Factory Farms, Antibiotics and Anthrax:

Putting Profits Before Public Health

Martin Donohoe, MD, FACP

Outline• Factory Farming

• Agricultural Antibiotics

• Cipro and Anthrax

• Bayer

• Conclusions

Factory Farming

• Factory farms have replaced industrial factories as the # 1 polluters of American waterways

• Large CAFOs make up 5% of livestock operations but produce more than 50% of food animals

• 1.4 billion tons animal waste generated/yr– 130 x human waste

Factory Farming• Cattle manure 1.2 billion tons

– 16kg livestock feces and urine produced for every 0.3kg steak

• Pig manure 116 million tons

• Chicken droppings 14 million tons

Factory Farm Waste

• Overall number of hog farms down from 600,000 to 157,000 over the last 15yrs, while # of factory hog farms up 75%

• 1 hog farm in NC generates as much sewage annualy as all of Manhattan

Factory Farm Waste

• Most untreated• Ferments in open pools• Seeps into local water supply, estuaries

– Kills fish– Causes human infections - e.g., Pfisteria

pescii, Chesapeake Bay

Factory Farm Waste• Creates unbearable stench

–Foul odors and contaminated water caused by CAFOs reduce property values in surrounding communities an estimated $26 billion nationally

• Widely disseminated by floods/hurricanes

Risks to Farm Workers

• Antibiotic-resistant infections• Carriage of antibiotic-resistant organisms• Aerosolized pig brains associated with

immune polyradiculoneuropathy (progressive inflammatory neuropathy) in pork processing plant workers– ?Other similar illnesses?

Agricultural Antibiotic Use

• Agriculture accounts for 70% of U.S. antibiotic use– Use up 50% over the last 15 years

• Almost 8 billion animals per year “treated” to “promote growth”– Larger animals, fewer infections in herd

Agricultural Antibiotic Use

• 84% of beef cattle, 83% of pigs, and 40-50% of poultry given non-therapeutic antibiotics

• Arsenic used in chicken and pork feed (banned in Europe; Poison-Free Poultry Act pending in U.S. Congress)

Consequences of Agricultural Antibiotic Use

• Campylobacter fluoroquinolone resistance– Infections/carriage by swine farmers associated with

inflammatory neuropathies• VREF (due to avoparcin use in chickens)• Gentamycin- and Cipro-resistant E. coli in

chickens

• 2009: Campylobacter found in 62%, Salmonella in 14%, and both in 8% of store-bought chickens

Consequences of Agricultural Antibiotic Use

• MRSA in pork, chickens– 49% of pigs and 45% of pig farmers

harbor MRSA– MRSA from animals throught to be

responsible for more than 20% of human MRSA cases in the Netherlands

• H1N1 carriage rates very high in CAFO workers

Antibiotic Resistant Pathogens

• CDC: “Antibiotic use in food animals is the dominant source of antibiotic resistance among food-borne pathogens.”

• CDC: 76 million people suffer foodborne illnesses each year in the U.S.– 325,000 hospitalizations– 5,000 deaths– > $152 billion/yr in medical costs, lost wages,

and lost productivity

Antibiotic Resistant Pathogens

• EU bans use of all antibiotic growth promoters effective 1/1/06

• FDA bans off-label use of cephalosporins in food animals (2008)

• Preservation of Antibiotics for Medical Treatment Act – awaiting vote in Congress

Alternatives to Agricultural Antibiotic Use

• Decrease overcrowding• Better diet/sanitation/living conditions• Control heat stress• Vaccination• Increased use of bacterial cultures and

specific antibiotic treatment in animals when indicated

Alternatives to Agricultural Antibiotic Use: Vegetarianism

• ↓ water/grain needs• ↓ animal fecal waste• ↓ rendering/mad cow disease• ↓ rBGH (→ ↑IGF-1 in milk)• Health benefits• Meatpacking = most dangerous job in US

Agricultural Antibiotics

• Three years after a Danish ban on routing use of antibiotics in chicken farming, the prevalence of antibiotic-resistant bacteria in chickens dropped from 82% to 12%

Agricultural Antibiotics

• 2008: USDA allows E. coli-tainted meat to be sold as pre-cooked hamburger patties, taco meat, pizza toppings, etc.

