Antibiotic resistance: Growing call for global reduction in antimicrobial use

By Katy Askew contact

- Last updated on GMT

Food sector urged to toughen stance on antibiotic use in animals ©pongpit01/iStock
Food sector urged to toughen stance on antibiotic use in animals ©pongpit01/iStock

Related tags: Antibiotic resistance

Europe is stretching its lead in the fight against antibiotic resistance as US regulators remain skeptical of tougher restrictions and multinational companies are accused of employing a “double standard” when it comes to emerging markets.

Globally, antibiotic-resistant bacteria are linked to around 700,000 deaths a year and this figure is expected to rise if antibiotic-resistant diseases continue to proliferate. According to a report commissioned by the UK government, this number could increase to 10m by 2050 if current drug resistance trends continue.

The over-use of antibiotics on animals destined to enter the food chain – either to promote growth or as a preventative treatment for healthy animals – has been linked to the development of so-called “superbugs​”.

In new guidelines, the World Health Organisation has called for a total global ban on the use of antibiotics to promote growth. The body suggests that healthy animals should be treated with antibiotics as a preventative measure only when disease has already been clinically diagnosed in the herd. Moreover, antibiotics deemed important to human health should not be used to treat livestock, the guidance suggests.

WHOlogo

“The development of these guidelines was driven by the need to mitigate the adverse human health consequences of ​use of medically important antimicrobials (i.e. antimicrobials used in humans) in food-producing animals."

- World Health Organization, 'Guidelines on use of medically important antimicrobials in food producing animals'

Europe sets pace

The European Union banned the use of antibiotics to promote growth back in 2006. The region has continued to set the pace for reductions in antibiotic use, according to a recent report from the European Medical Agency.

Between 2011 and 2015, sales of antibiotics for therapeutic animal use fell by a total of 13%. In some countries, reductions were significantly stronger. In France, from 2012-2016, antibiotic use in farm animals dropped by 37%. In the UK antibiotic use in food-producing animals decreased by 27% between 2014-16.

Nevertheless, antibiotic resistance remains a growing problem in the EU. The European Centre for Disease Prevention and Control described this as a “great concern” when it released data suggesting increased resistance to “several”​ antibiotic groups on the tenth annual European Antibiotic Awareness Day yesterday (14 November).

Vytenis Andriukaitis, European Commissioner for Health and Food Safety, stressed the severity of the threat. “With increasing resistance even to last-line antibiotics we face a frightening future where routine surgery, childbirth, pneumonia and even skin infections could once again become life threatening.”

He said there is a need to “bridge differences [in antibiotic usage levels] between EU Member States”​ and “raise the level of all of them to that of the highest performer”​.

To this end, the European Commission adopted the EU One Health action plan against AMR in June, Andriukaitis noted.

US resists regulation

The US administration rejected the WHO’s call to step up action on antibiotic use in the food chain, stressing that its recommendations were based on “low-quality evidence​”.

At the beginning of 2017, the US introduced new rules banning the use of antibiotics to promote weight gain. However, the regulation continues to allow prolonged use of the drugs for disease prevention in healthy animals.

USDA acting chief scientist Dr Chavonda Jacobs-Young lambasted the WHO for failing to clearly distinguish between antibiotic use for disease prevention and growth promotion.

“The WHO guidelines are not in alignment with U.S. policy and are not supported by sound science. The recommendations erroneously conflate disease prevention with growth promotion in animals,”​ he argued.

“Under current Food and Drug Administration (FDA) policy, medically important antibiotics should not be used for growth promotion in animals. In the U.S., the FDA allows for the use of antimicrobial drugs in treating, controlling, and preventing disease in food-producing animals under the professional oversight of licensed veterinarians. While the WHO guidelines acknowledge the role of veterinarians, they would also impose unnecessary and unrealistic constraints on their professional judgment."

Dr Jacobs-Young conceded that “alternative therapies”​ for disease prevention are desirable but added that “more data​” is needed to develop policy.

The US National Pork Producers Council went a step further, denouncing the WHO guidelines as “ill-advised and wrong”​. The NPPC said in a statement: “Denying pigs, cows and chickens necessary antibiotics would be unethical and immoral, leading to animal suffering and possibly death, and could compromise the nation’s food system.”

Campaigners call for corporate action

With a patchwork of global regulations on the use of antibiotics, campaigners are looking to the corporate world to step up efforts to reduce levels of drugs administered to animals in the food chain.

