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Researchers propose limiting meat intake to keep antibiotics effective
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Researchers said that capping drug use in animals, imposing a user fee on the price of veterinary antimicrobials or limiting meat intake could reduce up to 80% of antimicrobial use worldwide by 2030.
According to Ramanan Laxminarayan, PhD, director of the Center for Disease Dynamics, Economics and Policy (CDDEP), and colleagues, inappropriate use of antimicrobials in animals is a leading cause of drug resistance in both humans and animals. The researchers estimated that 131,109 tons of antimicrobials were used in animals globally in 2013. If left unchecked, this number is projected to increase to 200,235 tons by 2030.
“This scale up in antibiotics, primarily as a substitute for good nutrition and hygiene in livestock production, is simply unsustainable and will be devastating to efforts to conserve the effectiveness of our current antibiotics,” Laxminarayan said in a press release. “We already face a crisis, but continuing to use medically important antibiotics for growth promotion in animals is like pouring oil on a fire.”
In a recent report published in Science, the researchers proposed three strategies that address the contribution of antibiotic use in animals to drug resistance. The first involves a global regulation that would cap the use of antimicrobials at 50 mg per population correction unit (PCU), which could reduce 64% of consumption by 2030. Laxminarayan and colleagues noted that this amount of antimicrobial use is currently employed by some Europeans countries with “highly productive” livestock sectors. They added that even if the regulation is implemented only in China and in countries belonging to the Organization for Economic Cooperation, the cap would still reduce 60% of global consumption without affecting vulnerable farmers in low- and middle-income countries (LMICs).
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The second strategy is to limit global meat intake to 40 g per day, which is the equivalent of one fast-food burger per person. This would reduce 66% of antimicrobial consumption in food animals by 2030. However, the researchers acknowledged that this is an “unlikely” strategy given that meat consumption averages 260 g per day in the United States alone. A more realistic cap of 165 g of meat per day could reduce 22% of global consumption by 2030.
Finally, the third strategy is to impose a 50% user fee of the current price on veterinary antimicrobials, which could reduce 31% of global consumption. This policy would generate yearly revenues of $1.7 billion to $4.6 billion. Alternative user fee rates of 10% or 100% could reduce 9% or 46% of global consumption while generating $0.4 billion to $1.2 billion or $2.8 billion to $7.5 billion in revenues.
“A modest user fee on the price on veterinary antibiotics is appropriate given the magnitude of the threat and could discourage livestock rearing practices that involve using large quantities of antibiotics,” Laxminarayan said.
If any of these policies are implemented, the researchers said that “major investments” in farm hygiene and veterinary services would be needed to compensate for reductions in antimicrobial use among animals in LMICs.
“We face a critical choice if we are to have antibiotics that work. We can restrict our meat consumption to a recommended daily intake, or adopt state-of-art livestock practices globally to reduce antibiotic consumption,” Thomas P. Van Boeckel, PhD, a postdoctoral fellow at the Swiss Federal Institute for Technology (ETH), said in the release. “We cannot have both without putting the health of future populations at risk.” – by Stephanie Viguers
Disclosures: Laxminarayan reports receiving support from the Bill & Melinda Gates Foundation. Van Boeckel is supported by an ETH postdoctoral fellowship and the program for Adaptation to a Changing Environment from ETH Zurich. Please see the study for all other authors’ relevant financial disclosures.
Perspective
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Herbert L. DuPont, MD
All achievable approaches that reduce unnecessary exposure of humans and animals to antibiotics will pay public health dividends in the face of the growing international crisis of antibiotic resistance. The three approaches offered by Van Boeckel and colleagues to reduce animal exposure to antibiotics are unique and would be helpful, but they have economic implications that will limit interest to those who have to carry out the plans. There may be intermediate steps to take before asking for a limitation in consumer consumption of meat and taxing companies for antibiotic use. We are making headway in the animal use of antibiotics by removing from animal use any antibiotics or antibiotic classes used in human medicine. Use of antibiotics for growth promotion is decreasing and should be stopped.
I believe the problem of inappropriate use of antibiotics in humans is more fundamental to the crisis at hand and would like to see the development of effective ways to monitor antibiotic use, to restrict use of high risk drugs to specific diagnoses and to require doctors to select an approved drug for a condition being treated. Antibiotics should not ordinarily be available for treatment of nonstreptococcal pharyngitis, postviral bronchitis, acute nonfebrile sinusitis and flu-like illness of presumed viral cause.
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