Aiding & Abetting Disease

 

We’ve got to stop focusing solely on the bugs. Decisions we make individually and collectively; for example, through legislation, strongly shape the risk of disease.

Exhibit A: Next week members of the House Energy and Commerce committee will vote to amend the Animal Drug User Fee Act (ADUFA) in a way that will greatly expand the use of antibiotic drugs in cattle, pigs, and poultry. That step, says the National Resources Defense Council, a U.S.-based environmental legal group, would be “rash, unforgivable, and will hasten the spread of antibiotic resistance.”

How increased use of antibiotics hastens the spread of resistant infections was explained by infectious disease expert, Brad Spelberg, MD, to an international audience via webinar this past February. Referring to our overuse of the drugs as an “ecological tidal wave of antibiotics,” he said:

But boy I’ll tell ya, we sure do our damnedest to educate them [bugs] to be resistant.

The amount of antibiotics that we put into the environment every year in this country is absolutely staggering: 21,000 tons every year in just the United States. And the rate of use in agriculture is not going down it is going up. It is continuing to increase despite our clarion calls that we have a resistance crisis. We truly have a problem, Washington.

Yet Washington’s response, according to the NRDC analysis, is to pour more antibiotics into the environment and do so with improper motive: “The Food and Drug Administration loves ADUFA because it requires pharmaceutical companies to pay tens of millions of dollars in fees that pay salaries and maintain FDA budgets. Pharmaceutical companies love ADUFA because it has greatly reduced the time needed for FDA to approve new animal drugs, meaning increased product sales and profits.”

In essence, the NRDC says the proposed amendments accomplish this by reducing the regulatory reach of the FDA over the use of antibiotics:

Since 1962, FDA’s primary job has been to make sure that human and animal drugs are both safe and effective. In 2004, Congress allowed “conditional approvals” which allowed companies to sell certain new animal drugs without submitting all the data showing that those products are effective. Congress intentionally limited these conditional approvals to minor animal species (like goats and rabbits) or to minor uses in major species (intended for small numbers of dogs, cats, pigs, cattle, turkeys, or chickens). They rationalized that because the markets for these products were so small, pharmaceutical companies needed lower costs to bother making them.

The problem is that now these same companies want Congress to expand conditional approvals to major uses in major animal species like cattle, pigs and poultry. These markets are enormous. If this provision passes, companies won’t have to submit all the data needed to approve drugs (including antibiotics) used in tens of millions of animals. [Emphasis in original.]

This ploy is dangerous to public health. It is laser focused on increasing the use and sales of drugs, including animal antibiotics. And that increase will speed up the development and spread of superbugs.

As bugs evolve so must our notions of what drives disease. A growing literature says “profit-driven diseases” are giving rise to pandemics. And thus we have, for example, a special report in next month’s Scientific American that shifts the focus from the bugs to us. They say that resurgent outbreaks of infectious diseases in the U.S. are sickening thousands, and the causes are societal, countering the “conventional wisdom that says that infections are caused solely by germs.”

 

 

 

 

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