Inside D.C.

White House Mashes Antibiotics Forum

The White House held a “Forum on Antibiotic Stewardship” June 2, and, well, once again went a step too far.  The event was billed as “bringing together key human and animal health constituencies involved in antibiotic stewardship,” those with a stake in responsible – insiders call it “judicious” – use of antibiotics to better control antibiotic resistance whether on farm, in a doctor’s office or in a hospital.

It started out well enough.  Most in attendance believed they were merely attending a hastily thrown-together issue forum to discuss smart antibiotic use, while allowing the White House to collect a few socially conscious headlines.

The White House praised several ag/food companies which lately announced varying antibiotics policies – from Elanco Animal Health to Tysons Foods to Walmart – for steps taken to minimize the use of medically important antibiotics on farm.  More than 150 companies and organizations from agriculture and human medicine signed a pre-meeting “commitment” statement avowing their support for the responsible stewardship of antibiotics.

Apparently getting the human and animal sides of antibiotics use in the same room to discuss the mutual goal of limiting antibiotic resistance wasn’t newsworthy enough for the White House; the first clue was the ham sandwiches catered by Panera Bread, all with the legend “produced without antibiotics.”

Participants were first surprised when Administration officials announced FDA would publish the next day its final rule on the Veterinary Feed Directive (VFD), an “order” used by vets to ensure on-farm antibiotic use in feed and water is necessary and follows the rules of “stewardship.”  Stakeholders directly involved in reshaping the VFD over the last few years were under the impression the new rule wouldn’t be published for several weeks, at least that’s what FDA’s been saying.

Then the White House dropped its big bomb:  The President that morning signed a “memorandum” instructing those buying meat and poultry for the federal government to give “preference” to meat and poultry “produced according to responsible antibiotic-use (sic).”  Wading through the four-page memo you find “responsible antibiotic use” means a farmer/rancher follows FDA industry guidances on “judicious” use of medically important antibiotics, i.e. they’re used only on order of a licensed vet, and only to prevent, control or treat disease in animals.  No big deal, as this is the way 99.999% of agriculture operates today.

But with the White House press release accompanying/explaining the purchasing preference memo, the other shoe dropped.  “The Presidential Food Service (the White House kitchen) is also committing to serving meats and poultry that have not been treated with hormones or antibiotics.”  White House science advisor Dr. John Holdren reiterated a hormone-free, antibiotic-free White House.

The use of FDA-approved growth hormones in livestock production was never part of the forum agenda or discussion.  Confusing, it appears too many the standard for the White House is now predicated on a different and more extreme set of criteria than the rest of the federal government. One participant called it “generally unnecessary, and definitely confusing.”

“Certain statements in the White House press release could confuse consumers,” said the North American Meat Institute (NAMI), referring to the fundamental differences between hormones and antibiotics when it comes to chemical structure, function and use in livestock.  The meat processing group went on to say no meat or poultry is ‘treated’ with antibiotics, that strict federal withdrawal periods and residue monitoring are routine, and that antibiotics are federally approved and regulated and “can be essential in ensuring animal health and welfare.”

Another forum participant said, “The announcement…sends the wrong message to our trading partners and consumers.  It all of a sudden focuses on hormone-free products – which have not previously been part of the antibiotics discussion – and appears to imply hormone-free products are safer…because our president uses them.”

“The White House announcement seems to demonstrate a lack of faith in FDA’s approval process and oversight,” said NAMI.  NAMI called the White House pronouncements “out of sync with the Centers for Disease Control & Prevention’s (CDC) analysis based on a 2013 report on resistance in which the CDC said, “The really acute problem (with resistance) is in hospitals.”  (By the way, no news about a memo restricting antibiotic over-prescription by doctors or dealing with nosocomial infections in hospitals was issued by the White House, nor was there much discussion about the need for getting new “medically important” antibiotics developed and approved.)

NAMI clarified for the White House hormones are never used in poultry or swine production, but are FDA-approved for use in cattle.  “The White House can buy pork and poultry products from animals or birds raised without hormones at any local grocery store and under any brand name,” the group said. “Beef products from both hormone-treated and untreated cattle have far fewer hormones than foods like coleslaw and tofu…no organism is ‘hormone-free,’ although the phrase is commonly – and erroneously – used.”

The White House didn’t do its homework, apparently didn’t consult with FDA, USDA or anyone else who understands livestock and poultry production and the use of the products, export battles with China, Russia and others, and apparently hasn’t taken a recent gander at the U.S. position in our negotiations with Europe over “free trade.”  Calls to folks in the government for explanation of what the White House did/meant/intended yielded “we don’t know” or “let me check over there and get back to you.”

Still waiting…