Saturday, April 10, 2010

Many public health associations speak up about antibiotics

Many leading medical and public health associations have taken a strong stand in favor of sensible limitations on non-therapeutic antibiotic use in farm animals.

The leading bill, known as the Preservation of Antibiotics for Medical Treatment Act (PAMTA), would continue to permit veterinarians to use antibiotics to treat disease, but it would prevent farmers from using some classes of antibiotics on healthy animals in advance of illness simply to increase production.

The Union of Concerned Scientists has a nice summary of the concerns about non-therapeutic antibiotic use in farm production. Mainly, overuse of antibiotics may increase resistance, causing the medicines to work less well in the future when they are needed to treat diseases in people.

The list of medical and professional associations that support PAMTA includes the American Medical Association, American Public Health Association, American Academy of Family Physicians. This legislation is not a marginal environmental cause, but a very mainstream policy measure supported by sensible skeptical scientists and medical experts who have given it detailed scrutiny for reasonableness.

A notable omission from the list is the American Dietetic Association. According to information and correspondence provided by Ashley Colpaart, a long-time contributor to this blog, the Association's policy group considered a recommendation from the Hunger and Environmental Nutrition (HEN) practice group, but ultimately decided neither to endorse nor oppose PAMTA.

One issue in question is whether PAMTA is food safety legislation, since food safety issues are within ADA's purview but other environmental issues might be considered further afield. The CDC explains why it believes "antibiotic resistance is a food safety problem."

Another issue is that ADA reviewers may have thought mistakenly that the list of endorsers included only state affiliates of major public health associations, rather than the national offices. But, in fact, the most important national associations are on the list (it is an understandable mistake -- the state identification in parentheses is just the state where the national office is located).

For a long time, PAMTA has been opposed by the meat production industries and by the American Veterinary Medical Association, which has financial interests at stake. Among more independent public health and medical associations, the ADA's reluctance to take a position on this important and moderate legislation stands out like a sore thumb. Some years from now, if the serious concerns about antibiotic resistance are shown correct and these powerful medicines are weakened, ADA may be embarrassed about its lonely silence.


Anonymous said...

IMO this ban won't reduce the antibiotic resistance emergence much, which ultimately will force physicians to address their antibiotic use. As long as those on the human side of the fence can point their finger at those on the animal side of the fence and away from themselves, that will not occur.

The EU is farther down this path:

Antibiotic stewardship implementation in the EU: the way forward

Some PubMed results suggest that this issue is considerably more complex than it first seems on the surface. Witness:

Phillips I. Withdrawal of growth-promoting antibiotics in Europe and its effects in relation to human health. Int J Antimicrob Agents. 2007 Aug;30(2):101-7.

I suspect the economic consequences of such a ban are also complex. Those livestock ag segments with minimal use of growth promoting antibiotics will likely benefit from the economic consequence of reduced supply from those who currently are.

Rachel said...

thank you for this information. Yes, I agree that the ADA needs to take action as well!

EMR said...

It is a serious consideration and a cause of worry also.The use of antibiotics may not be the very right thing for consumption for some body conditions.