Five Minutes with Dr. Michael Apley: Will using antibiotics in animal agriculture kill you?

In just over a week the National Institute of Animal Agriculture will host a seminar designed to bring sanity to a subject that threatens to create a stampede among the general public. The snarling wolf pack circling the herd claims the use of antibiotics in animal agriculture will inevitably lead to a race of  smart ‘superbugs" that will be almost completely drug-resistant and force us back to fighting infections with the tools of the Middle Ages. 

It's an argument that has been lurking in the background for at least a quarter century.  Until recently, it could be likened to a slowly simmering pot of pseudo-scientific stew but the heat has been turned way up and that pot threatens to reach a full boil.  Proponents have taken bits and pieces of the science and jumped to conclusions that require unfounded leaps of faith. No matter; the public has reacted with concern and retailers, faced with selling product on trust (not necessarily fact), are reacting.

Earlier this week, Subway announced a ten year plan to rid their 27,000+ stores of meat from animals treated with antibiotics. It was announcement that delighted groups like the Natural Resources Defense Council, Friends of the Earth, Center for Food Safety, U.S. Public Interest Research Group and notoriously anti-science food blogger Vani Hari, also known as the Food Babe.

Subway joins Chipotle and Panera, two chains that have already said they will begin serving meat raised without antibiotics.  McDonald's is slowly switching to antibiotic-free chicken.  Expect several more restaurants and supermarket retailers to knuckle under soon.

In an interview published by Swinecast recently Dr. Mike Apley, a speaker at the symposium, said "We're all coming to the same conclusion, at the same time. Animal agriculture, veterinarian medicine, human medicine… we are all seeing that our new antibiotic pipeline is going to be much, much more limited."

Apley is concerned that the issue not advance to an ‘Us vs Them" shooting war.  Concerned that when shots are fired, truth is the first casualty, he's urging a ‘Come, let us reason together" approach.  It's something that will bring sane people to the table and create an open dialogue.  Those anti-animal ag folks wishing to end all animal ag at any cost?  They'll continue to stand outside the bigger tent and lob grenades.

Apley knows that getting agreement from all parties will be akin to the long, drawn out process behind finalizing the Trans Pacific Partnership. It will be difficult, many partners might become grudging participants and it might be d.o.a.  The Symposium and the opportunity it presents, he says, is important to furthering the discussion and reaching a rational consensus.

What are the facts?  What does the Symposium hope to accomplish?  Will the use of an antibiotic today to help end an infection in a calf unleash a submicroscopic avalanche of genetic modifications that will kill your grandchildren in 20 years?  I posed a few questions to the Doc.

Q. On the issue of antibiotics used in animal agriculture, let's start with a 'compare and contrast.'  Is a CAFO using the same meds on cattle as my doctor prescribes for me and my family?  To state the concern felt by many in the general public, does a cow and my child share a Z-pack when they get the sniffles?

A. A Z pack is part of the macrolide class.  We use many macrolides in food animal practice. They are similar enough that there can be cross resistance between the macrolides used in human medicine and in food animals.  This is also true for many of the antibiotic classes we use in food animals. That's the fact. However, it is completely irresponsible to imply that there is evidence that the use of macrolides in food animals has any effect at all on the ability of azithromycin to be effective in treating a Streptococcus pneumoniae infection in human pneumonia.  If there is evidence of this, I've completely missed it. That is why it is so necessary to have this discussion related to specific pathways and where there may or may not be a relationship.

Q. When you were interviewed by about your participation in the upcoming NIAA-hosted Antibiotics Symposium to be held in. Atlanta, November 3-5., you said "the Symposium's purpose of working to build a bridge between animal health and human health is important for both mutual fact-checking and to build relationships. We are all in this together. We can learn a lot from how each is approaching this. We can't let this break down into Us vs. Them, with lines drawn. We have to make sure we are talking about things together."  There are some militant groups that will never be part of the ‘come, let's reason together' concept.  Who are you trying to create a dialogue with and how can you handle those who will not come to the table?

A. My intent is to create and continue our dialogue with regulators, legislators, and those who sell the food we produce. There are groups who are only using the antibiotic issue as they used issues such as welfare, and environment, in an attempt to add cost to the food animal industries and eliminate animal protein from the American diet.  I have every intention of creating and expanding dialogue with groups who honestly have public health as their foremost issue in their agenda.  Some consider the use of antibiotics in food animals is a moral issue, where it is just morally wrong that we should use them at all. I am obviously not in that camp, but do believe that we have an obligation to use them only when they will produce a positive effect on the health and welfare of the animals under my care.  We should also only use antibiotics in food animals when there is minimal risk of causing any negative impacts on public health. I believe there are many applications of antibiotics in food animals which meet these two criteria. I also believe there places we can do better.

