Health

Why Aren’t We More Worried? – Imogen Watson – Medium

Photo: Circle of Docs

What do antibiotics have in common with lead and cigarettes? A great deal, according to a closer look at trends in the advancements of public health.

One of the CDC’s ten great public health achievements from the last decade was the implementation of childhood lead poisoning prevention. Lead was used to improve the quality of paint and gasoline. Lead-based paint was banned in the United States in 1978. This came after almost a century of discussion and scientific research clearly linking lead exposure to severe problems with behavioural and neural development.

Similarly, research that demonstrated a link between tobacco products and horrible diseases was ignored or even countered by tobacco companies as they continued to heavily advertise their products.

Fast forward to today, and the fact that cigarettes were labelled as healthy or advertised to children is certainly shocking. And whether or not we act on this information, most of us are very aware of the health issues linked to smoking. The regulations on smoking haven’t quite reached those of lead, but the mindset of governing bodies has certainly changed, with a concurrent shift in public attitudes.

In both of these cases, conclusive evidence about the health effects of these substances was readily available long before anything was actually done about it. This delay was a result of two factors: money and industry.

Just as the health threats of cigarettes and lead poisoning weren’t taken seriously, the problem of antibiotic overuse, particularly in meat production, is being overlooked, or underestimated at best.

Antibiotic resistance was recently dubbed “one of the biggest threats to global health, food security, and development today” by the World Health Organisation (WHO). Antibiotic resistant strains of bacteria are a product of natural selection and random genetic mutation, which occurs at an alarming rate. Microbiologist Leslie Pray found that a population of disease-causing bacteria will divide once every 30 minutes, with a high rate of mutation. This ability to multiply incredibly quickly means that they are exposed to certain antibiotics, the greater opportunity there is for a resistant mutation of the bacterium to occur and multiply.

Antibiotics are included in animals’ feed in consistent, low doses to promote quick weight gain. Unfortunately, these conditions are also perfect for the promotion of the growth of resistant bacteria. If a chicken lives in a factory where it is exposed to high amounts of bacteria, antibiotics would be included in its feed to prevent them from being infected. However, over time, the bacteria that causes this infection may mutate enough that it is resistant to the bacteria, and will survive in the factory.

If a human then buys some of this chicken and is exposed to the bacterium in some way, they have a high chance of becoming ill. This person would likely need antibiotics to treat the illness. However, as the person has an antibiotic resistant strain of the food poisoning infection, the antibiotics they are given have no effect whatsoever.

How antibiotic use in livestock affects humans. Image from Microbe Wiki

These drugs are already overprescribed for humans, but it is their use in the meat production industry that is a more targetable contributor. “A lack of effective (use of) antibiotics is as serious a security threat as a sudden and deadly disease outbreak” claims the Director General of WHO, Dr Tedros Adhanom Ghebreyesus. This fact is being pushed aside, however, for the simple reason that the use of antibiotics has economic benefits for meat producers. Not only do large meat factories yield more meat through antibiotic use, they also save money and time. If antibiotics are a part of animals’ diets, they can survive in less-than-ideal conditions.

The CDC claims that 23,000 people die yearly from infections caused by antibiotic-resistant strains of bacteria in the United States, and it is predicted that by 2050 this phenomenon will cause around 10 million deaths globally, more deaths than cancer. This is clearly a huge issue, yet we aren’t nearly as afraid of antibiotic resistance as we are of cancer.

To fully understand how much of a threat antibiotic resistance, just consider how reliant we are on these drugs today. In the United States, 17934 transplants were performed in the first four months of this year alone. Around 1 in 10 babies were born premature in 2016. For both of these sets of patients, antibiotics are vital to prevent infections and keep the individuals alive. Antibiotics are also used in chemotherapy, childbirth, and most surgeries, as well as hundreds of common infections. As antibiotic resistance increases, the threat of antibiotics becoming useless is very real. This could result in an extreme deterioration of medical capabilities, with new developments in surgery unlikely to occur and the majority of procedures being deemed too dangerous to perform without antibiotics.