Investor network FAIRR today urged companies - particularly in the US - to adopt “comprehensive”​ policies to phase out the routine use of antibiotics in healthy livestock. FAIRR noted the “growing policy gap”​ between the US and EU and suggested that the private sector should move to fill the breach.

According to Jeremy Coller, CIO of Coller Capital and Founder of the FAIRR Initiative, investors are “fired up​” on this issue.

“The rise of tiny antibiotic-resistant superbugs poses a colossal threat to both human health and the global economy. Big restaurant chains are in the eye of the storm and while investors are pleased by the growing number of commitments to responsible use of antibiotics, the magnitude of the risk demands swifter and deeper action. The clear message from this investor engagement is that we shouldn’t count our chickens only… producers of beef, pork and other livestock species also need to phase out the use of antibiotics critical to human medicine”

FAIRR highlighted the impact that investor activism has had in the UK to spur corporate action. Since a FAIRR investor engagement launched in 2016, four UK companies - The Restaurant Group, Greene King, Whitbread and Domino’s Pizza Group UK - have committed to phase out routine antibiotics on all livestock species.

UK retailers are also under pressure to respond. A new report from the Alliance to Save Our Antibiotics, out yesterday, found that five out of eight retailers included in the study – The Co-operative, Marks and Spencer, Sainsbury’s, Tesco and Waitrose – have introduced bans on suppliers using antibiotics for routine disease prevention. Morrisons has a ban on some species but not in others, Aldi has some restrictions but no ban, while Asda and Lidl have no restrictions other than minimum legal requirements, the Alliance revealed.

Cóilín Nunan, a scientific adviser to the Alliance, said: “We welcome recent reductions in farm antibiotic use, but much greater cuts are urgently needed if we are to preserve our remaining antibiotics.

“Our report shows that intensive livestock farmers have much to learn from the practices of more extensive farming systems, which often have minimal antibiotic use. Moving to later weaning of piglets, using slower-growing chickens, lowering stocking densities of animals kept indoors and keeping cattle on pasture are all essential and achievable measures which can lower antibiotic use.”

A ’double standard’ in emerging markets?

While campaigners in Europe argue that swifter action is needed, global restaurant chains have indeed toughened their stance to pressure suppliers to reduce antibiotics.

McDonald’s, for example, is working to curb the use of high-value human antibiotics in its global chicken supply chain.

In August of this year, McDonald's said it will cut “highest priority critically important antimicrobials”​ (HPCIAs) from McDonald's chickens in Brazil, Canada, Japan, South Korea, the US and Europe. In Europe, the company will make an exception for Colistin, a last resort antibiotic, which it said it will phase out by the end of 2019 when suppliers in Russia and Australia will also be required to end routine antibiotic usage.

A raft of US-based companies have made similar commitments to eliminate HPCIAs from their domestic chicken supply. These include Domino’s Pizza (2018-beginning), Dunkin’ Donuts (2018-end), Pizza Hut (2017), KFC (2018-end), Taco Bell (Q1-2017), Burger King(2018-end), Starbucks (2020) and Wendy’s (2017).

India-based Centre for Science and the Environment suggested that this demonstrates a “double standard”​ in the policies multinationals are adopting in emerging and developed markets.

In an assessment released by CSE earlier this week, the group contacted 11 foreign multinationals to request information on their plans to address antibiotic use in India’s poultry sector.

“Seven multinational brands… did not respond to us at all. Most of these, including McDonald’s, KFC and Pizza Hut, sell chicken-based food across the country. While some others shared their practices of sourcing and testing, they did not specify any timelines by which they planned to eliminate antibiotic misuse,”​ said Amit Khurana, Head, Food Safety and Toxins programme, CSE.

"Fast food multinational companies have adopted double standards. They have come out in the open and shown commitment to stop antibiotic misuse in the US and other countries, but have not taken any concrete steps in India. They do not seem to care about the Indian consumer and are not keen to cut-down on their contribution to the rising AMR in this country."​ - Chandra Bhushan, CSE deputy director general.

Jagdeep Singh Bachher, University of California chief investment officer of the Regents, stressed that “all food companies” – but especially those in the US – need to move “further and faster” on the issue.

“Antibiotic resistance is a rapidly emerging risk that could spell the end of modern medicine, and that is an enormous material threat to the global economy. The market cannot afford to see key sectors from big pharma to big farms infected by antibiotics risk.”

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