Here's the big concept. If we're doing something in food animals that clearly jeopardizes human health, we need to stop it. However, I refuse to accept the removal of valuable tools for protecting the health and welfare of food animals in the name of public health in cases where there is little or no evidence of any potential harm to human health and the removal will cause huge issues related to animal welfare and economic loss for food animal producers.

Q. Retailer participation in the Symposium will be important. Craig Wilson, Vice President of Food Safety and Quality Assurance at Costco, summed up their concerns when he said "Costco has been involved in this conversation for a long time. Consumers are very concerned with antibiotics even though they might not fully understand them."

Indeed, pressure is mounting on retailers who are starting to react by searching for sources of 'never, never' meat; products that have never been treated with antibiotics.  How will this Symposium help them make the best decisions for their businesses?

A. I hope we can focus on and make more transparent the actual resistance issues in both human and veterinary medicine. Then, we can look at specific antibiotic uses in relation to pathogens of concern. What we are really talking about is who bears the burden of proof. Should regulators be required to prove that there is a clear harm to public health before drugs are removed? Or, should we open the books and require veterinary pharmaceutical firms and/or the food animal industry to prove absolute safety in order to keep these valuable tools? 

That is the real issue boiled down to the basic components. As usual, the best path forward is most likely a compromise between those two views. It is reasonable to protect public health. It is also apparent that requiring proof of zero risk is only a thinly veiled attempt to create an impossible threshold.

Q. One of the most active foes of the current state of use of animal antibiotics is the Natural Resources Defense Council. They say "Drug-resistant bacteria can and do travel on meat but that's just one of many routes off the farm."


What's even worse, they claim "Antibiotic-resistant bacteria can teach other bacteria how to be resistant; this knowledge can even be passed on from harmless bacteria to pathogenic bacteria."  Should we be worried that we're facing a battle with smart pathogens?

A. This type of language is an attempt to oversimplify a very complicated issue. I will not debate at all that foodborne pathogens exist and that resistance genes can move into the environment from anywhere antibiotics are used, including the human population.  As to how to handle this issue, see my answer to your previous question. Our challenge is taking a very complicated scientific issue and boiling it down to soundbites that can be used by consumers to evaluate the issues.  Unfortunately, I see a trend on several fronts to just ignoring the complicated issues and moving forward with policy or retail strategies that are based on the wisdom of social media and the University of the Internet.

Q. Early this month, California's Governor Jerry Brown signed SB 27, a bill regulating the use of animal antibiotics.  He said the bill "addresses an urgent public health problem. The science is clear that the overuse of antibiotics in livestock has contributed to the spread of antibiotic resistance and the undermining of decades of life-saving advances in medicine."

He was reversing his position last year when he vetoed a similar measure because he believed it was unnecessary. Has the science become clearer in the past 12 months or was he bowing to political pressure?

A. Again, the need to boil a complicated issue down to a voter-pleasing sound bite severely undermines our ability to have an intelligent discussion.  To imply that food animal antibiotic uses are linked to resistance across all human resistance challenges is irresponsible and only serves to polarize the discussion. 

Q. A report released by the Center for Food Safety (CFS) this past week seeks to expand the antibiotics debate. Titled "America's Secret Animal Drug Problem," it addresses beta-agonists, steroid hormones, antioxidants, antibiotics arsenicals, and cocciodiostats." 

The report threatens to paint animal agriculture as seriously drug-addicted, saying the industry "uses over 450 animal drugs, drug combinations, and other feed additives to promote growth of the animals and to suppress the negative effects that heavily-concentrated confinement has on farm animals."  Should we be taking a much wider look at our use of drugs?

A. Drugs that are approved for use in food animals have undergone an approval process where environmental safety, food safety, target animal safety, target animal efficacy, and other technical sections have been addressed. The microbial safety component of food safety has advanced dramatically over the last 15 years. Any person is able to access the freedom of information summaries on drugs approved for use in animals and see summaries of the tests that were conducted in order to gain approval. 

It is interesting that an industry would be called out for using technology which has been proven safe and effective in the approval process to promote the health and welfare of animals under our care. It is also interesting that food animal producers are challenged for making their production more efficient, using fewer resources to produce safe and wholesome food for the consumers.  I'm happy to have the discussion about the safety and efficacy of these products.