• Multiple other food recalls since

Agricultural Antibiotics• 2010: AMA, AAP, APHA, IDS all oppose

non-therapeutic antibiotic use in livestock

• 2010: FDA urges phasing out antibiotic use

Campylobacter

• Most common food-borne infection in US

• 2.5 million case of diarrhea and 100 deaths per year

Campylobacter Resistance to Fluoroquinolones Increasing

• 13% in 1998, 18% in 1999, 20-80% currently

• Fluoroquinolone use up dramatically• Continues to increase• FDA proposed ban on fluoroquinolone use

in poultry– Supported by APHA, PSR and others

Fluoroquinolones

• Animal Use– Sarafloxacin (Saraflox) – Abbott Labs –

voluntarily withdrawn from market– Enrofloxacin (Baytril) – Bayer – FDA

withdraws approval (7/05), ban effective 9/05

• Human Use– Ciprofloxacin (Cipro) - Bayer

Anthrax

• Cipro – patent expired 2004• Doxycycline – generic• Penicillin - generic• Huge potential profits

– 300 million Americans, others– 20-25% increase in Cipro sales one

month after 2001 anthrax mailings, per the nation’s largest PBM

Cipro

• Was best selling antibiotic in the world for almost a decade

• Sales down since off patent, lower than levofloxacin and moxifloxacin

• Gross sales (first quarter of 2008) = $242 million

Bayer and Cipro

• 1997 onward – Bayer pays Barr Pharmaceuticals and two other competitors $200 million not to manufacture generic ciprofloxacin, despite a federal judge’s 1995 decision allowing it to do so– Ultimately absolved of wrongdoing:

“anticompetitive effects … were within the exclusionary zone of the patent, and thus could not be redressed by federal antitrust law.”

Cost of Cipro

• Drugstore = $4.50/pill• 2002: US government agreed to buy 100 million

tablets for $0.95 per pill (twice what is paid under other government-sponsored public health programs)

• A full course of ciprofloxacin for postexposure prophylaxis (60 days) would then cost the government $204 per person treated, compared with $12 per person treated with doxycycline

Cost of Cipro

• US government has the authority, under existing law, to license generic production of ciprofloxacin by other companies for as little as $0.20/pill in the event of a public health emergency– It did not, but it cut a deal with Bayer to reduce the

price of Cipro• Canada did override Bayer’s patent and ordered

1 million tablets from a Canadian manufacturer

Why?

• Weakening of case at WTO meetings that the massive suffering consequent to 25 million AIDS cases in Sub-Saharan Africa did not constitute enough of a public health emergency to permit those countries to obtain and produce cheaper generic versions of largely unavailable AIDS drugs

Other Consequences

• Opens door to other situations involving parallel importing and compulsory licensing

• Threatens pharmaceutical industry’s massive profits– the most profitable industry in the US

Other Consequences

• Weakens pharmaceutical industry’s grip on legislators– $110 million dollars spent on lobbying in

the first half of 2010– 1,228 lobbyists (2.3 for every member of

Congress)– Revolving door between legislators,

lobbyists, executives and government officials

Bayer

• Based in Leverkusen, Germany• 107,000 employees worldwide (2008)• Revenue: €31.16 billion (2009)• Pre-tax profits: €6.47 billion (2009)• US = largest market

Bayer

• Consists of Bayer HealthCare, Bayer MaterialScience, and Bayer CropScience

• Pharmaceuticals

• World’s leading pesticide manufacturer

• One of world’s largest seed companies

Bayer

• Number one biotech company in Europe (after 2001 purchase of Aventis CropScience)

• Controls over half of genetically-modified crop varieties up for approval for commercial use

• Risks of GMOs

History of Bayer

• Trademarked heroin in 1898– Marketed as cough syrup for children “without

side effects”, despite well-known dangers of addiction

• Patented acetylsalicylic acid as aspirin in 1899

History of Bayer

• WW I: invented modern chemical warfare; developed “School for Chemical Warfare”

• WW II: part of IG Farben conglomerate, which exploited slave labor at Auschwitz, conducted unethical human subject experiments (including funding Mengele)

• Manufactured and supplied Zyklon B (without usual odorant) to the SS for use in gas chambers

History of Bayer

• 24 board members and executives indicted in Nuremberg Trials– 13 received prison sentences– Longest sentence to Fritz Meer

• Convicted for plunder, slavery, and mass murder• Released from prison in 1952• Chairman of supervisory board of Bayer 1956-

1964

History of Bayer

• Early 1990s – admitted knowingly selling HIV-tainted blood clotting products which infected up to 50% of hemophiliacs in some developed countries– US Class action suits settled for

$100,000 per claimant– European taxpayers left to foot most of

bill

History of Bayer

• 1995 onward - failed to follow promise to withdraw its most toxic pesticides from the market

• Failed to educate farmers in developing nations re pesticide health risks

• 2 to 10 million poisonings / 200,000 deaths per year due to pesticides (WHO)

History of Bayer

• 1998 –pays Scottish adult volunteers $750 to swallow doses of the insecticide Guthion to “prove product’s safety”– Sued the FDA to lift moratorium on human-

derived data

• 2000 – cited by FDA and FTC for misleading claims regarding aspirin and heart attacks/strokes

History of Bayer

• 2000 – fined by OSHA for workplace safety violations related to MDA (carcinogen) exposures

