Serving Up A New Bird
Major corporate players McDonald’s, Tyson Foods, and Chick-fil-A bring about major changes in the quest to preserve lifesaving antibiotics.
McDonald’s has been an American icon for generations, its golden arches familiar to even the youngest of children. Now, the fast-food giant is set to become a symbol of a new and critically important movement in public health. Over the next two years, when Mickey D’s customers order chicken sandwiches, Chicken McNuggets, or any other chicken item on the menu, they’ll be among the first of the chain’s 27 million daily visitors in the United States to get something with a subtle but important difference: The chicken will have been raised without any of the antibiotics that are used in human medicine. The change might go largely unnoticed by McDonald’s customers, but the company’s decision is a huge victory in the effort to curb the growth of antibiotic-resistant superbugs.
McDonald’s is among a handful of high-profile companies, along with some large school districts and hospitals, that are helping to lead a movement to curtail the use of medically important antibiotics in food production. In late April, Tyson Foods, the nation’s biggest chicken producer, pledged to stop using human antibiotics in its flocks by the end of September 2017. Tyson raises some 2 billion birds annually, about 21 percent of the U.S. market. In a statement, Tyson says that it stopped using all antibiotics in its 35 broiler chicken hatcheries in 2014 and has scaled back the use of human antibiotics to treat chickens by more than 80 percent since 2011. The company is forming working groups with independent farmers and others in its beef, pork, and turkey supply chains to forge ahead with reducing human antibiotic use in cattle, pigs, and turkeys as well.
McDonald’s and Tyson’s moves follow last year’s promise by the fast-food chain Chick-fil-A to convert 20 percent of its poultry supply to a “no-antibiotics-ever” policy for 2015. The company also is working with its suppliers to make its entire poultry supply antibiotic-free by 2019. Also, in 2014, Perdue Foods, one of the country’s leading chicken-processing companies, announced that it was eliminating the use of antibiotics in its hatcheries. (The company stopped using antibiotics for promoting the growth of its birds in 2007.) In January of this year, Perdue also announced that it has introduced antibiotic-free chicken products for school lunch programs and has committed to a no-antibiotics-ever policy for additional school lunch items sold under various labels.
In late May, Wal-Mart, the nation’s largest grocery store chain, said it would ask its poultry, meat, seafood, dairy, and egg suppliers to report annually on their use of antibiotics following the principles of the American Veterinary Medical Association. And in June, the White House convened its first forum on how to combat antibiotic resistance. The meeting, which Pew experts participated in, included 150 food producers, agriculture groups, and public health organizations, and showed a new focus on the issue by the federal government.
“This is unprecedented change in a relatively short amount of time,” says Elizabeth Jungman, director of Pew’s public health projects. “This changes how chickens will be produced for Americans and marks real progress for consumers’ health.”
For decades, poultry and meat producers have been using antibiotics that are essential for people’s health to help promote the growth of their farm animals. Scientists explain that overuse of these medically important antibiotics enables germs to encounter them repeatedly in the environment and, over time, to become superbugs, by developing mutations that make them resistant to the drugs. People can be exposed to these bugs in soil and groundwater that is fouled with animal waste as well as through contaminated meat.
Since 2008, Pew has been working to raise awareness about the threat antibiotic resistance poses to public health and to encourage policies that phase out the overuse and misuse of these lifesaving drugs. “We’re asking animal producers to use antibiotics as a last resort and not the first option,” says Gail Hansen, a veterinarian and former public health officer who works on Pew’s antibiotics project. “Right now, antibiotics really are a shortcut, allowing producers to overcrowd animals and keep them in dirty conditions. It’s a total waste of lifesaving antibiotics to use them to get the animals to slaughter more quickly.”
Pew worked closely with McDonald’s prior to the company’s recent announcement and has helped forge key relationships with school districts that are changing their chicken-buying habits. “Pew shared their thoughtful point of view on responsible antibiotic use policies, which helped to clarify and reinforce our position,” says Jill Manata, vice president for global public affairs and corporate social responsibility engagement at McDonald’s. “Our customers want food they feel good about eating and that they know is sourced responsibly. Knowing that this is important to our customers only made our decision easier to make.”
Early Warning Signals
Fears about antibiotic resistance date back to the 1940s. Alexander Fleming, the Scottish scientist who won the Nobel Prize in 1945 for his discovery of penicillin, predicted that misuse of his wonder drug in low doses could lead to bacterial resistance. Within a decade, the emergence of penicillin-resistant bacteria proved Fleming’s warnings prescient. By 1969, the Swann Report on the use of antibiotics in animal husbandry and veterinary medicine in the United Kingdom documented the growing threat of multidrug antibiotic-resistant bacterial strains. The report concluded that “the use of antimicrobials in food animal production, especially when used in growth promotion, is of great concern and that limiting factors should be put in place to secure the use of antibiotics of greatest importance in human administration for therapeutic uses only and in some cases [exclude them from] animal use altogether.”
