WASHINGTON, Nov. 30, 2016 - As he
heads out the door, President Obama will put in place two key parts of his
administration’s strategy to restrict the use of antibiotics in agriculture,
part of a broader strategy for fighting drug-resistant germs. But he’s also
leaving behind some proposals that could easily be reworked or spiked by the
incoming Trump administration.
By the end
of December, all on-farm usage of medically important antibiotics must take
place for the first time under the oversight of a veterinarian. And starting
next year, no antibiotics important in human medicine will be labeled for use
for growth promotion and feed efficiency.
The FDA is expected to publish a
series of notices in December formally approving the last of the drug
companies’ labeling changes, which are expected to be effective Jan. 1.
Following that date, only disease treatment and prevention will be approved
uses on animal antibiotic labels.
The twin actions, which stem from a
strategy that the administration first unveiled in 2010, should have a
“transformational impact” on the antibiotic resistance issue, said Sam Kass,
Obama’s former White House food policy adviser.
The administration came under sharp
criticism from consumer advocates for not mandating that companies remove
growth promotion from antibiotic labels. The label changes were undertaken
voluntarily at FDA’s request. But the end result was the same. All companies agreed to end the sale of the
drugs for growth promotion, and that effectively ends such usage,
according to Michael Taylor, who stepped down earlier this year as FDA’s deputy
commissioner for foods.
“It is sometimes disparaged as a
voluntary process,” he said of the labeling changes. “The only thing voluntary
about it was the alignment around the goal that the industry and producers both
realized needed to be achieved, which was that you’ve got to move past this
ancient, anti-public health technology to a place that is better, that
consumers will accept.”
Taylor sees little chance that the
industry will reverse these major initiatives. “There’s very little incentive to turn backwards on this issue given
where the market is and consumers are. It’s a global phenomenon.”
Indeed,
earlier this fall, McDonald's
announced that all of the chicken it is buying now has been raised
without the use of medically important antibiotics. Meanwhile, Smithfield
Foods, Tyson Foods and other major U.S. and foreign livestock producers agreed
to a statement that lays out a series of steps to reduce the use of
antibiotics, including ending the use of antibiotics for growth promotion in
countries where it continues to be permitted. The statement also calls for
improving reporting on antibiotic usage and the development of new practices
and products to replace the use of antibiotics. The statement came out even as the
United Nations formally
called on all countries to have national action plans to fight
antibiotics resistance.
Harry Snelson, a spokesman for the American Association of
Swine Veterinarians, said the requirement for veterinarian approval to use
antibiotics will be a change for producers but there appears to be broad
awareness of the coming rule. He said the use of antibiotics for growth
promotion, which will effectively be banned in January, has been declining for
some time. “In most cases, veterinarians
and producers are resigned to that (usage) going away,” he said.
Another major step that the FDA took under Obama was
to begin reporting each year on sales of antibiotics for food animals. The reports, the first of which was required in 2010 in
response to a law Congress passed in 2008, have since doubled in size to 58 pages
as FDA has added new data requirements. FDA isn’t finished: In May, the agency finalized
a rule that will require companies to begin
providing estimates of sales broken down by animal species – cattle, hogs,
chickens and turkeys. FDA says the data would “help further target efforts to
ensure judicious use of medically important antimicrobials.”
The administration also is trying to
ramp up on-farm monitoring of antibiotic usage to determine to what extent
resistance may be occurring in agriculture, but Taylor is concerned that the
department may not get the necessary money. Congress hasn’t funded the
initiative, although some money could eventually be included in USDA’s fiscal
2017 budget, which likely won’t be finalized until next spring. The monitoring
is needed to verify “changes in the use of these drugs to actual reductions in
resistance over time. That’s the public health goal of this whole exercise,”
Taylor said.
As Donald Trump’s new administration
takes charge in 2017, the drug companies could focus on limiting some of the
reporting requirements that Obama has implemented. “We are taking a look at
regulatory changes to see if there are suggestions we can make for greater
efficiency. The issue of reporting is an area that needs attention,” said Ron Phillips, vice president of
legislative and public affairs for the Animal Health Institute, which
represents the drugmakers. “We have
long advocated for a science-based, well-thought out system of reporting all
uses of antibiotics that would help users become better and more efficient. Current sales reporting meets none of these
criteria.”
The new FDA leaders also could address concerns
about the veterinarian oversight requirement. The National Grain and Feed
Association and the American Feed Industry Association in August petitioned FDA for relief,
saying most vets lack personnel and resources needed to implement and maintain
the computer systems.
Another issue Obama’s FDA is leaving behind is the
idea of setting limits on how long some antibiotics can be given to livestock
and poultry for treatment of infections. There are currently no time
limits on some uses of the drugs. The agency in September said that it would solicit industry and public input on what the
limits should be. (The deadline for
comments
to be filed was extended this week to March 13.) The drugs the agency is
looking at include tyrosine and chlortetracycline.
AHI
hasn’t filed its comments yet, but Phillips said that any new usage
limits should be "driven by science and recognize that all of these
products will be used only under the direction of a veterinarian."
Environmentalists
and consumer advocates have also
petitioned FDA to stop seven classes of antibiotics from being used for disease
prevention, including macrolides, penicillins and tetracyclines. But that plea
is almost certainly going nowhere in a Trump administration.
#30
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