23,000 Deaths Every Year in U.S. Alone: The Alarming Rise of Antibiotic Resistance

The United Nations gathered Wednesday to address the alarming rise of antibiotic resistance at a day-long meeting in New York. The U.N. General Assembly, made up of delegates from 193 countries, has only convened health-related meetings on three other issues: Ebola, HIV, and noncommunicable diseases. According to the World Health Organization, which collaborates with the U.N. on health-related priorities, “Antimicrobial resistance has become one of the biggest threats to global health, such as human development.” At this high-profile meeting, Heads of State and Heads of Delegations addressed the urgency of the situation and discussed multisectoral approaches to addressing antimicrobial resistance. This U.N. meeting elevated the discussion to a historic level and led to the approval of a declaration, but did not result in legally binding actions and failed to include language to eliminate excessive antibiotic use in animal agriculture.

In an interview with Vox, Kevin Outterson, Professor of Law at Boston University, stated that “it has taken 15 years to get [antimicrobial resistance] back on the global agenda” since the UN last tried to take action in September 2001. Experts are warning that we may be entering or have already entered a post-antibiotic era and immediate global action must be taken.

The development of resistance by bacterial, viral, and fungal microorganisms to antimicrobial medicines is primarily due to management practices, the improper and overuse of these medicines in human, agriculture and aquaculture, as well as antimicrobial residues that make their way into water, soil, and crop systems. In the U.S., antibiotic-resistant microorganisms cause over two million illnesses and approximately 23,000 deaths each year as a direct result of antibiotic-resistant infection. Many more people fall ill or die from other conditions that were complicated by an antibiotic-resistant infection.

The vast majority of antibiotics sold in the U.S. are given to non-organic livestock. According to Physicians for Social Responsibility, the non-therapeutic use of antibiotics in livestock production accounts for nearly 80 percent of all antibiotics used in the United States. Typically, low levels of antibiotics are administered to animals through feed and water to prevent disease and promote growth. This is generally done to compensate for overcrowded and unsanitary living conditions, as is common in concentrated animal feeding operations (CAFOs), and to fatten livestock to get them to market sooner. This process increases the risk of infectious disease outbreaks that would be averted under living conditions appropriate to each species.

Under the Organic Foods Production Act, certified USDA livestock producers cannot use growth promoters and hormones, whether implanted, ingested, or injected, including antibiotics. Additionally, certified USDA Organic livestock producers cannot use subtherapeutic doses of antibiotics, meaning they cannot administer low-dose antibiotic treatments that are not for the purpose of treating sick livestock. The standards also require that producers maintain living conditions that prevent infectious diseases from becoming established and adversely affecting livestock health.

In the spring of 2014, the National Organic Standards Board voted to uphold the phase out in apple and pear production of the antibiotic streptomycin, which was set to expire on October 21, 2014. This vote came after a similar proposal to extend an exemption for oxytetracycline, another antibiotic used in apple and pear production, was rejected at the spring 2013 NOSB meeting. Beyond Pesticides, with other organizations, led the effort to remove antibiotics from organic apple and pear production because of their contribution to antibiotic resistance, organic consumer expectation that antibiotics are not used in organic food production, and the availability of alternative practices and inputs.

Additionally, the wide use of triclosan, an antibacterial in antimicrobial soaps and personal care products, also has led to an increase in bacterial resistance. In a decision that was long overdue, on September 2, 2016, the Food and Drug Administration banned triclosan in soaps, while EPA continues to allow for its use in common household products and toys. Beyond Pesticides raised concerns about the health effects of triclosan in 2004 in its piece, The Ubiquitous Triclosan, and petitioned the agency to ban the chemical in 2005. In 2015, triclosan was banned in the European Union. For nearly two decades, scientific studies have disputed the need for the chemical and linked its widespread use to health and environmental effects and the development of stronger bacteria that are increasingly difficult to control.

For more background, see Beyond Pesticides’ triclosan page.