We’ve seen the effects of industry on government policy before, and the current debate surrounding antibiotic use is following a similar script. In the case of lead poisoning, the lead industry attempted to fool the public by celebrating their “implementation of certain regulations.” Tobacco companies shared this strategy of publicly celebrating miniscule changes.

Not only is this an obvious attempt by the industry to avoid facing the issue, it is very similar to what is happening right now. Figures of the meat industry does not deny the existence of antibiotic resistance in the information that they publish, but are quick to reassure the audience by acknowledging new regulations set in place by the US Food and Drug Administration (FDA), which banned the use of antibiotics purely for economic purposes.

These kinds of regulations seem progressive and targeted, which is why companies involved in the meat industry, such as the American Meat Institute and BEEF.com magazine, use it as a fall back. However, the current policies and regulations surrounding antibiotic use in the meat industry are inadequate, especially with the current rate of increase in antibiotic resistance. Farmers have come forward with claims that some producers surpass the new regulations by simply labelling the antibiotics differently and using them for the same purpose, indicating a huge loophole in the system.

Systemic faults are also seen in the distribution of responsibility between government agencies. The FDA, CDC and United States Department of Agriculture (USDA) all overlook food production, yet there are gaps and overlaps in the foods that they manage. Donald Trump recently announced plans to reform the food safety system, giving authority to the USDA.

Unfortunately, this brings to light new concerns about conflicting priorities, because the USDA also has a responsibility to promote agriculture. The USDA would find it incredibly difficult to increase food safety by banning antibiotic use if it means that they have to compromise economic gains in the agricultural industry. The system does require reform, but after more research and planning has been done.

Without jumping to the typical “big companies are bad” cliché, it is worth being aware of how much attitudes can change, and how much of an influence money has on otherwise logical reasoning. We waited in fear for superbugs to become a reality, and now there are over a dozen of them. The discussion has now turned to the day that we run out of new drugs to try or can no longer use antibiotics in any form, and I’m not sure that’s a fear I’m willing to “wait and see” about.What do antibiotics have in common with lead and cigarettes? A great deal, according to a closer look at trends in the advancements of public health.

One of the CDC’s ten great public health achievements from the last decade was the implementation of childhood lead poisoning prevention. Lead was used to improve the quality of paint and gasoline. Lead-based paint was banned in the United States in 1978. This came after almost a century of discussion and scientific research clearly linking lead exposure to severe problems with behavioural and neural development.

Similarly, research that demonstrated a link between tobacco products and horrible diseases was ignored or even countered by tobacco companies as they continued to heavily advertise their products.

Fast forward to today, and the fact that cigarettes were labelled as healthy or advertised to children is certainly shocking. And whether or not we act on this information, most of us are very aware of the health issues linked to smoking. The regulations on smoking haven’t quite reached those of lead, but the mindset of governing bodies has certainly changed, with a concurrent shift in public attitudes.

In both of these cases, conclusive evidence about the health effects of these substances was readily available long before anything was actually done about it. This delay was a result of two factors: money and industry.

Just as the health threats of cigarettes and lead poisoning weren’t taken seriously, the problem of antibiotic overuse, particularly in meat production, is being overlooked, or underestimated at best.

Antibiotic resistance was recently dubbed “one of the biggest threats to global health, food security, and development today” by the World Health Organisation (WHO). Antibiotic resistant strains of bacteria are a product of natural selection and random genetic mutation, which occurs at an alarming rate. Microbiologist Leslie Pray found that a population of disease-causing bacteria will divide once every 30 minutes, with a high rate of mutation. This ability to multiply incredibly quickly means that they are exposed to certain antibiotics, the greater opportunity there is for a resistant mutation of the bacterium to occur and multiply.