• 2000 – fined by Commerce Dept. for violations of export laws

History of Bayer

• 2001 – FDA-reported violations in quality control contribute to worldwide clotting factor shortage for hemophiliacs

• 2002 - Baycol (cholesterol lowering drug) withdrawn from market– Linked to 100 deaths and 1600 injuries– Accused by Germany’s health minister of

failing to inform government of lethal side effects for 2 months

History of Bayer

• 2006: Bayer CropScience genetically-modified, herbicide-tolerant “Liberty Link” rice contaminates U.S. food supply– Bayer keeps contamination secret for 6

months, then US government takes another 18 days to respond

– Places $1.5 billion industry at risk

History of Bayer

• “Liberty Link” rice contamination:– 9/06: 33/162 EU samples tested positive

for Liberty Link contamination– EU initially requires testing of all

imported rice, then stops in response to US pressure

– Japan ban imports of US rice– Over 1,200 lawsuits

History of Bayer

• 2007: Member of rubber cartel fined $356 million by European Commission

• 2007: Bayer suspends sales of Traysol (aprotinin) 2 years after data show increased deaths in heart surgery patients (Bayer withheld data)

• 2008: FDA warns Bayer re unapproved marketing claims for Bayer Women’s Low Dose Aspirin plus Calcium and Bayer Heart Advantage

History of Bayer

• 2008: Explosion at Bayer CropScience plant in Institute, WV, kills 2 workers

• Above-ground storage tank that can hold up to 40,000 lbs of methyl isocyanate) located 50-75 ft from blast area– Underground storage tank at plant site can

store an additional 200,000 lbs

Comparison: Bhopal

• 50,000 to 90,000 pounds of methylisocyanate released in Union Carbide Bhopal, India explosion–7000-10,000 dead within 3 days, 15,000-

20,000 more over next 10 years; tens of thousands injured

–Persistent water and soil contamination

History of Bayer

• 2009: $4 million settlement reached re 2006 release of chemical odorant propyl mercaptan and organophosphate pesticide Mocap from Bayer Cropscience plant in Alabama in 2006, which caused 2 deaths

• 2009: Sued by CSPI for false claims about selenium in its “One A Day Men’s Health Formula” multivitamin reducing prostate cancer risk

History of Bayer

• 2009: Bayer ordered by FDA and a number of states attorneys general to run a $20 million corrective advertising campaign about its birth control pill Yaz

• 2009: Oregon taxpayers on hook for ¾ of cleanup costs for one of Oregon’s most contaminated dump sites (pesticides)

History of Bayer

• 2010: FSA orders Bayer to stop misleading advertising re its IUD Mirena

• 2010: Cited by Political Economy Research Institute as #1 toxic air polluter in the U.S.

• 2010: Loses cases to Dow AgroSciences LLC and Monsanto over patent infringement cases involving genetically-modified crops

History of Bayer

• 2010: Fire at BayerCropScience Plant in india caused by leaking ethoprophos (toxic pesticide ingredient) kills one worker

• Late 1990s - 2010s: Bayer pesticides spirotetramat, imidacloprid, and clothianidin implicated in (honeybee) “colony collapse disorder”

Bayer’s Corporate Agenda

• Bluewash: signatory to UN’s Global Compact

• Greenwash: “crop protection” (pesticides)

• Promotion of anti-environmental health agenda: “Wise Use,” “Responsible Care” movements

Bayer’s Corporate Agenda

• Corporate Front Groups: “Global Crop Protection Federation”

• Harrassment / SLAPP suits against watchdog groups–e.g., Coalition Against Bayer

Dangers

Bayer’s Corporate Agenda

• Lobbying / Campaign donations / Influence peddling:– Member of numerous lobbying groups

attacking “trade barriers” (i.e., environmental health and safety laws)

– Spent $8,498,512 for lobbying in 2009– Gave $319,482,000 to federal candidates in

the 2008 election through its PAC, 42% to Democrats, 58% to Republicans

Bayer

• Fortune Magazine (2001): one of the “most admired companies” in the United States

• Multinational Monitor (2001, 2003): one of the 10 worst corporations of the year

Conclusions

• Triumph of corporate profits and influence-peddling over urgent public health needs

• Stronger regulation needed over:– Agricultural antibiotic use– Drug pricing

• Stiffer penalties for corporate malfeasance necessary (fines and jail time)

• Important role of medical/public health organizations and the media

Reference

• Donohoe MT. Factory farms, antibiotics, and anthrax. Z Magazine 2003 (Jan):28-30. Available at http://zmagsite.zmag.org/Jan2003/donohoe0103.shtml

Contact Information

Public Health and Social Justice Website

http://www.publichealthandsocialjustice.org

http://www.phsj.orgmartindonohoe@phsj.org