The use of antibiotics on the farm has been a not-so-slowly simmering issue for a long time. I remember first discussing it 15 years ago with representatives of a few of the larger pharmaceutical companies.
Dr. Leah Dorman supports a One Health approach, tying together animal health, public health and environmental health.
Today, thanks to some very unscientific but sensationalistic reporting by rush-to-ill-judgment organizations like ABC News, the long-simmering issue of antibiotic use threatens to come to a full, rolling boil. From previous experience, I know talking about the science behind a subject with unschooled mass media reporters is a waste of time.
Dr. Dorman wants to inject the facts into the discussion and she's rallied an impressive group of people to join in on a symposium called "A One Health Approach to Antimicrobial Use and Resistance: A dialogue for a common purpose." With all the nonsense swirling about, I hope the opinion leaders understand two important parts of that title: "dialogue" and "common purpose."
One of the leaders of this dialogue and the man who will wrap up things with a talk on ‘The Path Forward" is Dr. Lonnie J. King, DVM, MS, MPA, Diplomate ACVPM, Dean and Professor of the Department of Veterinary Preventive Medicine at The Ohio State University. He's well-grounded in studies of infectious diseases, emerging zoonoses, food safety, epidemiology and public health. His professional training and experience include earning a BS form The Ohio State University in 1966 followed by a DVM form that same school in 1970. He also holds an MS in Epidemiology from the University of Minnesota and an MPA in Public Administration from American University, Washington, D.C.
I don't know about you, but I'm impressed.
A few other people who know what they're talking about are Dr. Ron DeHaven, Executive VP of the American Veterinary Medical Association, Dr. Guy Loneragan of Texas Tech, and Dr. Randy Singer, an epidemiologist at the University of Minnesota. Here's hoping the uneducated press will attend en masse to become educated.
But the subject of this interview is Dr. Dorman, who carries some impressive credentials, too. She's Director of Food Programs with the Ohio Farm Bureau Federation. She was Assistant State Veterinarian with the Ohio Department of Agriculture and she earned her DVM from The Ohio State University. She's one of the people responsible for the program that should become a vital part of the discussion and decision-making process behind what antibiotics you're allowed to us.
Q. The Second National Symposium on Antibiotic Use in Food Animals will be held Nov. 13-15 in Columbus, Ohio. Let's start with some perspective. Why was this Symposium developed, and what sets it apart from similar events?
A. The title this year is "A One Health Approach to Antimicrobial Use and Resistance: A dialogue for a common purpose."
NIAA did an antibiotic forum in the fall of 2011 in Chicago. The subsequent whitepaper has received considerable traction throughout the US and internationally. It has been translated into at least one additional language. After the conference, NIAA created an issue-based council called the antibiotics council, which then decided that a second, follow-up conference was needed in order to continue the dialogue.
Building off the first conference, this year we plan to get outside the agricultural echo chamber and reach out to the public health community in order to find ways to work together for a common goal, which is improving health through judicious antimicrobial use and decreasing the impact of antimicrobial resistance. Agriculture will be leading the conversation in a one-health perspective.
This conference is designed to have small, facilitated table discussions amongst the participants. The information will then be captured and used to generate further discussion and potential actions. We hope to avoid scientific tug-of-wars and really get down to learning from each other and working on a collective path forward.
Q. The venue itself - Columbus, Ohio – why locate the Symposium there? What advantages does it bring?
A. Ohio ranks 7th in population and 35th in size. Ohio is home to over 11.5 million people and we also rank fairly high in the major livestock commodities - 2nd in table eggs, top 5 in veal, 8th in pork, 10th in turkeys, 11th in milk, 13th in sheep, 15th in meat chickens and 16th in beef. Ohio also ranks in the top five in half of the food processing groups and is home to some major restaurant chains. That creates a lot of people and a lot of livestock in a really small space, which can create some interesting agricultural, public, and environmental health issues.
The location is convenient, as 60% of the US population is within a day's drive. Columbus is home to The Ohio State University, which is the only university in the nation to have seven health colleges on one campus - veterinary medicine, human medicine, dentistry, pharmacy, optometry, nursing, and public health. They also have a College of Food, Agricultural, and Environmental Sciences. Dr. Lonnie King is the Dean of the College of Veterinary Medicine as well as the Executive Dean of those seven health sciences and is a keynote speaker at this year's conference. Hosting the forum near Ohio State allows academia, the public health community and the animal health community and others from across the nation to attend and engage in the dialogue.
