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Antibiotic apocalypse: will a no-deal Brexit affect our health?

Antibiotic use is a collective agreement: we all remain safer so long as everyone follows a set of common rules.

Four years ago, a group of scientists conducting a routine study at a farm in Shandong, eastern China, found something they weren’t supposed to. In a sample obtained from an apparently healthy pig, the researchers discovered a new gene located on a strain of e-coli bacteria that was resistant to colistin, the world’s antibiotic of last resort. It had never been seen before. 

If you’ve got a stubborn infection that refuses to heed all other drugs, colistin is your last bet. Its status as an antibiotic of “last hope” is why doctors are parsimonious and precise about prescribing it. No new antibiotics have been discovered for treating the infection that colistin can be used upon, and the European Medicines Agency says the prospect of discovering alternatives in the near future is “limited”. 

So it was a grim surprise when scientists discovered the resistant gene had travelled to chickens, too. “We’d known there were colistin resistant bacteria for some time, but the difference with this one was that it was mobile – it could spread – from poultry, to humans,” Timothy Walsh, a professor of microbiology at the University of Cardiff and honorary chair at the Chinese Agricultural University, tells me over the phone. “We realised it was a tsunami coming our way.” 

Antibiotic resistance, where a microbe mutates or develops a gene that resists antibiotic treatment, is one of the greatest threats to human life. Already in Europe an estimated 33,000 people die each year from antibiotic-resistant infections. The UK’s chief medical officer Sally Davies has described the threat as a looming “apocalypse” that could wipe out humanity before climate change does – and has called for an Extinction Rebellion-style campaign to meet the challenge of antibiotic resistance. If bacteria become resistant to drugs like colistin, we will return to a pre-penicillin age; simple infections will become fatal, and routine operations like hip replacements and caesareans impossible. 

These rare drugs are being willfully squandered for profit. Livestock farmers often use antibiotics across entire herds – not to cure illness, but to prevent it. Chinese farmers had been dousing animal feed with colistin to artificially fatten pigs, a practice that has been illegal in the EU since 2006 (one of the side effects of dosing animals with antibiotics is enhanced growth). Once scientists discovered the resistant gene among pigs and poultry, they successfully pressured China’s government into banning the drug in animal feed. “We now remove 8,000 tonnes of colistin from Chinese agriculture every year,” Walsh tells me.

When antibiotics are used in farming, they diffuse into the atmosphere through water and slurry, making the surrounding environment into a reservoir for residues, resistant pathogens and antimicrobial properties – a toxic soup with unpredictable effects for human bodies. Though the World Health Organisation has urged governments to restrict colistin use to people, British farmers are still allowed to use the drug; in 2016, the government licensed three new colistin products for farming. The decision, Walsh told the Bureau of Investigative Journalism in 2017, was “sheer, utter madness”. 

Like vaccines, antibiotic use is a collective agreement: we all remain safer so long as everyone follows a set of common rules. Over the past five years, British farmers have voluntarily curbed their use by about 40 per cent. Should the UK crash out of the EU without a deal on 31 October, as seems increasingly likely, they could find themselves backed into a corner.

“If we come out of the EU without a deal, the financial pressure on farmers could lead to a worsening of standards,'' says Suzi Shingler, campaign manager at the Alliance to Save Our Antibiotics, a group founded by the Soil Association and Alliance for Compassion in World Farming. “If farmers come under pressure to produce meat really cheaply, because they face competition from really cheap imports, we’re worried they’re going to start cutting corners – putting more animals in sheds, making them breed quicker and have bigger litters – that sort of thing.”

Antibiotics go hand in hand with the economy of industrial megafarms, where animals are reared in appalling conditions – weaned young, crowded together, slaughtered painfully and pumped with antibiotic-rich feed as a prophylactic against the spread of contagious diseases. This bargain-basement model of intensive farming is detrimental to both animals and people; a 2017 UN report identified the overuse of antibiotics in farming as an acute threat to human health. 

Intensive farming, where animals are subject to extreme living conditions, is also more prevalent in the US, where chickens suffer lameness from overcrowding, pigs are fed on fattening drugs that cause their bones to break and animals are injected with growth hormones. US regulations covering the routine use of antibiotics in agriculture are woeful; the Food and Drug Administration has implemented a plan where pharmaceutical manufacturers voluntarily stop labelling antibiotics as “growth promoters”. Meanwhile, some 70 per cent of all antibiotics sold in the US are used on animals, and the US Department of Agriculture has been attempting to resist World Health Organisation guidelines with a plan that will allow megafarms to dose healthy animals with antibiotics. 

The EU currently bans imports of meat from the US. These restrictions offer farmers a degree of security; absent a trade deal with the EU, future agreements with countries that permit routine antibiotic use seem more likely. The US sees the UK as its European foothold – and Brexit as an opportunity to open a European economy to its farming business, after years of the EU refusing to accept its farming standards. It has already stated that areas of “divergence” would need to be overcome if the UK wants a trade deal with the US post-Brexit. 

Former environment secretary Michael Gove said there will be no compromises on animal welfare or environmental standards after Brexit. The government’s plan for antibiotic resistance aims to reduce the use of antibiotics in animals by 25 per cent between 2016 and 2020. But the UK’s Veterinary Medicines Directorate, the body that regulates farm antibiotics, has so far not confirmed that it plans to implement new EU regulations banning the prophylactic use of antibiotics in farming, which come into force after 2020

When contacted, a spokesperson said the government intends to “tighten control on the use of antibiotics, including the preventative use of antibiotics, in line with the new EU veterinary medicine legislation”. Nonetheless, if Britain fails to adhere to the ban outright, its regulations will be weaker than those elsewhere in Europe. 

Free from burdensome EU regulations guarding against the abuse of antibiotics, pesticides and other intensive farming practices, Brexiteers hope that Britain might benefit from cheaper food. But intensive farming is exactly what we don’t need more of. Faced with a climate crisis, the world desperately needs more enlightened farming, based on stewardship of the planet and a regard for human health and animal welfare.

Though our post-Brexit future is uncertain, people will continue to want meat, milk and eggs. Faced with cut-throat competition from cheap meat that is intensively reared using unethical and unhealthy practices, British farmers may find themselves with an ugly ultimatum: follow these standards, or face death by market competition. 

> This piece is from our Know Your No Deal series on the different ways a no-deal Brexit will impact the UK

Hettie O'Brien is the New Statesman’s online editor.