Factory Farms, Antibiotics and Anthrax:

							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?
 Food-Borne Infections in the U.S.
• Each year:
  –1/6 Americans affected
  –128,000 hospitalizations
  –3,000 deaths
• Salmonella = most common infection
     Agricultural Antibiotic Use
• Agriculture accounts for 70% (29 million lbs) of
  U.S. antibiotic use
   – Use up 50% over the last 15 years
   – Only 10% used to actually treat infections
• Almost 8 billion animals per year “treated” to
  “promote growth”
   – Claim: 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/donoho
  e0103.shtml
       Contact Information
 Public Health and Social Justice
              Website
http://www.publichealthandsocialjustice.org
       http://www.phsj.org
     martindonohoe@phsj.org