Half a century later, the reason for concern has become clear. Each year, at least 2 million Americans develop antibiotic-resistant infections, and at least 23,000 people die as a result, according to the Centers for Disease Control and Prevention. Health care experts fear that if the trend goes unchecked, modern antibiotics could become largely ineffective in treating even the most common and curable microbe-borne illnesses.
Ironically, only a fraction of the world’s lifesaving antibiotics are used in human medicine. A Pew analysis of data from the U.S. Food and Drug Administration shows that 7.7 million pounds of antibiotics were sold to treat sick people in 2011, compared with 29.9 million pounds sold for food animal production—a number that rose to 32 million pounds in 2012. An FDA report found that between 2009 and 2013, domestic sales and distribution of medically important antibiotics approved for use in food animal production grew by 20 percent.
Antibiotics have been used in food production in several ways. In chicken hatcheries, antibiotics are injected into eggs to prevent bacteria from getting in during vaccination and causing disease when the chicks hatch. Chicken, cattle, and pigs are routinely fed small amounts of antibiotics to promote growth. Another type of routine antibiotic use in livestock involves feed additives called “ionophores,” which are thought to increase feed efficiency by as much as 10 percent. Ionophores are not used in human medicine and have not been found to result in resistance to medically important antibiotics.
Antibiotics also are used in livestock husbandry for veterinary-prescribed treatment of sick animals and flocks. Companies that committed to a no-antibiotics-ever purchasing policy, such as Chick-fil-A, say they will not buy meat from animals that have been treated with antibiotics for the health and welfare of the animals. Treated animals can still be sold in other food supply chains. McDonald’s does not have a no-antibiotics-ever policy; instead, the company has committed to avoiding the use of medically important antibiotics and still plans to buy from suppliers that use ionophores for flock maintenance.
Routine use of antibiotics in food animal production began in earnest in the 1950s, when farmers raising domestic livestock for food production observed increased growth rates in chickens and pigs when antibiotics were added to the grain mash. In the 1970s and 1980s, industrialized agriculture intensified the demand for faster-growing animals, which led to an expansion of intensive feedlots and altered the animals’ diets, making them more vulnerable to some diseases. This created a surge in the use of antibiotics for both disease prevention and treatment. Maintaining cattle, chickens, and pigs on low doses of antibiotics for growth promotion and disease prevention became the industry’s way of doing business.
With that in mind, Pew, in partnership with the American Academy of Pediatrics and the Keep Antibiotics Working coalition, created a working group of more than 50 health, medical, and consumer groups to share ideas, forge alliances, and advocate for appropriate animal stewardship and use of antibiotics. The working group has met with FDA experts to spur regulation of antibiotic use in the animal food production industry—some of the first traction on the topic in nearly four decades. Those moves include FDA taking the first steps to end the use of medically important antibiotics for growth promotion by the end of 2016 and to ensure veterinary oversight of all remaining uses in animal feed and water. The next step is further action to address routine antibiotic use for disease prevention or control in healthy animals, according to members of the working group.
Because the livestock industry has been so heavily dependent on antibiotics since the 1950s, phasing them out takes time, Hansen says. “Modern farming in the United States makes such extensive use of antibiotics that it is impossible to separate them out without substantial changes in how we raise food animals.”
At Chick-fil-A, the commitment to a no-antibiotics-ever policy has meant rethinking every step of its supply chain, says Rob Dugas, a company vice president. “Our suppliers, in order to provide the volume of chicken that we need, had to go back to the very beginning of the supply chain, starting with the feed, to ensure that there were no antibiotics anywhere in the feed mills, the hatcheries, and the grow houses,” and then follow through all the way to the processing plants. That meant changing how far apart the chickens are kept as they grow and how sick birds are separated from healthy ones. “It raised the whole level of thinking in the industry around best practices that might be new and innovative and allow [the suppliers] to continue to make the margins that they wanted,” says Dugas. “All of that coming together is a really daunting challenge.”
There is a strong debate within the food-production industry about whether reducing the routine use of antibiotics will result in major costs and other trade-offs. “People are concerned about our ability as an industry to raise chickens with these changes,” says Bruce Stewart-Brown, a veterinarian who is senior vice president of food safety, quality, and live operations for Perdue Foods.
He says that since Perdue stopped using antibiotics to promote growth, “our birds grow a little bit slower than other folks’ birds.” But, he adds, that’s a worthwhile trade-off for consumers.
