Antibiotic resistant bacteria are responsible for at least 700,000 deaths each year and cost billions in healthcare spending, lost wages and lost national productivity, est. $100tn and 10m deaths per year by 2050

Excerpt from The Guardian, Oct 2017

Resistant bacteria are a grave threat and getting worse.

They are responsible for at least 700,000 deaths around the world each year: 23,000 in the United States, 25,000 in Europe, more than 63,000 babies in India. Beyond those deaths, bacteria that are resistant to antibiotics cause millions of illnesses – 2m annually just in the United States – and cost billions in healthcare spending, lost wages and lost national productivity.

It is predicted that by 2050, antibiotic resistance will cost the world $100tn and will cause a staggering 10m deaths per year.

Disease organisms have been developing defenses against the antibiotics meant to kill them for as long as antibiotics have existed. Penicillin arrived in the 1940s, and resistance to it swept the world in the 1950s.

Each time pharmaceutical chemistry produced a new class of antibiotics, with a new molecular shape and a new mode of action, bacteria adapted. In fact, as the decades passed, they seemed to adapt faster than before. Their persistence threatened to inaugurate a post-antibiotic era, in which surgery could be too dangerous to attempt and ordinary health problems – scrapes, tooth extractions, broken limbs – could pose a deadly risk.

For a long time, it was assumed that the extraordinary unspooling of antibiotic resistance around the world was due only to misuse of the drugs in medicine: to parents begging for the drugs even though their children had viral illnesses that antibiotics could not help; physicians prescribing antibiotics without checking to see whether the drug they chose was a good match; people stopping their prescriptions halfway through the prescribed course because they felt better, or saving some pills for friends without health insurance, or buying antibiotics over the counter, in the many countries where they are available that way and dosing themselves.

But from the earliest days of the antibiotic era, the drugs have had another, parallel use: in animals that are grown to become food.

Eighty percent of the antibiotics sold in the United States and more than half of those sold around the world are used in animals, not in humans. Animals destined to be meat routinely receive antibiotics in their feed and water, and most of those drugs are not given to treat diseases, which is how we use them in people.

Instead, antibiotics are given to make food animals put on weight more quickly than they would otherwise, or to protect food animals from illnesses that the crowded conditions of livestock production make them vulnerable to. And nearly two-thirds of the antibiotics that are used for those purposes are compounds that are also used against human illness – which means that when resistance against the farm use of those drugs arises, it undermines the drugs’ usefulness in human medicine as well.

Antibiotic resistance is like climate change: it is an overwhelming threat, created over decades by millions of individual decisions and reinforced by the actions of industries.

It is also like climate change in that the industrialized west and the emerging economies of the global south are at odds. One quadrant of the globe already enjoyed the cheap protein of factory farming and now regrets it; the other would like not to forgo its chance. And it is additionally like climate change because any action taken in hopes of ameliorating the problem feels inadequate, like buying a fluorescent lightbulb while watching a polar bear drown.

But that it seems difficult does not mean it is not possible. The willingness to relinquish antibiotics of farmers in the Netherlands, as well as Perdue Farms and other companies in the United States, proves that industrial-scale production can be achieved without growth promoters or preventive antibiotic use. The stability of Maïsadour and Loué and White Oak Pastures shows that medium-sized and small farms can secure a place in a remixed meat economy.

Whole Foods’ pivot to slower-growing chicken – birds that share some of the genetics preserved by Frank Reese – illustrates that removing antibiotics and choosing birds that do not need them returns biodiversity to poultry production. All of those achievements are signposts, pointing to where chicken, and cattle and hogs and farmed fish after them, need to go: to a mode of production where antibiotics are used as infrequently as possible – to care for sick animals, but not to fatten or protect them.

That is the way antibiotics are now used in human medicine, and it is the only way that the utility of antibiotics and the risk of resistance can be adequately balanced.

Excerpted from Big Chicken by Maryn McKenna published by National Geographic on 12 September 2017. Available wherever books are sold.

Plucked! The Truth About Chicken by Maryn McKenna is published in the UK by Little, Brown and is now available in eBook @£14.99, and is published in Trade Format @£14.99 on 1 February 2018.