Natural Resources Defense Council, San Francisco, CA, 94104, USA.
Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
Curr Environ Health Rep. 2022 Jun;9(2):339-354. doi: 10.1007/s40572-022-00351-x. Epub 2022 Apr 27.
Industrial food animal production accounts for most animal-source protein consumed in the USA. These operations rely on an array of external inputs, which can include antimicrobials of medical importance. The use of these drugs in this context has been the subject of public health debate for decades because their widespread use contributes to the selection for and proliferation of drug-resistant bacteria and their genetic determinants. Here, we describe legislative and regulatory efforts, at different levels of governance in the USA, to curtail food animal consumption of medically important antimicrobials.
The features and relative success of the US efforts are examined alongside those of selected member states (Denmark and the Netherlands) of the European Union. Evaluation of efforts at all levels of US governance was complicated by shortcomings in prescribed data collection; nevertheless, available information suggests deficiencies in policy implementation and enforcement compromise the effectiveness of interventions pursued to date. The political will, robust systems for collecting and integrating data on antimicrobial consumption and use, and cross-sectoral collaboration that have been integral to the success of efforts in Denmark and The Netherlands have been notably absent in the USA, especially at the federal level.
美国消费的动物源蛋白质主要来自工业食品动物生产。这些企业依赖大量外部投入,其中可能包括具有医学重要性的抗菌药物。几十年来,这些药物在这种情况下的使用一直是公共卫生辩论的主题,因为它们的广泛使用导致了耐药细菌及其遗传决定因素的选择和增殖。在这里,我们描述了美国在不同治理层面上的立法和监管努力,以限制食用动物消耗具有医学重要性的抗菌药物。
美国的努力的特点和相对成功与欧盟成员国(丹麦和荷兰)的努力进行了对比。对美国各级治理工作的评估因规定的数据收集存在缺陷而变得复杂;尽管如此,现有信息表明,政策执行和执法方面的缺陷影响了迄今为止为实施干预措施而进行的努力的有效性。丹麦和荷兰的成功离不开政治意愿、收集和整合抗菌药物消费和使用数据的强大系统以及跨部门合作,而这些在美国,尤其是在联邦层面上明显缺失。