NEW SCHOOL GUIDELINES
It isn’t just corporate America that is making major changes to combat antibiotic resistance. Chicken is the leading protein served in schools. “If we can make headway in that particular product, it means a lot in terms of production practices, in terms of nutrition, and in terms of the school food budget really being shifted to more sustainable and healthful products,” says Kathy Lawrence, director of strategic development with School Food FOCUS, a New York City-based nonprofit organization that helps schools buy more nutritious and sustainable food.
So three years ago, School Food FOCUS, with research guidance from Pew’s antibiotics project, helped the Chicago Public Schools find a poultry supplier with a surplus of antibiotic-free drumsticks—some 600,000 pounds—that the schools could buy at a low price since drumsticks are not in high demand in grocery stores. That initial purchase was a success, and the school system is continuing to buy antibiotic-free chickens. “It really became, over time and through a lot of work, a match made in heaven,” says Lawrence.
Working with Pew, School Food FOCUS developed new purchasing guidelines for school districts to use when sending out requests for proposals or bids for chicken, to help the schools and the suppliers better understand the issues around antibiotic resistance. School Food FOCUS’s guidelines led to the development of its National Procurement Initiative, in which 15 school districts across the country—serving 2.3 million students—are shifting toward purchasing more healthful, regionally sourced, and sustainably produced school food, beginning with chicken. The initiative, School Food FOCUS, and Pew also helped develop the Certified Responsible Antibiotic Use Standard, the first standard that will be verified by the U.S. Department of Agriculture. It will also require veterinary oversight to determine when prescriptions of medically important antibiotics are needed in poultry production. This identifiable standard allows institutional purchasers to know with certainty how antibiotics were used on the birds when they order chicken. And School Food FOCUS is collaborating with Health Care Without Harm, a national effort to help hospitals buy more sustainable foods.
The combined purchasing power of public schools and hospitals has the potential to have a real impact on the production of chicken and other foods. “Every time a school district or hospital or university starts putting these kinds of guidelines in their bids for chicken or other products,” says Hansen, “it sends a signal out to industry that they’re really going to have to change.”
In addition to eliminating antibiotics from its poultry, McDonald's says it is hopeful about making commitments to reduce antibiotics in its beef products by working with other industry partners.
MORE THAN CHICKENS
But even with corporate America taking the lead and efforts underway in schools and hospitals, Hansen says, there is still need for government action. In December 2013, FDA took some important steps by asking drug companies to voluntarily remove “feed efficiency” and “growth promotion” as acceptable uses from the labels of all antibiotics. FDA officials say that by the end of 2016, antibiotics for growth promotion will no longer be marketed in the U.S.
There is scant data on use of antibiotics. So Pew is urging FDA to monitor and provide public reporting on specifically how and why the drugs are used.
What is happening now in the United States has already been playing out in Europe, where the European Union in 2006 banned the use of medically important antibiotics for growth promotion. The Netherlands, for example, also set specific goals for reducing antibiotic use in food animal production, and by 2012, total sales of antibiotics for food animals dropped by 51 percent.
Pew’s Hansen says the latest developments in the United States are encouraging. Several companies, including McDonald’s, Chick-fil-A, and Tyson, have volunteered to submit themselves to verification audits to ensure that they are fulfilling their antibiotic-use commitments. Tyson was the first company to successfully complete an audit by the USDA, and it plans to sell chickens to the 15 schools in the initiative for the fall semester.
In the long run, preserving lifesaving antibiotics will require more than changing how chickens are grown and must extend to other livestock, including cattle. Tracing antibiotic use is far easier in chickens than in cattle, says Hansen. Most chickens make a one-way journey from the hatcheries where they are born to the farms where their lives come to an end. But after calves are weaned, they move to transition farms and may end up at auction or at other indirect stops before they find themselves in a feedlot. “It’s not going to be as easy as chickens,” Hansen says. “But it can be done.”
Corporate purchasers may again help speed that along. For its part, McDonald’s says it is hopeful about making commitments to reduce antibiotics in its beef products as well by working through the Global Roundtable for Sustainable Beef, an industry partnership that also includes Wal-Mart, Sam’s Club, and other retailers. Marion Gross, senior vice president and chief supply chain officer for McDonald’s North America, says she is optimistic about the possibility of making progress on reducing antibiotic use in beef production. “It’s a huge undertaking, but it is one that we are very passionate about as well,” she says. “It’s not going to be easy, but we’re willing to dig in and see what we can do.”
Science journalist Amanda Mascarelli has written for The Washington Post, Audubon, Nature, and Science.