Public Health & Industrial Farm Animal Production: Setting the Record Straight

For years a groundswell had been building from a widespread group of experts and advocates in the areas of public health, environment, social justice, and animal welfare sounding the alarms about the serious problems industrial food animal production poses. But until the Pew Commission on Industrial Farm Animal Production (PCIFAP) decided to take on the politically controversial issue, there had never been a comprehensive examination of industry’s practices by such a respected and diverse panel of experts. Following a grueling 2½ -year discovery process, and despite several overt attempts by industry to discredit it, the Commission concluded that the scientific evidence was too strong and the public health risk too great to ignore and offered a series of consensus recommendations on how to repair our unsafe food animal production system.

The tone and timing of the AVMA’s 38-page response to the PCIFAP final report, 15 months after it was released, is quite telling. The document’s executive summary starts out by suggesting that the PCIFAP’s technical reports (published separately) were “biased,” and that, “the Pew report contains significant flaws and major deviations from both science and reality.” Another telling facet is that the “response” contains very little scientific citation to backup its rebuttal. It’s not a coincidence that this response coincides with the recent revelation that the Obama Administration supports the idea of banning the use of key antibiotics as growth promoters in food animals, which happens to be one of the PCIFAP’s key recommendations. Not to mention, this year’s version of the Preservation of Antibiotics for Medical Treatment Act (PAMTA) appears to have a much better chance of passing than in any prior year.

The AVMA depends heavily on its relationships with the animal agriculture, pharmaceutical and other industries. The AVMA’s attack on the PCIFAP final report smacks of being more like an industry-choreographed campaign to defeat PAMTA than a conscientious review of a hugely important document.

Two prominent veterinarians trained in public health are dismayed over the AVMA’s PCIFAP final response. One of those veterinarians is the PCIFAP’s vice chairman, Dr. Michael Blackwell. As the former dean of University of Tennessee’s College of Veterinary Medicine, a retired assistant U.S. surgeon general, and a former chief of staff at the Office of the U.S. Surgeon General, Dr. Blackwell’s expertise in both veterinary medicine and public health is undeniable.

Dr. Blackwell says he’s, “shocked over the fact that the AVMA did not try to learn the truth about the Commission’s work, even from one of its own members,” and “instead chose to write a response from the perspective of the industry.” Dr. Christine Hoang, assistant director for the AVMA’s scientific activities, confirmed that the writing group, selected by AVMA leadership, never reached out to Dr. Blackwell or even attempted to poll other members of the PCIFAP to clear up any questions they may have had with the final report recommendations. Dr. Blackwell pressed the AVMA to allow him to discuss the Commission and its report. However, he says the writing group only allowed him 20 minutes via phone to speak to six committees. Dr. Blackwell concluded that the AVMA was not interested in what he had to say. When asked why the AVMA writing group did not reach out to PCIFAP members, the AVMA’s CEO, Dr. Ron DeHaven, said that the writers felt discussions would not be productive, because they had reviewed the same data and came up with different conclusions. Dr. DeHaven added that a few of the AVMA writing group members, who had been contacted by the PCIFAP during its discovery process, felt that the PCIFAP final recommendations did not reflect information that they had provided the PCIFAP commissioners and believed that further discussion with PCIFAP members was not warranted.

In a letter to his Texas congressional representatives, another AVMA member, Dr. Raymond Tarpley, shared his disappointment with the organization’s stance on PAMTA:

“I am dismayed that my professional organization (the AVMA of which I am a member) has chosen to pursue a reckless policy that favors the misuse of critical antibiotic compounds for reasons other than medical necessity. Microbial resistance to loose and repeated antibiotic exposure for non-therapeutic reasons has been proven, and while the AVMA has apparently buckled to pressures from industrial animal agriculture, it is without doubt an unwise investment in the health of our animals and human population to continue to use these valuable compounds to promote industry profits at the expense of societal risk”

In a letter to the White House earlier this month, Big Food representatives tried to defend the use of antibiotics in food animals as growth promoters, using similar arguments that the AVMA laid out in its PCIFAP final report response. Industry continues to point to European data, collected by countries that banned the use of antibiotics for growth promotion in food animals several years ago, to bolster its claim that a ban in the U.S. would backfire and increase the number of sick animals. In its PCIFAP final report response, the AVMA claimed animal deaths and disease in Denmark rose following its ban, “requiring more therapeutic antibiotic use to treat the resultant diseases.”

Dr. Tarpley dismisses the AVMA’s interpretation of the Danish data:

“Contrary to statements by the AVMA, the ban on antibiotics in Denmark has been shown to have positive benefits for human and animal welfare, while not harming the industry. Their interpretation of the Danish data reflects the bias of the AVMA in the spin of data favorable to industry.”

Setting the Record Straight

It’s not just Dr. Tarpley who dismisses the AVMA’s findings on antibiotic bans. Last month, two Danish researchers from the National Food Institute at the Technical University of Denmark, Drs. Frank Møller Aarestrup and Henrik Wegener, submitted written testimony for a U.S. House Committees Rules hearing on PAMTA to, “set the record straight.”

“As you may be aware, representatives of organizations funded by U.S. agri-business have criticized and mis-represented the facts on the Danish ban of antibiotics since its inception.”

They explained that over the long-term, the ban on antibiotics for growth promotion in Danish pigs not only reduced antibiotic use by more than 50 percent but overall pork production has increased by 43 percent.

Despite its recognition that veterinarians should increase their coordination among physicians and public health professionals, the AVMA’s stance on public health prevention appears to be out of sync with the rest of the world. In video and audio recordings posted on the AVMA’s website, Dr. DeHaven kept using the the term “theoretical risk.”

