Obama antibiotics plan calls for monitoring farms, drug usage

By Philip Brasher

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WASHINGTON, March 26, 2015 - A White House strategy for fighting antibiotic resistance calls for studying the extent of the problem on farms and lays out plans for developing new drugs that producers can use more safely.

The plan, being released Friday, affirms the steps the Food and Drug Administration has taken to phase out the use of medically important antimicrobials for growth promotion, through the voluntary cooperation of drug makers, and to require veterinary oversight of all other uses of the antibiotics.

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It does not set targets for reducing drug usage but includes plans for monitoring the impact of the voluntary strategy and analyzing the extent of resistance on farms.

The 63-page National Action Plan, which also addresses human use of the drugs, says the five-year strategy “will lead to major reductions in the incidence of urgent and serious” disease threats.

“All of us who depend on antibiotics must join in a common effort to detect, stop, and prevent the emergence and spread of resistant bacteria,” says the plan, which builds on the recommendations of a report released in the fall fall by the President's Council of Advisors on Science and Technology.

Much of what is in the plan has already been under discussion or portions were included in President Obama's fiscal 2016 budget proposal, including an on-farm monitoring plan that has raised some concerns from livestock producers who are concerned about anonymity.

The strategy also includes a three-year goal to collect data on antibiotic use and resistance in food-producing animals and to measure the impact of industry stewardship programs.

The plan also details several research goals. Within three years, USDA-funded research teams are to develop three possible alternatives to antibiotics that are now used for growth promotion. The drugs are supposed to avoid the guts of food animals while enhancing animal immune systems and resistance to disease.

Within five years, the goal is to develop alternatives to antibiotics that can be used to treat at least three priority bacterial pathogens.

The plan also sets goals for educational efforts aimed at promoting better stewardship of existing antibiotics. 

Public health advocates have criticized FDA for not going further in banning non-therapeutic uses of medically important drugs instead of relying on the cooperation of companies.

The administration's strategy “ignores clear evidence that the use of medically important antibiotics for routine disease prevention creates a public health risk that is identical to those posed by routine use for growth promotion,” said Steve Roach, senior analyst with the advocacy group Keep Antibiotics Working. “Drug makers regularly exploit this loophole by advertising the growth benefits that can result from using antibiotics for disease prevention and FDA has failed to crack down on this practice.”

FDA is to begin publishing periodic updates summarizing progress in the phase-out of growth-promotion drugs. Administration said that the phase-out would effectively ban growth-promotion usage since drug makers had agreed to cancel that as an approved purpose.

The plan leaves a lot of details to be filled in, such as what are the “appropriate metrics” that should be used for gauging the success of industry stewardship efforts. Those metrics will be the key, said Liz Wagstrom, chief veterinarian for the National Pork Producers Council. “Stewardship is about appropriate use, and not about just volume of use,” she said.

She also said that research needed to be focused on alternative production and vaccination strategies, not just new antimicrobial products. That is likely USDA's intent but it is not spelled out clearly, she said.

USDA has requested $10 million from Congress in fiscal 2016 for the on-farm monitoring of antibiotic resistance. “There is an assumption by some that farm practices constitute the biggest problem with antimicrobial resistance, but we're not sure that's exactly true,” Kevin Shea, administrator of USDA's Animal and Plant Health Inspection Service, told a House committee earlier this month.

 

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