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Ah, to be in Denmark

March 19, 2012 - The World Health Organization (WHO) announced last week that antimicrobial resistance (AMR) to antibiotics could well put an end to the practice of modern medicine.  Dr. Margaret Chan, WHO's Director-General, told participants at an EU health conference that AMR is exacerbated by three current global conditions: inappropriate use of antibiotics in humans and animals, increasing world travel, and lack of development of new drugs.  Rates of death among patients infected with drug-resistant germs is on the rise.

In 2010, there were 650,000 cases of drug-resistant tuberculosis worldwide.  (If I am remembering correctly, the increase in tuberculosis was first observed in Russian prisons, and in Russian AIDS victims.)  As a result, only an extremely expensive, prolonged battle is capable of curing as many as 50% of these cases.  The drugs used are toxic, and in constant short supply.  Other illnesses are drug resistant as well, in some cases unresponsive to all available treatments.  Hospitals in some locales are the last place anyone would want to go.  They "have become hotbeds for highly resistant pathogens, like MRSA, ESBL, and CPE," according to Chan.

Chan was also quick to praise Denmark's new/old approach to raising farm animals, without the use of antibiotics.  Alert to the possibility of antibiotics resistance, the elimination of antibiotics as growth promoters began in Denmark in the late 1990s.  A WHO international review panel concluded the Danish ban reduced human health risks without harming farm animals or reducing farm incomes.  Industry and government data suggest that livestock production has since increased.  Best of all, AMR has declined.  Prominent organic veterinarian Hubert Karreman has been quoted as saying that animals can be kept healthy through better sanitation, a high forage diet, and exercise.  Antibiotics are unnecessary when an organic regimen is put in place.

Karreman's observations regarding sanitation are particularly relevant, since industrial farms rely upon intensive crowding of farm animals.  The effects of this inhumane treatment have been written about extensively.  Not the least of these is the easy transmission of disease; the proliferation of germs is accelerated by the filthy conditions all too commonly found at industrial farms.  The book The CAFO Reader: The Tragedy of Industrial Animal Factories, describes this problem at length. 

Here in the United States, the Food and Drug Administration (FDA) proposed a partial ban on the use of cephalosporins in farm animals back in January.  While providing the appearance of doing good, the ban would, in fact, accomplish very little, since cephalosporins make up less than one percent of total antibiotics used in American livestock.  (It should be noted here that 80% of all antibiotics in the US are used for growth promotion in farm animals.)  Public health advocates hastened to point out that the token measure would do little in the way of combating the increase in antimicrobial-resistant diseases.  The proposal is therefore meaningless, particularly in light of the fact that the use of cephalosporins is already on the decline in the United States!

Gail Hansen, of the Pew Campaign on Human Health and Industrial Farming, said that by ceasing to administer many classes of antibiotics, less powerful bacteria are encouraged to move in to fill the void.  The increase in more powerful bacteria is not inevitable.  She further warned, however, that American farmers must take the elimination of powerful antibiotics as growth promoters very seriously.  Veterinarian Dr. Karreman asserts that when a conventionally farmed herd is converted to organic methods, the farmer's vet bill is typically reduced between 70 and 75 percent.  Since we all know this is ultimately about money, why the delay?  Antibiotics have proven to be a tremendous boon to both humans and animals alike.  It pays to use them only when they are needed to treat illness.

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