Antibiotics are included in animals’ feed in consistent, low doses to promote quick weight gain. Unfortunately, these conditions are also perfect for the promotion of the growth of resistant bacteria. If a chicken lives in a factory where it is exposed to high amounts of bacteria, antibiotics would be included in its feed to prevent them from being infected. However, over time, the bacteria that causes this infection may mutate enough that it is resistant to the bacteria, and will survive in the factory.

If a human then buys some of this chicken and is exposed to the bacterium in some way, they have a high chance of becoming ill. This person would likely need antibiotics to treat the illness. However, as the person has an antibiotic resistant strain of the food poisoning infection, the antibiotics they are given have no effect whatsoever.

These drugs are already overprescribed for humans, but it is their use in the meat production industry that is a more targetable contributor. “A lack of effective (use of) antibiotics is as serious a security threat as a sudden and deadly disease outbreak” claims the Director General of WHO, Dr Tedros Adhanom Ghebreyesus. This fact is being pushed aside, however, for the simple reason that the use of antibiotics has economic benefits for meat producers. Not only do large meat factories yield more meat through antibiotic use, they also save money and time. If antibiotics are a part of animals’ diets, they can survive in less-than-ideal conditions.

The CDC claims that 23,000 people die yearly from infections caused by antibiotic-resistant strains of bacteria in the United States, and it is predicted that by 2050 this phenomenon will cause around 10 million deaths globally, more deaths than cancer. This is clearly a huge issue, yet we aren’t nearly as afraid of antibiotic resistance as we are of cancer.

To fully understand how much of a threat antibiotic resistance, just consider how reliant we are on these drugs today. In the United States, 17934 transplants were performed in the first four months of this year alone. Around 1 in 10 babies were born premature in 2016. For both of these sets of patients, antibiotics are vital to prevent infections and keep the individuals alive. Antibiotics are also used in chemotherapy, childbirth, and most surgeries, as well as hundreds of common infections. As antibiotic resistance increases, the threat of antibiotics becoming useless is very real. This could result in an extreme deterioration of medical capabilities, with new developments in surgery unlikely to occur and the majority of procedures being deemed too dangerous to perform without antibiotics.

We’ve seen the effects of industry on government policy before, and the current debate surrounding antibiotic use is following a similar script. In the case of lead poisoning, the lead industry attempted to fool the public by celebrating their “implementation of certain regulations.” Tobacco companies shared this strategy of publicly celebrating miniscule changes.

Not only is this an obvious attempt by the industry to avoid facing the issue, it is very similar to what is happening right now. Figures of the meat industry does not deny the existence of antibiotic resistance in the information that they publish, but are quick to reassure the audience by acknowledging new regulations set in place by the US Food and Drug Administration (FDA), which banned the use of antibiotics purely for economic purposes.

These kinds of regulations seem progressive and targeted, which is why companies involved in the meat industry, such as the American Meat Institute and BEEF.com magazine, use it as a fall back. However, the current policies and regulations surrounding antibiotic use in the meat industry are inadequate, especially with the current rate of increase in antibiotic resistance. Farmers have come forward with claims that some producers surpass the new regulations by simply labelling the antibiotics differently and using them for the same purpose, indicating a huge loophole in the system.

Systemic faults are also seen in the distribution of responsibility between government agencies. The FDA, CDC and United States Department of Agriculture (USDA) all overlook food production, yet there are gaps and overlaps in the foods that they manage. Donald Trump recently announced plans to reform the food safety system, giving authority to the USDA.

Unfortunately, this brings to light new concerns about conflicting priorities, because the USDA also has a responsibility to promote agriculture. The USDA would find it incredibly difficult to increase food safety by banning antibiotic use if it means that they have to compromise economic gains in the agricultural industry. The system does require reform, but after more research and planning has been done.

Without jumping to the typical “big companies are bad” cliché, it is worth being aware of how much attitudes can change, and how much of an influence money has on otherwise logical reasoning. We waited in fear for superbugs to become a reality, and now there are over a dozen of them. The discussion has now turned to the day that we run out of new drugs to try or can no longer use antibiotics in any form, and I’m not sure that’s a fear I’m willing to “wait and see” about.


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