“…the Pew Commission recommends the elimination of the use of certain antibiotics in animals based on a purely theoretical risk to human health.”

Recent statements from Dr. Frederick Angulo, a veterinarian himself and the Center for Disease Control and Prevention’s Deputy Chief of the Enteric Diseases Epidemiology Branch, appear to contradict Dr. DeHaven’s claim.

“There is scientific consensus that antibiotic use in food animals contributes to resistance in humans. And there’s increasing evidence that such resistance results in adverse human health consequences at the population level.”

There is overwhelming evidence documented not only in the PCIFAP’s technical report, Industrial Farm Animal Production, Antimicrobial Resistance and Human Health, which was conducted by experts at the Johns Hopkins Bloomberg School of Public Health, but in other peer-reviewed research conducted all over the world, that proves the use of antibiotics in food animals contributes to the growing pool of antibiotic resistance in nature. It is undeniable that low-dose use of antibiotics, (i.e., using it as a growth promoter in animals) leads to the selection of bacteria with resistance to many of the antibiotics doctors depend on to treat people for serious infections.

Dr. Blackwell didn’t hold back his disappointment in a letter that he recently sent to Dr. DeHaven regarding the AVMA’s refusal to recognize that animal agriculture is a major contributor to antibiotic resistance.

“To my knowledge, the AVMA remains the only major medical or public health organization not recommending changes in agriculture practices to help ensure sustainability where the use of antimicrobials is concerned. As a public health veterinarian I find this disconcerting and embarrassing”

Public Health vs. Cost Effectiveness

So why is the AVMA clinging to this term “theoretical risk?” Here lies one of public health’s biggest conundrums. The goal of public health professionals is to take all reasonable efforts to protect people from preventable diseases. Often times reasonable can be defined as cost effective. The big question, especially now as the health care reform debate rages on across the country, is whether preventative health care measures are cost effective? If you’re only focusing on quarterly returns and immediately measurable public health benefits, the answer most likely is no. This is especially true in the eyes of Big Ag, because it’s going to cost money upfront to retrofit all of those industrial farms that are dependent on antibiotics to make up for the unhealthy conditions in which the animals we eat are produced. Not to mention, you can’t measure in a short period time how much money was saved due to public health disease prevention measures.

How do you measure the cost savings or return on investment in cases where an antibiotics ban prevented people from getting sick and going to the doctor or the hospital? We know a great deal about the costs of drug resistant infections in the United States in terms of health care costs, increased morbidity, and increased risk of death. Over longer periods of time we can measure whether doctor visits or reported illnesses are decreasing among certain populations or regions touched by industrial animal agriculture. Dr. Ellen Silbergeld, a nationally renowned expert in antimicrobial resistance and its relations to agriculture, and the lead author of the PCIFAP’s antimicrobial resistance technical report, says there is no question that removing antibiotics and other antimicrobials from animal feed will save money through reduced human medical costs. Dr. Silbergeld says based on multinational studies (ex. Austrian study) in Europe following the ban on antimicrobials in animal feeds, “there is clear evidence that this ban was associated with reduced prevalence of drug resistant pathogens in people in hospitals in the E.U.”

It doesn’t surprise me that researchers in Denmark found that Danish farmers initially saw increases in animal disease when the antibiotic ban went into effect. However, after farmers improved ventilation systems and gave the animals more space, within a relatively short period of time they found production actually increased while at the same time they greatly reduced the need for antibiotics.

When it comes to cost savings, particularly when you’re looking at environmental health cost savings, the PCIFAP argues that you have to take into account the externalized costs of industrial animal production. Right now Big Ag is very happy to let the public pick up the tab. Those externalized costs, among a host of other things, include increased environmental health risks from the introduction of antibiotic resistant bacteria like MRSA or novel viruses like the current H1N1 swine flu, particulate matter known to exacerbate asthma, the emissions of countless toxic gasses from enclosed barns and environmental pollution from excess nutrients (animal feces & urine) contributing to the dead zones in the Gulf of Mexico and choking the Chesapeake Bay. Don’t forget about the contamination concerns of nitrates and other pollutants in well water from all that liquid animal waste sprayed onto or pumped into the ground that is not agronomically absorbed.

The PCIFAP’s technical report entitled An Economic Analysis of the Social Costs of the Industrialized Production of Pork in the United States can be applicable in almost any public health prevention cost analysis. This particular analysis determined that when you consider several “external” costs of industrial hog production and subsidies, using the alternative and more sustainable hoop barn system costs about 25 percent less than the use of conventional concentrated animal feeding operations (CAFOs). (Ironically, without including externalities, CAFOs only have a 26-cents per hundredweight advantage over hoop barns.) Using the same equation that researchers devised for the PCIFAP economics report and inputting the externalized costs, we could get a glimpse at the potential cost effectiveness of an antibiotics ban for growth promotion in industrial food animal production in the U.S. The tough part is agreeing on what those externalized costs are and whether they can be attributed to animal agriculture — hence the reason for all of this industry obfuscation and attempts to misuse science to muddy the issues. The longer Big Ag can hold off on paying for upgrades and changes to the system the longer it can continue to make money at the public’s expense.

It’s interesting to note that Dr. DeHaven himself played a role in the PCIFAP’s early discovery process. During a 2006 meeting in Washington, DC Dr. DeHaven took part in a discussion panel consisting of several members of the

USDA invited to discuss their role in regulating animal agriculture. At the time, Dr. DeHaven was the head of the USDA’s Animal and Plant Health Inspections Service.

I sincerely hope that the 78,000 veterinarians, whom AVMA leadership say they represent, view the AVMA’s response to the PCIFAP final report with the same scrutiny as Drs. Blackwell and Tarpley. It’s a black eye on an incredibly important profession filled with some of the most brilliant people I know.