The UK’s massive use of antibiotics on farms is breeding lethal drug resistance into bacteria, writes Zac Goldsmith. Although we use five times more antibiotics per animal than Scandinavian countries, Cameron is mysteriously reluctant to clamp down on abuses.
On accepting his part of the Nobel prize for the discovery and isolation of penicillin, Alexander Fleming warned: “there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”
From the very moment these miracle drugs became available to us, there has never been any doubt about the link between misuse of antibiotics and resistance to them.
But despite that, we have spectacularly failed to heed Fleming’s warning, and as a consequence, we now face the nightmarish prospect of losing modern medicine as we know it.
The Chief Medical Officer, Dame Sally Davies, has described an “apocalyptic scenario”, adding that “here are few public health issues of potentially greater importance for society than antibiotic resistance.”
Without action, she has warned of a return to a “19th-century environment” within 20 years, in which routine operations carry a deadly risk. The World Health Organisation has said that antibiotic resistance is already a bigger crisis than AIDS.
Cameron is failing to prevent the abuse of antibiotics
The Prime Minister has also described the issue as “an extremely serious problem”, and has recently announced a suite of measures to help drug companies deliver new drugs.
Clearly we must hope that works, but what is troubling is his failure to address the widespread abuse of the precious antibiotics we already have.
There is no escaping that fact that the principle cause of this crisis is our industrial-scale misuse of the antibiotics. And now that the medical establishment has sounded the alarm, you’d expect this, perhaps the greatest single threat to our health, to top the political agenda and dominate the tabloid news. If only.
In fairness, GPs and hospitals are making an effort to cut back on unnecessary antibiotic use. But virtually nothing is being done to limit misuse of antibiotics where it is most prevalent – in agriculture.
Half of all antibiotic use is on intensive farms
A staggering half of all antibiotics are splurged on intensive farms, where animals are kept in conditions where they would die without them. The overall use of antibiotics per animal on UK farms increased by 18% between 2000 and 2010.
Even more worrying, according to the Veterinary Medicines Directorate, the farm use of antibiotics that are critically important to humans is at a record high. The problem is even worse in the US, where roughly 80% of all antibiotics are used on farms.
At the same time we are fast losing our antiobiotics to resistance: penicillin for staphylococcal wound infections, ampicillin for infections of the urinary tract and ciprofloxacin for treating gonorrhoea. We are increasingly having to use reserve antibiotics, and worryingly, seeing the spread of resistance to them as well.
In 2006 there were just five cases where patients failed to respond to even so-called last resort antibiotics, but last year that number was 600.
25,000 needless deaths a year from resistant bacteria
Each year in the EU alone, says the World Health Organization in its report Tackling antibiotic resistance from a food safety perspective in Europe, over 25,000 people die from infections caused by antibiotic resistant bacteria.
The link between misuse and resistance is not disputed, and so we have to ask then why emergency action isn’t being taken. Dally Sally’s predecessor, Sir Liam Donaldson, warned that “every inappropriate or unnecessary use on animals or agriculture is potentially signing a death warrant for a future patient.”
So why isn’t the Government listening? Why aren’t the newspapers hounding Ministers for action? Why aren’t MPs being bombarded by angry letters?
In short, what makes this crisis different, and less important to policy makers than the AIDs crisis of the 1980s, which successfully galvanised drug companies and the authorities?
One answer perhaps is that there is less focus – there is no single infection to fight, no single drug to be found.
Confronting the vested interests of the factory farmers
But that can’t fully explain the apathy. For me, the key difference is vested interest. Factory farming is dependent on routine use of antibiotics and would have to adapt dramatically if they were removed. The resistance put up by the lobby groups is immense, and the lobbyists have long tentacles that reach deep into Government departments.
Their principle argument is that cheap meat would no longer be available without antibiotics, but even if that were true, how ‘cheap’ will that meat seem if the price we have paid for it is the loss of the very tools that make modern medicine possible?
Last year I initiated a debate in Parliament on the issue, and was given sight of a briefing by one lobby group – the British Poultry Council. It made all kinds of assurances – that farms only use antibiotics when prescribed by trained vets, that the problem is mostly down to human use of antibiotics, and so on.
It even cited its pride that the use of growth-promoting antibiotics was banned ten years ago – but somehow failed to mention that at the time it lobbied hard against the ban.
One very senior Lib Dem MP outsourced his reply to the NFU
Following my debate, a number of people wrote to their MPs asking them to support the campaign for responsible use of antibiotics. As if to prove the point I had made about vested interest and the lobby groups, one very senior Lib Dem MP asked the National Farmers Union to respond on his behalf.
It would be wrong to suggest there has been no progress. Following my debate, a Health Minister wrote to me to explain that “Routine prophylactic use of antibiotics in both humans and animals is not acceptable practice. I am writing to [DEFRA] to ensure that existing veterinary guidance makes that very clear.”
Then last year, the Cabinet Office confirmed it would look at resistance as a national security issue. The Government subsequently announced a 5-Year Antimicrobial Resistance Strategy, the details of which will be released later this year.
But in DEFRA, there remains breathtaking complacency, with one Minister telling a Select Committee recently that antibiotics “tend to be used more sparingly in the veterinary world than in the medical world.” This is simply untrue.
Why does the UK use five times more farm antibiotics than Scandinavia?
The UK should learn from other countries that are taking the issue more seriously. It is an extraordinary fact that use of antibiotics per pig and poultry is three to five times higher in the UK than in the five Nordic countries Denmark, Finland, Iceland, Norway and Sweden.
In the Netherlands, there has been a 50% reduction in livestock antibiotic use from 2009 levels by 2014. In addition, farmers must prove that the older, weaker antibiotics cannot be used before they are allowed to use antibiotics critical for humans. Despite dire predictions of falling productivity, there has been no downward trend at all.
We are seeing similar actions in Denmark, Norway, Sweden. Even the US has banned the use of fluoroquinolones in poultry.
The bottom line is that there is no escaping the need to ban the routine, prophylactic use of antibiotics on farms, and to ban absolutely the use on farms of all antibiotics that are important for humans.
That requires Government to prioritise human health over short-term vested interest, and that, I believe, will only happen with sustained public pressure.
This article first appeared in The Ecologist on 24 July 2014