Driven by Profits from Antibiotics, Animal Health Industry Is Feeding Risks of ‘Superbugs’ & Next Pandemic Antimicrobial Resistance 28/07/2021 • Chandre Prince Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) A new report calls out the animal health industry for fuelling superbug resistance as a result of uncontrolled use of antibiotics and other drugs in intensively farmed livestock. Antimicrobial resistance (AMR), fostered by the wanton use of antibiotic-laced feed and growth-boosting supplements for livestock and poultry, could lead to the “next pandemic”, warns the first-of-its-kind report on AMR that focuses on the long-ignored global animal health sector. The new report, Feeding Resistance, on the growing threat of superbug risks associated with animal health products, was issued last week by a group of forward-looking investors ahead of the opening of this week’s major UN pre-summit on food systems in Rome. Globally, some 70% of antibiotics and other antimicrobial drugs are fed to livestock and poultry, accelerating the risk of widespread antimicrobial resistance, warns the report, released by an investor network called the FAIRR Initiative last week. (A) Largest five consumers of antimicrobials in livestock in 2010. (B) Largest five consumers of antimicrobials in livestock in 2030 (projected). (C) Largest Increase in antimicrobial consumption between 2010 and 2030. (D) Largest relative increase in antimicrobial consumption between 2010 and 2030. CHN, China; USA, United States; BRA, Brazil; DEU, Germany; IND, India; MEX, Mexico; IDN, Indonesia; MMR, Myanmar; NGA, Nigeria; PER, Peru; PHL, Philippines. (PNAS, 2015) Critical drugs are still being marketed by the industry, worth some US$ 47 billion annually, as growth promoters and preventative medications, leading to their misuse and overuse in the world’s 70 billion animals raised in industrial livestock complexes, charges the report. The report analysed publicly-available data from 10 of the largest publicly-listed animal health companies that manufacture and sell antimicrobials for use among livestock, poultry and also in fish farms, and which comprise about 40% of the sector overall. Intensive, industrial-style livestock and poultry production comprises the majority of those animals today that eventually end up as meat in supermarkets and on restaurant menus in developed countries – and increasingly in emerging economies as well. “For animal health companies, antibiotics and other antimicrobials are a volume business. The overuse and misuse of these products in animal agriculture is a significant contributor to the global risk of AMR, catalysed by manufacturing, marketing and sales practices,” the report states. “The animal health sector is failing to live up to its responsibilities to manage the risks we all face from antibiotic resistance,” said Jeremy Coller, the British philanthropist who is the chair of FAIRR. “It’s absolutely necessary for animal pharma to improve its antibiotics stewardship.” Industry labelling of antibiotics as animal growth products contributes to AMR Livestock applications of antibiotics in metric tons/year, among the few dozen countries reporting use. (The Antibiotic Footprint) In particular, the FAIRR report calls out 10 of the world’s leading animal health companies, which represent roughly 40% of the sector, for failing to adequately address and reduce AMR risks. These include Dechra Pharmaceuticals PLC (UK), Elanco Animal Health Inc (USA), Jinhe Biotechnology Co. Ltd. (China), Merck / MSD (USA), Orion Oyj (Finland), Phibro Animal Health Corporation (USA), Vetoquinol (France), Virbac (France), Zoetis Inc. (USA) and Zydus Cadila / Cadila Healthcare (India). “By labelling products for growth promotion and prophylaxis, animal health companies are directly influencing how farmers administer antibiotics to their animals,” said Jo Raven, senior manager at FAIRR and co-author of the report. Sales of antibiotics represent approximately 24% of the total animal health market, and between 7-43% of individual companies’ total revenue, with figures likely to be higher if expanded to include all antimicrobials, the report found. The impacts can be immediate on the farmworkers themselves – even before drug-resistant bacteria or viruses spread more widely into the population, he warned. Assessment of industry exposures to AMR risks Antibiotic ‘severely restricted by WHO for human use – promoted by industry for everyday, non-medicinal use in humans Ugandan dairy farmer Tony Kidega has taken a keen interest in turning the tide of antimicrobial resistance (AMR) in his country. -as part of a pilot project under way there Raven cited a German study that found that up to 86% of humans who work with pigs directly – mainly veterinarians and farmers – carry livestock-associated MRSA, which can be a dangerous bacterial infection in the chronically and ill, resistant to many leading antibiotics. Data from China and Viet Nam, collected as recently as 2018, illustrates the scale of the problem. In Viet Nam’s heavily agricultural Mekong Delta region, the use of antibiotics as prophylaxis can account for as much as 84% of total antibiotic use in animal agriculture. In China, the use of such antibiotics for growth promotion accounts for an estimated 53% of total antibiotic use in livestock. The report found that none of the10 largest publicly-listed animal health companies have a comprehensive strategy to mitigate the impact of AMR, nor do they have responsible marketing policies for use of antimicrobials in agriculture. It suggests that this is a particular problem in emerging markets where product labels can be a farmers’ only guide around when to use drugs and what doses. In emerging markets, in particular, “sales, marketing and package sizing practices contribute to growing AMR… ” the report states, and companies operating in such markets “do little to change the ingrained behaviour of their routine use for growth promotion or prophylaxis.” For instance, the report cites the example of a product called Winmyco – sold by the Indian firm Zydus Cadila in 25kg bags and described as a “growth promoter” – which contains the antibiotic tylosin, categorised by the WHO in a 2016 report as a high-priority drug “critically important” for human health. “This antibiotic is severely restricted for use in humans, yet is being promoted for everyday use for non-medical purposes in animals,” the report warns. WHO, FAO and OIE have failed to address industry practices – despite long-term risks to humans and agricultural production AMR risks across the animal agriculture value chain. WHO cites AMR