The case for strictly limiting use of antibiotics on farms isn't just compelling; it's terrifying.
Perdue Farms, the giant Eastern Shore poultry producer, has eliminated the use of antibiotics for chickens that aren't sick for a simple reason: It's great for business.
Certainly, if you talk to the company's chairman, Jim Perdue, or its other top executives, they'll express concern for the wellbeing of the chickens farmers grow for them and for the public health effects on humans caused by the overuse of antibiotics, but they have taken aggressive steps — limiting even the use of a class of antibiotics that aren't used in humans — because the market for chicken that can be labeled antibiotic free is growing much faster than the market for conventional chicken.
Consumers are demanding it, and it's not just a fringe, foodie phenomenon. That's why McDonald's no longer buys chicken that was raised with antibiotics that are also used to treat humans. Panera, Chipotle and Subway don't either. Chick-fil-A, Papa John's, Pizza Hut and Taco Bell have publicly committed to doing the same. Last year, shareholders in KFC warned that the company was likely to "lose market share to companies who have stronger policies in place." Smart businesses give customers what they want. That's why Perdue has led the way, with Tyson Foods and other big producers following its lead.
All that makes it curious that the General Assembly has engaged in such heated debate about legislation to prohibit the use of medically important antibiotics — principally those used to treat humans — in animals that aren't sick. The legislation would require a veterinarian to certify the specific need for using such drugs based on a documented disease, the need to control a disease, in conjunction with surgery, or after an event that increases the likelihood of disease.
The public health case for the legislation isn't just compelling, it's terrifying. The more we use antibiotics, the more bacteria evolve to resist them. And those resistant infections are claiming more and more lives. According to the Centers for Disease Control, 2 million Americans contract antibiotic-resistant infections every year, and 23,000 die from them. Many others die from conditions that were exacerbated by resistant bacteria. Increasingly, patients are showing up with infections that don't respond to multiple classes of antibiotics, and sometimes ones that don't respond to any antibiotics at all.
The CDC identifies a number of contributors to the rise of antibiotic resistance, including the over-prescribing of antibiotics by doctors. But livestock operations are the single biggest problem; 70 percent of the antibiotics that can be used in humans are actually sold for use on livestock. Drug-resistant bacteria in animals can be passed on to humans through the meat they eat. Even vegetarians aren't safe; if water or fertilizer containing waste from animals contaminated with drug-resistant bacteria is used on crops, the superbugs can also be passed along to humans through the vegetables they eat.
The public health community in Maryland is united behind the effort. The Maryland Hospital Association, Maryland Nurses Association, MedChi, the Maryland Academy of Family Physicians, the Maryland Pharmacy Coalition, the Maryland Public Health Association, the Nurse Practitioner Association and other groups either endorsed the bill as it was introduced or wanted a stronger version.
The federal government has taken some steps to regulate antibiotic use, for example by prohibiting their use to encourage growth, but there remain enormous loopholes that allow routine use of the drugs to prevent disease in animals. The odds that the anti-regulation Trump administration will strengthen those rules seem slim, so it's up to states to act. California was the first state to do so, and several others are considering it.
After much debate, Maryland's legislation was given preliminary approval in the Senate today . In the end, senators with close ties to the agriculture industry praised the bill, but only after its sponsors agreed to a series of amendments that weaken it somewhat. We hope the House of Delegates will restore tougher language on the use of antibiotics to prevent disease and more robust reporting requirements for the drugs' use. We need to be able to track what kinds of antibiotics are being used in what quantities, and having veterinarians report that information to the state Department of Agriculture is hardly onerous.
Regardless, the legislation moving through the legislature this year represents vital progress in protecting human health. We hope that the General Assembly will pass it, Gov. Larry Hogan will sign it, and other states will follow.