Factory Farms, Antibiotics and Anthrax:

1
Factory Farms, Antibiotics and Anthrax

• Putting Profits Before Public Health
• Martin Donohoe, MD, FACP

2
Outline

• Factory Farming
• Agricultural Antibiotics
• Cipro and Anthrax
• Bayer
• Conclusions

3
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

4
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

5
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

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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

7
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

8
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?

9
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

10
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)

11
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

12
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

13
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
• gt 152 billion/yr in medical costs, lost wages,
  and lost productivity

14
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

15
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

16
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

17
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

18
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

19
Agricultural Antibiotics

• 2010 AMA, AAP, APHA, IDS all oppose
  non-therapeutic antibiotic use in livestock
• 2010 FDA urges phasing out antibiotic use

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Campylobacter

• Most common food-borne infection in US
• 2.5 million case of diarrhea and 100 deaths per
  year

21
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

22
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

23
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 nations largest
  PBM

24
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

25
Bayer and Cipro

• 1997 onward Bayer pays Barr Pharmaceuticals and
  two other competitors 200 million not to
  manufacture generic ciprofloxacin, despite a
  federal judges 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.

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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

27
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 Bayers patent and ordered 1
  million tablets from a Canadian manufacturer

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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

29
Other Consequences

• Opens door to other situations involving parallel
  importing and compulsory licensing
• Threatens pharmaceutical industrys massive
  profits
• the most profitable industry in the US

30
Other Consequences

• Weakens pharmaceutical industrys 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

31
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

32
Bayer

• Consists of Bayer HealthCare, Bayer
  MaterialScience, and Bayer CropScience
• Pharmaceuticals
• Worlds leading pesticide manufacturer
• One of worlds largest seed companies

33
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

34
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

35
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

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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

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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

38
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)

39
History of Bayer

• 1998 pays Scottish adult volunteers 750 to
  swallow doses of the insecticide Guthion to
  prove products 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

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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

41
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 Germanys health minister of failing
  to inform government of lethal side effects for 2
  months

42
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

43
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

44
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 Womens Low Dose Aspirin plus
  Calcium and Bayer Heart Advantage

45
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

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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

47
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 Mens Health Formula
  multivitamin reducing prostate cancer risk

48
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 Oregons most contaminated dump
  sites (pesticides)

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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

50
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

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Bayers Corporate Agenda

• Bluewash signatory to UNs Global Compact
• Greenwash crop protection (pesticides)
• Promotion of anti-environmental health agenda
  Wise Use, Responsible Care movements

52
Bayers Corporate Agenda

• Corporate Front Groups Global Crop Protection
  Federation
• Harrassment / SLAPP suits against watchdog groups
• e.g., Coalition Against Bayer Dangers

53
Bayers 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

54
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

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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

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Reference

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

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Contact Information

• Public Health and Social Justice Website
• http//www.publichealthandsocialjustice.org
• http//www.phsj.org
• martindonohoe_at_phsj.org