as one of the top 10 global public health threats facing humanity. A 2019 UN report estimated that drug-resistant bacteria kills roughly 700,000 people a year – with a prediction that it would hit 10 million by 2050 if AMR continues at its current rate. But the World Health Organization (WHO) and the global health community have largely focused on the injudicious use, or overuse, of antibiotics in human populations. Global health policymakers have largely sidestepped the potentially bigger challenges posed by uncontrolled administration of such drugs to animals. Many antimicrobials such as tylosin, which are used both in human and animal health, are not even mentioned in the new WHO AWaRe classifications of antibiotics that guides global health policymakers and professionals about drugs that should be reserved or restricted for only the most urgent medical uses. So despite being noted by WHO as “critically important” to human health in its comprehensive 2016 report, there is in fact no clear, up-to-date guidance from the the global health agency about the extent that such drugs could or should be used in animal health as well. Despite signals of change – such as the formation of a “One Health” initiative with the World Organization for Animal Health (OIE) and the Food and Agriculture Organization (FAO), none of the UN agencies are tracking data or aggressively promoting the problems associaed with unfettered antimicrobials use in animal husbandry. The World Bank has meanwhile warned that AMR could lead to an 11% decline in livestock production in low-income countries by 2050. A pig pokes his head out of a barn in Oosterhout, Netherlands – where air pollution produced by livestock in rural areas has been linked to higher rates air pollution – and during the pandemic, more COVID-19 deaths. Along with being a major contributor to AMR, intensive livestock production is also a major driver of climate change – with livestock consuming some two-thirds of the world’s grain and cereals production, which in turn drives deforestation and ground water pollution. Ruminant livestock also are major emitters of methane, a powerful climate changing gas, and residues from livestock excrement mixes with other air pollutants to form airborne particulate matter that contributes significantly to air pollution in regions such as Europe. “AMR cannot be solved without stewardship and cooperation from this industry which manufactures, markets and sells antimicrobial products to protein producers to treat the animals we eat,” said Coller, warning that: “An AMR crisis threatens to make even routine operations such as a hip or knee replacement life-threatening because we may no longer have effective antibiotics available to treat patients in recovery.” Vaccines and probiotics can replace medicines – and reduce reckless antibiotic use Inspecting a pig’s health in Busia, western Kenya. The report calls for increasing farmer/consumer, public and policymaker awareness of the risks associated with the overuse and abuse of antimicrobials in animal health products – so as to exert pressure on industry to reduce their use. It also calls on companies to increase their marketing to farmers of practical alternatives and measures that can reduce the need for antimicrobial products – which include antiviral and antiparasitic medicines along with antibiotics. Those can include: the better use of diagnostic tools; more use of vaccines; and more use of novel preventative and curative medicines. Proven treatments include: probiotics, prebiotics, immunotherapeutics, and in-feed enzymes, as well as bacteriophages (the deployment of harmless viruses that can infect and kill harmful bacteria). “Many of these alternatives show positive outcomes or have promise but require further development and widening of use in order to be cost-effective. Some animal health companies are recognising the commercial opportunities associated with alternatives to antibiotics,” states the report. New alternatives could be “extremely valuable” and could become the preferred option for farmers worldwide, it concludes. Other sales and marketing measures, such as reducing package sizes to reduce the risk of unused or expired medicines being released into the environment, are also important, the report recommends. Labelling also should be clearer to prevent misuse of drugs. Currently, animal health companies take an inconsistent approach to these measures. For example, where farmers lack access to veterinarians, particularly in emerging markets, often the product label is their only guide to uses, dosage, method of application, and expiry date. Addressing antibiotic residues in wastewater Current manufacturing practices, including the WHO’s Good Manufacturing Practice (GMP) certification, which is the global standard for manufacture of pharmaceuticals – also fail to address antibiotics discharge in wastewater generated by factories producing animal drugs. “This means untreated wastewater releases antibiotic residues into the environment around factories increasing the risk of resistance,” Raven pointed out. Encouraging meaningful industry commitments On the more positive side, some of the large animal health companies have publicly committed to invest $US 10 billion collectively in alternatives by 2025, with the aim to develop 100 new vaccines, 20 new diagnostic tools, 20 nutritional enhancement tools, and 30 other products that will help to reduce the need for antimicrobials. They include Boehringer Ingelheim, Ceva Sante Animale, Elanco Animal Health, IDEXX Laboratories, Merck & Co., Phibro Animal Health Corporation, Vetoquinol, Virbac, Zenoaq and Zoetis. Those commitments need to be fulfilled – and more, FAIRR asserts – for the well-being of industries themselves as well as the health of people the world over at risk from AMR. “Animal health companies that do not increase their exposure to alternatives are likely to face increased financial pressures in the medium to long-term as the animal protein sector looks beyond antibiotics and towards preventive care and alternative treatment options as its first line of defence for protecting welfare and animal health,” states the report. “This report is a vital contribution to building the momentum needed to ensure the protection of the animal health sector from damaging practices and increasing regulatory risk,” says Coller. Image Credits: pxfuel, Charyse Reinfelder, Global trends in antimicrobial use in food animals, PNAS 2015 , antibioticfootprint.net, Tony Kidega, Flickr: Dutchairplaneshooter, ILRI / Charlie Pye-Smith. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.