost 95,000 Americans were infected with MRSA and 18,650 died due to the infection, with fifteen percent of cases being contracted in public settings outside of hospitals.
  • Despite its current barriers, the problem of antibiotic resistance can be changed, with steps in the right direction already being made. In 2003, the McDonald’s Corporation publicized that it would only purchase chickens from producers who did not use antibiotics for subtherapeutic purposes. Also, as recently as 2006, four of the countries’ top ten chicken producers, Tyson Foods, Foster Farms, Perdue Farms, and Gold Kist, revealed that they had stopped the use of antibiotics as a growth promoter.
  • There is hope for change and it can become a reality by taking a stand at the consumer level. The first step towards change is education. Knowledge truly is power, so spread the word because the more people know about the issue, the more they can try and do something to about it. The second step in making a change is choice. The consumer has more power than people think so try to buy organic, eat locally, and support small, free range farms. The third step, which will really make a difference, is advocate, by writing letters to the Congress people that were chosen to represent the consumer. Support can also be shown by joining an activist group and getting involved. PAMTA began the antibiotic free movement, now the consumer has to finish it. Change for a healthier future is possible, but only if the consumer wants to help make the change.
More information:
http://mpaenvironment.ei.columbia.edu/sitefiles/file/Summer%2011%20reports/Fall%20reports/PAMTA%20Final%20Report%20web.pdf
http://www.keepantibioticsworking.com/new/PRfiles/KAW%20press%20release%20on%20PAMTA%20Senate%20reintroduction%206.17.2011.pdf

Monday, May 7, 2012

Pernicious Penicillin: The Downfall of Antibiotics


    • The problem of antibiotic resistance stems from a long series of adverse actions, dating back nearly seventy years. 
    • The initial incident began during WWII, when Alexander Fleming’s penicillin became widely known as a bacterial killing miracle drug. In 1941, the U.S. government made an appeal to Pfizer, today’s largest international pharmaceutical corporation, to advance the speed at which penicillin was being produced. A large supply would then be sent overseas to aid the injured Allied soldiers. Four months later, Pfizer was manufacturing five times more penicillin than originally planned. Not only was this a major turning point in human history, but it set the stage for the rise of antibiotic’s role in the future.                                                    
    • The plan for penicillin, as well as many other antibiotics, had been slightly modified. Researchers had discovered that similar drugs and medications that improved humans’ health could also be used in animals to help them as well. In 1951, the mass produced penicillin was approved by the FDA to use in animal feed. Sadly, this approval was not intended for therapeutic uses like curing or treating otherwise fatal infections, but for more nontherapeutic or subtherapeutic uses such as routine disease prevention and growth promotion at low doses. 
    • Not long after, in the 1960s, the FDA became concerned with the long-term use of antibiotics in animals and thought it might pose a threat to both animal and human health. In 1970, the agency conducted several studies where they found that subtherapeutic levels of antibiotics within animal feed contributed to the expansion of antibiotic-resistant bacteria. For more than forty years since then, the FDA has collaborated with various researchers that have linked subtherapeutic use of antibiotics in animal agriculture to the advancement of antibiotic-resistance.
    • However, as recently as 2011, the FDA announced that it would end all attempts to withdraw approval of penicillin in animal feed. The present predicament of antibiotic-resistant bacteria can be seen as a breakdown in government policy.
    • For more information on organizations promoting solutions
      http://www.ucsusa.org/ 
      http://www.pewenvironment.org/  http://www.nrdc.org/
    • Current news articles on the issue                                                  http://www.bloomberg.com/news/2012-05-07/squash-superbugs-with-fast-track-antibiotics-approval.html                          

Tuesday, May 1, 2012

Antibiotics: Animals in Agriculture

  • In 2011, the CDC estimated that of the 48 million Americans who contracted foodborne illnesses, 128,000 were hospitalized and 3,000 died from a food related disease.
  • Industrialized farms have been integrating antibiotics into our farm animal’s feed since 1946, where it was discovered that the drugs caused animals to effectively put on more weight as well as to grow at a more rapid rate. In today’s confined animal feeding operations or CAFOs, not only are antibiotics used to promote growth, but to also battle against the unsanitary environment that our livestock, fish, and poultry are raised in.
  • According to the FDA, the animal’s living conditions are a breeding ground for illness and germs and are the reason why 28.8 million pounds of antibiotics are used in food animals annually. In addition, livestock and poultry alone account for as much as eighty percent of all antibiotic use in the United States.
  • According to Sustainable Table, this extreme overuse is too much for the animals’ digestive systems. The excess antibiotic use causes nearly eighty to ninety percent of the antibiotics to pass through the animal and into the surrounding ecosystem in the form of concentrated fecal matter. In fact, more than one billion tons of excrement is produced yearly, filled with not only antibiotics, but antibiotic-resistant bacteria originating within the animals’ bowels. Once dumped into the environment, the antibiotics come across additional bacteria and create new resilient strands. These impervious strands then come in contact with the public, producing a sizeable amount of illnesses and diseases which are becoming quite costly.

  • In 2009 alone, the National Academy of Sciences, a private, nonprofit establishment that offers expert advice on both national and international disputes, calculated that within the United States exclusively, antibiotic- resistant bacteria’s health care costs surpassed $4 billion. This value is a reflection of merely the hospital and pharmaceutical fees and does not account for other losses such as productivity and individual torment.

  • With all of this evidence, the CDC has come to the conclusion that within the U.S., the leading cause of antibiotic resistance amongst foodborne pathogens is due to an overload of antibiotic use in animals used for food consumption.