addressing antibiotic resistance · addressing antibiotic resistance: local leadership...
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Addressing Antibiotic Resistance:Local Leadership Opportunities
Antibiotic Resistance is a Problem
“Antibiotic resistance is one of the top five threats to public health.”
Antibiotic Resistance is a Problem
Antibiotic Resistance is a Problem
Antibiotic Resistance is a Problem
Few New Antibiotics Being Developed
1614
12
7
42
1983-1987 1988-1992 1993-1997 1998-2002 2003-2007 2008-2012
Source: Infectious Diseases Society of America (IDSA) Clin Infect Dis. 2011;52:S397-S428, http://www.tufts.edu/med/apua/news/news-newsletter-vol-30-no-1-2.shtml
80% of Antibiotics Sold for Livestock Use
sold for meat & poultry production
sold to treat sick people
Graphic published by Pew Charitable Trusts, February 2013
Antibiotic Use Increases Per Kg Meat
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
g ab
xsa
les/
kg (s
laug
hter
wei
ght)
Time (Year)
Increasing in the U.S.
Antibiotic Uses
Treat disease Control disease outbreak
Antibiotic Uses
Treat disease Control disease outbreak Prevent disease XPromote growth X
How Resistant Bacteria Develop & Migrate
Source: GAO Antibiotic Resistance
How Resistant Bacteria Develop & Migrate
How Resistant Bacteria Develop & Migrate
Resistance Happens!
MCR-1 – easily transferable colistin resistance likely from animal to humans
Resistance Happens!
MCR-1 – easily transferable colistin resistance likely from animal to humans
Superbugs On Retail Meat & Poultry
Resistant Bacterium % chicken samples positive
Campylobacter jejuni 2%
Enterococci 47%
E. coli 24%
Salmonella 6%FDA, National Antimicrobial Resistance Monitoring System, Retail Meat Annual Report, 2012
Frequency of bacteria resistant to three or more classes of antibiotics on retail chicken (2012)
Progress in Federal Law
FDA Guidance #213 No antibiotic use for
growth promotion Veterinary oversight of
antibiotics use
Gaps in Federal Law
FDA Guidance #213 No antibiotic use for
growth promotion Veterinary oversight of
antibiotics useX Use still allowed for
disease preventionX Voluntary complianceX No tracking or reduction
targets
Ending Growth Promotion Not Enough
Cordova, C. et al. NRDC Fact Sheet: FDA’s Efforts Fail to End Misuse of Livestock Antibiotics, 2015.
Netherlands
New California Law is An Important Step
SB-27• Prohibits growth promotion and “regular pattern”
of use for disease prevention
New California Law is An Important Step
SB-27• Prohibits growth promotion and “regular pattern”
of use for disease prevention
• Requires veterinary oversight
New California Law is An Important Step
SB 27• Prohibits growth promotion and “regular pattern”
of use for disease prevention
• Requires veterinary oversight
• Requires CDFA to collect information about use and antimicrobial
resistance in CA
New California Law is An Important Step
SB 27• Prohibits growth promotion and “regular pattern”
of use for disease prevention
• Requires veterinary oversight
• Requires CDFA to collect information about use and antimicrobial
resistance in CA
• Applies only to animals raised in CA
Local leadership opportunities
Local leadership opportunities
City Procurement
Local leadership opportunities
City Procurement
Consumer Information
City Procurement
• Require City Departments purchasing raw meat to provide information to SFE on:
Suppliers and antibiotic use practices Proposed timeline for antibiotic-free
purchasing Estimated cost of purchasing antibiotic-free
raw meat
• SFE review information, develop procurement regulation
Consumer Information
• Right-to-Know Legislation
Retailers of raw meat to disclose to SFE suppliers’ practices
SFE to share information on public website
Affected Parties
Large stores selling raw meat with more than 25outlets are required to comply with the proposedordinance. Voluntary for small businesses.
• Safeway • Whole Foods • Costco• Lucky Supermarket• Trader Joe’s • Walgreens
• Target• Grocery Outlet• Bristol Farms• Cash & Carry• Foods Co• CVS
Market Shift
Market Shift
Market Shift
Likely Supporters
• NRDC• SF Marin Medical Society• Prevention Institute• Clean Water Action• Physicians for Social Responsibility• CALPIRG• Healthcare Without Harm• Environmental Working Group• Food Chain Workers Alliance• Keep Antibiotics Working Coalition• Roots of Change• The Antibiotic Resistance Action Center, Milken Institute
School of Public Health, The George Washington University• Numerous Individual Doctors and Scientists