On April 8, the University of California at San Francisco (UCSF) Medical Center stepped into the debate about antibiotic use in animal agriculture. Under the guidance of physicians and foodservice staff alike, UCSF’s Academic Senate unanimously approved a resolution to phase out the procurement of meat raised with non-therapeutic antibiotics and urged all ten University of California campuses to do the same. This resolution is not just a symbolic decision – serving over 650,000 meals per year to patients, staff, and the community, and with a food budget of close to $7 million, UCSF and its food purchasing choices have the power to send a strong message to the market and to policymakers. 

“There is overwhelming scientific consensus that overuse of antibiotics in livestock is a health hazard to people,” said Dr. Thomas Newman, a member of the Academic Senate who spearheaded the resolution with the help of the non-profit San Francisco Bay Physicians for Social Responsibility. He is in good company. Independent experts ranging from the World Health Organization to the U.S. National Academy of Sciences agree that the routine use of antibiotics in animal agriculture cultivates antibiotic-resistant bacteria, threatening the long-term efficacy of antibiotics for human use.

Two-thirds of the drugs that animals in our food supply get in their feed and water, from penicillins to macrolides, might sound familiar to anyone who has been to the hospital recently. In fact, eighty percent of all of the antibiotics sold in the U.S., almost 30 million pounds on an annual basis, are used for meat production. The majority are given to otherwise healthy animals in order to promote faster growth and to compensate for unsanitary and overcrowded living conditions.

“We believe that health care is best positioned to lead our society away from its addiction to antibiotics in animal agriculture,” said Gary Cohen, President of the non-profit organization Health Care Without Harm. He added: “Hospitals have both the mission-critical rationale and the economic clout.” Health Care Without Harm works to leverage both health care’s healing mission and purchasing power on a range of sustainable food issues, from organic production to local food purchasing. UCSF is one of over 440 hospitals across the country that have signed Health Care Without Harm’s Healthy Food in Health Care Pledge, which states that healthy food must come from a food system that is ecologically-sustainable, economically-viable, and socially-just.

However, hospitals attempting to purchase sustainable food face serious supply chain challenges. In the case of meat produced with non-therapeutic antibiotics, the market to date has been small in the U.S., making these products costly. For now, UCSF is taking a two-pronged approach to procurement. “We have reduced the amount of red meat being served,” stated Jack Henderson, Associate Director of Nutrition and Food Services at UCSF, “And secondly, we are pursuing a source of beef that is grass-fed, raised without non-therapeutic antibiotics, and that still fits within our budget. It is a complex maneuver, but we believe it is the right thing to do for our patients, our staff, and our visitors.”

Health Care Without Harm is working with nearly 100 other hospitals nationwide that have committed to this “less meat, better meat” approach. Leading the pack is Fletcher Allen Health Care in Burlington, Vermont which created a long-term antibiotics reduction plan in 2005. Currently, close to 100 percent of Fletcher Allen’s beef has been raised without non-therapeutic antibiotics, and the hospital hopes that all of its chicken will soon meet this standard. Fletcher Allen estimates that its food service budget rose by $75,000 when it switched to a line of chicken products raised without the routine use of antibiotics. The cost of treating a patient infected with a resistant bacterial infection like MRSA (Methicillin-resistant Staphylococcus Aureus), however, is not far off.

While purchasing initiatives by hospitals can generate much-needed market demand, smarter shopping alone cannot solve agriculture’s role in the antibiotic resistance crisis. A true and comprehensive solution will only come when federal policy bans the routine, non-therapeutic use of antibiotics in livestock production. Unfortunately, there have been minimal public policy gains in this arena. The only policy in place is a 2012 guidance document from the Food and Drug Administration that asks the livestock and pharmaceutical industries to voluntarily reduce the consumption and sales of antibiotics in favor of more “prudent” use.

The most comprehensive policy under consideration is the Preservation of Antibiotics for Medical Treatment Act (PAMTA). PAMTA would ban eight classes of medically-important antibiotics from non-therapeutic use in animal agriculture. Along with Health Care Without Harm, more than 300 organizations, including the American Medical Association and the American Public Health Association, stand behind the bill. However, due to lobbying pressure from pharmaceutical companies and agribusiness, keen on continuing the injudicious use of antibiotics to speed up the pace of meat production and earn profits, PAMTA has failed to pass in Congress three times since 2007.

As hospitals like UCSF push for change in the market, demanding that we put public health ahead of profit, Congress and the FDA should take note and act, before medicine’s wonder drugs become a thing of the past.