When the Food and Drug Administration announced last December it was working to phase out the non-therapeutic use of antibiotics in agriculture, the headlines made it appear that finally, after nearly 40 years of concern, the regulator was going to take real action on the issue. While some, including a senior epidemiologist at the Centers for Disease Control, were heartened by the fine print of the FDA plan, critics of the meat industry’s use of antibiotics—for both growth promotion and preventive purposes—were beyond underwhelmed.
There’s another plan however, one that was recently argued for in a paper published by The New England Journal of Medicine, that doesn’t suffer from the voluntary nature of the FDA’s approach: Tax ’em.
Aidan Hollis and Ziana Ahmed call what they’re proposing a “use fee,” but the argument—that using antibiotics in agriculture is making them increasingly useless in human medicine, which has a very real monetary cost that the industry should help pay for—is akin to the idea of a carbon tax. Want to do something that’s terrible for society? Cool, sure, fine—but don’t expect it to be cheap.
The 30 million pounds of antibiotics that were purchased for agricultural uses in 2011 are exactly that.
As Hollis and Ahmed write, “Such promiscuous use of antibiotics is not surprising: non-pharmaceutical-grade antibiotics are typically priced at approximately $25 per kilogram, and there is little regulation or oversight of their use.”
That puts a $340 million price tag on the drugs the industry bought in 2011. In 2009, meat and poultry sales totaled $154.8 billion, according to the American Meat Institute.
If a tax, or usage fee, was enacted, the drugs would likely be used in a more targeted manner, bringing down the overall usage, and in instances where antibiotics were needed to protect the lives of valuable livestock from actual infections—not just the nebulous idea of their potential—the taxed cost of the drugs would certainly amount to less than the financial hit a rancher might incur from losing a chunk of a herd or flock. The tax would have to be structured to ensure that that would be the case.
As Brad Plumer notes at Wonkblog, the revenue could be used to further protect human and livestock populations from a drug-resistance-related catastrophe: by funding antibiotic research.
What's more, the user fee is fairly simple to administer, and the revenue could help fund crucial public research into new antibiotics (or strategies to limit resistance). That's a big deal, since pharmaceutical companies are increasingly reluctant to sink the necessary money—from $800 million to $1.7 billion per drug—into new antibiotics.
That may be a lot of money, but it's nothing compared with the value that Hollis and Ahmed place on the antibiotics that already exist—the ones that are becoming increasingly ineffective. The pair suggest “a plausible estimate of the increase in life expectancy attributable to antibiotics might be 2 to 10 years.”
If we multiply this increase by 300 million Americans and a dollar value of, say, $100,000 per life-year, we arrive at an estimate for the worth of the current stock of antibiotics of $60 trillion to $300 trillion in the United States alone.
That’s value—in lives, in dollars—worth protecting.