Despite vast resources, the United States’ attempts to contain the coronavirus have fallen woefully short. The country is also bungling a slower-moving health crisis: the global spread of antibiotic-resistant bacteria. Scientists are united on the need to curb antibiotic overuse — a key driver of resistance. So far, however, the response of US officials has been severely lacking — particularly when it comes to regulating the rampant use of antibiotics in agriculture.

In the United States, 65% of all antibiotics that are considered important in human medicine (including tetracyclines and penicillins) are sold for use in livestock. Most are given to entire groups of animals, even when none is sick. This practice is dangerous and unnecessary, as has been demonstrated in European countries. Denmark phased out the use of antibiotics for disease prevention in healthy animals in 1995, before also ending their use for growth promotion in 1998. By 2000, the Danish livestock industry was consuming just 40% of the antibiotics it had six years earlier. The European Union banned all growth-promotion antibiotics in 2006, and will end the use of antibiotics for disease prevention in 2022. In the US government’s 2015 action plan for combating antibiotic resistance, however, much too little attention is given to agriculture’s role. Although the US Food and Drug Administration (FDA) banned the use of antibiotics for growth promotion in 2017, the use of many of the same products for herd-wide disease prevention remains legal.

The European strategy offers an effective, well-documented roadmap for US policymakers to follow to reduce unnecessary antibiotic use in livestock, and there are three key interventions that should be adopted without delay.

Set ambitious targets for reducing use

One important lesson from Europe is to set public targets for reducing antibiotic use in livestock. Between 2009 and 2012, the Netherlands set consecutive reduction targets of 20%, 50% and 70%. It met the last one in 2019. When the use of antibiotics in livestock began increasing again after earlier reductions, Denmark established a more specific target for its pig sector to reduce antibiotic use by 10% between 2009 and 2013, and by an extra 15% by 2018. By the end of 2018, fewer than 1% of Denmark’s pig farms had failed to reach the target.

Two reports, in 2018 and 2019, from the European Commission’s Health and Food Safety Directorate General underscore that several countries consider ambitious targets to have been essential to quickly reaching significant reductions in antibiotic use in food-producing animals. By contrast, the US action plan fails to set any national targets or timelines for its livestock sector to reduce antibiotic consumption.

End antibiotic use for disease prevention

After the ban on antibiotic use for growth promotion in 2006, the Netherlands’ livestock sector continued its intensive consumption of these drugs for other uses. Only after several other policy changes were instituted — including an end to antibiotic use for disease prevention — did livestock antibiotic use fall by 50% over a four-year period.

In the United States, many antibiotic products added to livestock feed before the FDA’s 2017 ban on their use for growth promotion continue to be legally added to feed for disease prevention. This loophole helps to explain why overall antibiotic sales for livestock use have dropped by only 21% from 2009 levels. The pig and cattle industries consume 81% of livestock antibiotics sold in the United States. These industries use antibiotics 3–6 times more intensively than their counterparts in Denmark or the Netherlands.

Track use of antibiotics on farms

The EU measures and reports on trends in antibiotic use and resistance to inform strategies for reducing the need for antibiotics in livestock production. Since 2009, the European Medicines Agency (EMA) has issued transparent and increasingly detailed reports that invite accountability; nearly half of participating countries now supply the EMA with farm-level data, or plan to do so soon. Collecting data at a farm level is crucial to identify which uses are avoidable and which farmers and veterinarians are doing well at reducing use. Data are also essential for reaching national reduction targets established to help curb overuse and its contribution to antibiotic resistance.

US policymakers have been repeatedly urged to build a national system for collecting mandatory data on antibiotic use and resistance at a farm level. No system has been built, nor are there plans to do so.

Three in every four new or emerging infections in people originates in wildlife or farm animals. The COVID-19 virus is an example. In the current pandemic world, a nation that tolerates and even promotes a cloak of secrecy over why and how many human-class antibiotics are used on its livestock farms seems like a nation unable or unwilling to protect its people.

The current five-year US action plan to combat antibiotic resistance runs only through to 2020. It is unclear when, or if, it will be updated — let alone improved. If the ever-shrinking global supply of antibiotics to treat life-threatening infections is to be protected, action is required. As one of the world’s major consumers of antibiotics, the United States must follow Europe’s example in curbing its overuse of these precious medicines in livestock production as a matter of urgency.