But even though America has taken some steps to help curb superbugs, infectious disease researchers and doctors just don’t think the government’s strategy is enough. That’s because it doesn’t take into account some major consumers of antibiotics: farm animals.

Antibiotic resistance is one of the greatest threats to humans worldwide, according to the Infectious Diseases Society of America, a professional group of disease specialists. It costs the US health-care system over $21 billion each year to treat resistant infections. Those treatments aren’t always successful, though: antibiotic resistance claims about 23,000 lives in the US each year, from its more than 2 million annual illnesses across the country.

The US government made history on September 18th when President Obama signed an executive order establishing a task force to combat antibiotic resistance at the federal level. The order outlined general goals such as tracking the use of antibiotics and creating incentives for drug development. Some applauded the announcement, while pointing out other countries’ continued failure to do the same.

There's not the same control [on antibiotic use in animals] as there is in people Approximately 80 percent of antibiotics are used on animals, not humans. "There’s not the same control or restriction on their use as there is in people," says Stuart Levy, a microbiologist at Tufts University who has spoken out against the overuse of antibiotics for 30 years. And some of the drugs used on animals are medically important for humans. So when they’re overused in animals, we humans end up with bacterial infections that our drugs can’t treat. Resistance occurs when bacteria encounter antibiotics in their environment in doses too small to kill them. This allows them to adapt to the drugs in ways that help them resist to larger doses in the future. And although many emerge from human antibiotic use (about 50 percent of people who take antibiotics don’t actually need them), it’s thought that the large quantities of antibiotics given to livestock for disease prevention, treatment, and growth purposes leads to people ingesting bacteria that doesn’t respond to antibiotics. That’s why some epidemiologists and infectious disease experts are stung that the agricultural uses of antibiotics didn’t receive more attention in the bill. Obama’s plan largely glossed over the use of antibiotics in agriculture Obama’s plan largely glossed over the use of antibiotics in agriculture. Besides banning their use for growth purposes — something the FDA had already announced it would do in December 2013 — it doesn’t address the preventative use loopholes that remain. "I think it’s a step in the right direction," Levy says, "but we wanted a leap." Other scientists were more blunt in voicing their discontent. "It reads as if it had been written by someone either from the meat industry, or the vet drug industry," says James Johnson, an infectious disease researcher at the University of Minnesota. Although the government’s strategy bans the use of antibiotics for growth purposes, Johnson says, one could easily continue to use them for that purpose, and call it a preventative measure. "The language is the standard party line about how antibiotic use in animals makes stronger animals — that it’s all wonderful. But that’s just one perspective, and I don’t think it’s a science-based perspective."

A better strategy, would be to change the way meat is produced in the US, says Lindsay Grayson, an infectious disease researcher at the University of Melbourne, in Australia. Large-scale chicken farms, for instance, can scale down their use of antibiotics by thinking in terms of infection control. Physically separating different batches of birds and minimizing overcrowding is key, he says. That way, when one bird gets sick, the bird can be diagnosed before disease spreads. "No one is against using antibiotics to treat sick animals," he says, "but we shouldn’t endorse mass preventive use on a daily basis simply because your farming practices allow for rapid spread."





Not everyone is of this opinion, however. Christine Hoang, assistant director of scientific activities at the American Veterinary Medicine Association, says the goals outlined by the Obama administration are good enough. They reflect the FDA’s stance on antibiotics use in food production and the intention to phase out growth promotion uses, she says. "There aren't really any loopholes," Hoang says. Under Obama’s plan, drugs will be used to treat and prevent disease, she says, and there will be more veterinary oversight. "I don't think we should limit antibiotic use any more. It's a great detriment to us as a profession, as well as to animal welfare, to restrict them further." Hoang’s take was echoed by Paula Cray, microbiologist at North Carolina State University and former leader of the USDA’s Bacterial Epidemiology and Antimicrobial Resistance Research Unit, who added that the planet will be home to 4 billion additional humans by 2100, all of which will expect to be fed. "There’s a need to double the production of animal protein," she says. And that kind of production — the kind that presumes that every human will want to eat meat — will take a certain capacity, one that may not be compatible with less crowded animal housing practices. This might very well be the thought process behind the US antibiotic plan. Instead of trying to change farming practices — which guarantees a painful fight with large agricultural corporations — the government has opted to push for the development of new drugs, ones that will be used on either humans or animals, but not both. Accordingly, the US has promised to support basic research and "leverage existing partnerships" that will help reduce the obstacles that pharmaceutical companies face during clinical trials. The White House also pledged to inject drug research with an additional $800 million a year to develop new medicines. That may not be enough. There aren't really any loopholes "I’m not sure that the incentive part will get the pipeline full," says Henry Chambers, chair of the Antimicrobial Resistance Committee at the Infectious Diseases Society of America. Developing a new drug costs about $5 billion. When companies make that kind of an investment, it’s because they expect sales numbers for the drug to be high enough to turn a profit. But when doctors encounter a new antibiotic, their instinctive reaction is to use it sparingly, so they have it on a rainy day. "The first inclination is to say, ‘Wow this is really good, we better not use it because resistance will occur,'" Chambers says. Besides, new antibiotics might not be better than the old ones, he says. And some, such as ciproflaxin and daptomycin, may have serious side-effects. Doctors who choose new antibiotics therefore end up making their patients purchase drugs that are probably just as effective, but far more expensive. When you look at it that way, Chambers says, the incentive for doctors to use new drugs isn’t all that high. And without doctors pushing the drugs out to patients, drug companies aren’t as likely to profit off their $5 billion investment. For many companies, even the government incentives don’t make antibiotics as appealing as blood-pressure pills and cancer medications.