The excessive use of antibiotics in agriculture threatens to render them useless. As the largest producer and consumer of agricultural drugs, China can either be part of the solution, or part of the problem.
China produces and consumes more antibiotics than any other country. Half of this supply, (96m kgs a year) goes to farmers, who mix the drugs into their livestock’s feed and water. And they use about seven times more antibiotics than comparable farmers in the United States. Farmers use antibiotics for two reasons: When animals contract a bacterial infection, they are given antibiotics for a short period to treat the infection and stop it spreading to other animals.
The second, more controversial use of antibiotics is as a means of promoting faster growth. In the second scenario, animals are fed low doses of antibiotics for most of their lives, resulting in bigger pigs and chubbier chickens.
While this practice might increase farmers’ profits, it comes with serious risks. Bacteria are constantly mutating as they multiply. If the same antibiotic is used continually, it increases the chances that an antibiotic-resistant mutation will arise and spread unchecked. This “superbug” can then spread to humans, with doctors powerless to stop it. Already, research has shown that in some Chinese cities children are being born with a resistance to a wide spectrum of antibiotics.
“We are essentially back to an era with no antibiotics,” as Dr. John Conly of the University of Calgary put it in an interview in late 2010. That summer, bacteria containing the enzyme NDM1 had been found to be behind infections that were resistant to existing medicines.
The bacteria had begun to produce this enzyme after a single gene passed from one strain to another. This free-roaming gene created a string of superbugs, including a resistant strain of E. Coli. One in 10 of the resulting diseases was pan-resistant, meaning no existing antibiotics were effective against it.
Meanwhile, China is being hit particularly hard by the rise of resistant bacteria. While 2% of tuberculosis cases worldwide are resistant to multiple drugs, the figure in China is 6.8%.
While the prospect of unstoppable superbugs might be enough to keep health experts up at night, the response from governments has been sluggish. The EU and Switzerland implemented a ban on growth-promoters in 2006, but North America and China – by far the world’s biggest meat producers – have only banned the use of a few specific drugs.
In 2012, the Chinese Ministry of Agriculture publicly shut down several chicken farms in Shandong province, claiming that these farms had used “excessive amounts” of antibiotics. What is missing, however, is clear information for China’s farmers on how much usage is too much, or any comprehensive plan for reducing the overall amount used in China’s agricultural sector. Unless the whole sector cuts back on its use of antibiotics, closing a few farms will achieve nothing.
The immediate prospects for effective regulation do not look good. In an interview published by the Ministry of Agriculture, Minister Han Changfu explained that tackling the misuse of antibiotics was a key priority. However, he made no reference to the core issue of antibiotic-resistant diseases. Instead he spoke generally of the need to reduce “abusive use” of antibiotics, and to make sure there was minimal drug residue in meat sold for human consumption. In 2011, rumours surfaced that the MOA was planning to ban the use of antibiotics for growth promotion, but this has yet to materialise.
A ban is not the best solution anyway, according to Dr. Aidan Hollis, a health economist at the University of Calgary. “In a country with millions of farmers, it’s difficult to enforce a ban.” He adds that since many growth-promoting antibiotics are also used to treat infections, it is impossible to differentiate between the two uses through a ban.
In Dr. Hollis’ view, the key to getting farmers to use fewer antibiotics is to understand the economics behind a farmer’s decision to use growth-promoters, and changing the incentive structure. “If your animals are sick, and you use an antibiotic for a short time to stop that infection, then that is a high value use of antibiotics. If you are buying antibiotics continually in order to produce slightly more meat, then that is a low value use.”
His solution exploits this distinction. In a recent article in the New England Journal of Medicine Dr. Hollis and his colleague Ziana Ahmed propose charging farmers a user fee for agricultural antibiotics. The amount levied would be high enough make “low value” uses of antibiotics (i.e. growth promotion) uneconomical, while still allowing farmers to use antibiotics for the “high value” uses. The money raised through the fee would go towards the development of new antibiotics.
Hollis and Ahmed’s is a simple solution, but the Chinese Ministry of Agriculture is a long way from publicly admitting the scale of the problem, let alone solving it. One explanation for this inertia is that the people who stand to lose the most from regulation wield the most influence over the regulators.
Livestock farming in China is big business: one large farm in Fujian province produces as many as 50m birds annually. At this level of intensity, growth-promoting antibiotics can boost individual farmers’ profits significantly. Any reduction in the use of these drugs will hurt the biggest producers most of all, and the biggest producers are the ones most likely to have allies in the Ministry of Agriculture.
In the optimistic view, China’s farmers might yet be convinced of the need to stop using growth-promoting antibiotics if they are given clear, accurate information about the long-term risks involved. Dr Hollis says that farmers have “twice the incentive” to tackle the problem. “Farmers are at risk from resistant infections like everyone else, and without working antibiotics, they won’t be able to protect their animals from disease.”
One way or another, China’s farmers will eventually use fewer antibiotics. The choice is theirs: either cut back now, or wait for them to become useless.