Tug-of-war on antibiotic issue (commentary)

Tug-of-war on antibiotic issue (commentary)

ANTIBIOTIC resistance is a serious matter, and despite the many activist talking points to the contrary, vigilance regarding antibiotic use in animal agriculture is especially important to the industry.

For that reason, the National Institute for Animal Agriculture (NIAA) recently hosted its third symposium grappling with the issue; the most recent meeting occurred Nov. 11-13 in Kansas City, Mo. (The timing was especially appropriate given that the week of Nov. 18 was designated as Antibiotic Awareness Week.)

Nevertheless, some assume a popular line of thinking that the cause of the problem is really straightforward and assign the blame to animal agriculture.

For example, one well-touted talking point (sourced from Pew) claims that "up to 70% of all antibiotics sold in the United States go to healthy food animals."

I've previously addressed in this column how the sales percentage number is a misrepresentation of reality, but worse yet, the talking point's conjecture is that nearly ALL production animals, i.e., healthy, receive antibiotics. It portrays the industry's antibiotic use as wholly indiscriminate and irresponsible; that's an inaccurate depiction of what's really occurring out there.

Within that world view, if the cause is clear-cut, the solution must be too. The activists argue that we simply need to heighten our vigilance about antibiotic use in animal agriculture. That slant assumes that such steps would subsequently stop and potentially reverse mounting challenges associated with antimicrobial resistance.

Slowing antimicrobial resistance isn't that easy, however. In fact, Steve Solomon of the Centers for Disease Control & Prevention describes it as the "single most complex problem in public health."

As much as we'd like to make it so, resistance is not resistance is not resistance. Rather, the discussion requires specificity.

Resistance is a matter of detailing specific interactions of the antibiotic and bacteria of interest against the backdrop of the respective host.

Moreover, the presumption that resistance transfer is a one-way street (from animals to humans) isn't correct. Science has demonstrated that resistance goes both ways; it can also be transferred from humans to animals. Therefore, when it comes to antibiotic use, we always need to ask about the animal health implications of human use and the human health implications of animal use.

With that in mind, any educational efforts require the input of all disciplines.

There is no use of antibiotics, in any form, that doesn't potentially advance resistance. The Lancet explains, "Antibiotic resistance arises because of actions in health care, the pharmaceutical industry, agriculture and the community. Through a complex web, the effects of resistance are also felt in all these realms. This is partly the reason for producing a commission, rather than a series of separate articles, to reflect the interconnectedness of the problem."

Several important themes seemingly emerged during NIAA's recent symposium.

First, the biology of resistance is highly complex, so anyone who believes he/she might fully possess all the answers or a clear understanding of how it all works needs to dig deeper.

Second, simply establishing policy with arbitrary provisions that aren't based on science may lead to unintended consequences.

Third, bacteria don't respect international borders. Thus, policy development in the U.S. is admirable but doesn't really get us very far unless there's also cooperation across the globe.

Therefore, this discussion needs to be reshaped and requires a two-pronged approach.

First, resistance needs to be carefully monitored and better understood, and second, better incentives are needed to speed up the development of new antibiotics.

In regard to the second point, The Lancet also notes, "The golden age of antibiotic discovery, when the rate of discovery of new molecules kept pace with bacterial innovation, is now a distant memory, and the drug discovery pipeline for antibiotics is not so much dry as arid."

As much as some would like to make it a tug-of-war of human versus agricultural use, that approach doesn't really advance a solution.

To that end, any attempt to address antibiotic resistance needs to be all-inclusive, and solutions must be developed from the perspective of science, not simply a political divide between animals and people.

*Dr. Nevil C. Speer is with Western Kentucky University and serves on the board of the National Institute for Animal Agriculture, a national organization devoted to engaging livestock producers and livestock health professionals in developing solutions for issues in the livestock industry.

Volume:85 Issue:48

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