Q. The audience you want to reach – who are they and what do you want them to take away when the Symposium closes?
A. The audience: animal health community, public health community, environmental health community, agricultural industry (farm to table), regulatory, consumers, academia, policy makers, and media
I hope the participants understand the issue of antibiotic use and resistance better and have gained some additional perspectives. A wise man once said, "If you think you understand antimicrobial resistance, then someone didn't explain it to your correctly." They need to understand that antibiotic resistance is complicated and there is no silver bullet solution, maybe silver buckshot.
The audience will engage in open dialogue giving input to outlining and prioritizing key issues, barriers and potential paths forward. I expect that a white paper will come out of this conference covering both the presenters" discussions as well as the table discussions. I hope that each participant, as well as others that did not attend, might be able to use the information in their daily work to work together to improve health.
Q. Let's break the symposium down into its day parts. The first day of the Symposium focuses on antimicrobial use in agriculture, something that's becoming increasingly controversial. I've read reports that claim up to 80% of all antibiotics are used on the farm and point to that number as proof of overuse. What are the facts?
A. Actually, the first day focuses on antimicrobial use, period. This includes animal, plant and public health, so we are looking at a much bigger picture than just agriculture. We will also be discussing judicious use programs in animal and public health. There will be time for questions and answers with the speakers and a facilitated discussion will complete the day.
Of the reported 80% of antibiotics sold for use in food animal production, 28% of that amount are ionophores, which is a class of antibiotics not used in human medicine and therefore have no potential to contribute to the burden of human antibiotic resistance. Unfortunately, FDA does not track the amount of antibiotics used in human medicine in the same manner, so there is no comparable data. Also keep in mind that the amount (by weight) of antibiotics used to medicate a 1500 cow tends to be more than an average human would need. We need to compare apples to apples.
Q. The second day looks at antimicrobial resistance. Any use of antibiotics eventually leads to resistant strains of bacteria. The issue is overuse. What kinds of information are you trying to develop for day two?
A. Yes, the second day looks at antimicrobial resistance, but you have jumped to conclusions on your next two statements regarding how resistant strains develop and who might be "overusing." We could argue about those statements, but we will simply agree to disagree, which is the point of having this type of forum. Let's stop throwing each other under the bus, listen and learn from each other, get past our differences, and find common ground. After all, we are all in this together.
Back to day two. Presenters will discuss how antimicrobial resistance develops and where it comes from, new research on the interplay of animal and human resistant bacterial populations, and the impact on public health of environmental contamination with antimicrobial residues. We also hope to have a report from the various antimicrobial resistance working groups, international perspectives and hospital and community infections. We also plan to have two more facilitated discussions.
Q. The last day of the program will provide a focus forward. With all the controversy swirling around the use of antibiotics, fueled by recent and often sensationalistic reporting, which way is ‘forward?"
A. We want to take a look at what might be coming (or potentially not coming) to us in the way of new and better antimicrobials. We also want to consider alternatives to antimicrobials and consider what might be some of the issues in developing potential alternatives. The regulatory environment impacts the pharmaceutical industry as well as the livestock industry. USDA will bring us up to date on the nationally funded antimicrobial resistance research.
The way forward - a great question! Most notably, the way forward is to create an understanding that EVERYONE is a stakeholder in this issue in some form or fashion – it's not just an ag issue – it's a public health issue that's very complex. The way forward is to quit having public interest groups lean on ‘drive-by" talking points because politics won't resolve antimicrobial resistance.
Lastly, the purpose of the symposium is driven by agriculture's commitment to public health and consumer safety – we're driving the conversation to ensure that meaningful communication and solutions are established.
(Editor's note: For more information about this Symposium, Click here: http://www.animalagriculture.org/Solutions/Symposia/2012_antibiotics/index.html)
Chuck Jolley is a free lance writer, based in Kansas City, who covers a wide range of ag industry topics for Vance Publishing.