An Integrated Systems Approach is Needed to Ensure the Sustainability of Antibiotic Effectiveness for Both Humans and Animals

World Health Organization, The Evolving Threat of Antimicrobial Resistance: Options for Action (2012); Landers T. Cohen B. Wittum T. Larson E. , “A Review of Antibiotic Use in Food Animals: Perspective, Policy, and Potential,” Public Health Reports 127, no. 1 (2012): 4–22.

Van Boeckel T. Brower C. Gilbert M. , “Global Trends in Antimicrobial Use in Food Animals,” Proceedings of the National Academy of Sciences, 112, no. 18 (2015): 5649–5654.

Nelson R. , “FDA Action on Animal Antibiotics Could Still Have Loopholes,” The Lancet Infectious Diseases 14, no. 5 (2014): 376–377.

Executive Office of the President, National Strategy for Combating Antibiotic-Resistant Bacteria (2014): 1–33.

United States Department of Agriculture, “Feedlot 2011 Part I: Management Practices on U.S. Feedlots with a Capacity of 1,000 or More Head,” Animal and Plant Health Inspection Services (2013): 1–143; United States Department of Agriculture, “Swine 2006 Part II: Reference of Swine Health and Health Management Practices in the United States,” Animal and Plant Health Inspection Services (2007): 1–78; Zhu Y- G. Johnson T. Su J-Q. , “Diverse and Abundant Antibiotic Resistance Genes in Chinese Swine Farms,” Proceedings of the National Academy of Sciences 110, no. 9 (2013): 3435–3440.

Food and Agricultural Organization of the United States, World Organization for Animal Health, World Health Organization, “Joint FAO/OIE/WHO Expert Workshop on Non-Human Antimicrobial Usage and Antimicrobial Resistance: Scientific assessment” (2003): 1–35.

Levy S. Marshall B. , “Antibacterial Resistance Worldwide: Causes, Challenges and Responses,” Nature Medicine 10, no. 12 (2004): S122–S129.

Marshall B. Levy S. , “Food Animals and Antimicrobials: Impacts on Human Health,” Clinical Microbiology Reviews 24, no. 4 (2011): 718–733; Casey J. Curriero F. Cosgrove S. Nachman K. Schwartz B. , “High-Density Livestock Operations, Crop Field Application of Manure, and Risk of Community-Associated MRSA Infection in Pennsylvania,” JAMA Internal Medicine 173, no. 21 (2013): 1980–1990.

U.S. Food and Drug Administration, “Guidance for Industry #209: The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals” (2012): 5–14.

See United States Department of Agriculture (Swine 2006), supra note 5; European Medicines Agency, “Referral Procedure on Veterinary Medicinal Products Containing 3rd and 4th Generation Cephalosporins under Article 35 of Directive 2001/82/EC,” Veterinary Medicines and Product Data Management (2012); EMA, “CVMP Guideline on the SPC for Antimicrobial Products (EMEA/CVMP/SAGAM/383441/2005),” Veterinary Medicines Division (2014).

Graham J. Boland J. Silbergeld E. , “Growth Promoting Antibiotics in Food Animal Production: An Economic Analysis,” Public Health Reports 122, no. 1 (2007): 79–87; Bray J. Taylor C. Cherry T. Carey J. , “Performance Comparison between the Use and Nonuse of an Enteric Health Medication Program across Five Consecutive Commercial Broiler Flocks,” Journal of Applied Poultry Research 18, no. 2 (2009): 165–171; MacDonald J. Wang S. , “Foregoing Sub-Therapeutic Antibiotics: The Impact on Broiler Grow-Out Operations,” Applied Economic Perspectives and Policy 33, no. 1 (2011): 79–98.

McBride W. Key N. Mathews K. , “Subtherapeutic Antibiotics and Productivity in US Hog Production,” Applied Economic Perspectives and Policy 30, no. 2 (2008): 270–288.

Aarestrup F. Jensen V. Emborg H.D. , “Changes in the Use of Antimicrobials and the Effects on Productivity of Swine Farms in Denmark,” American Journal of Veterinary Research 71, no. 7 (2010): 726–733.

Levy S. , “Reduced Antibiotic Use in Livestock: How Denmark Tackled Resistance,” Environmental Health Perspectives 122, no. 6 (2014): A160–A165.

Wierup M. , “The Swedish Experience of the 1986 Year Ban of AGPs, with Special Reference to Animal Health, Disease Prevention, Productivity, and Usage of Antimicrobials,” Microbial Drug Resistance 7, no. 2 (2001): 183–190.

Cogliani C. Goossens H. Greko C. , “Restricting Antimicrobial Use in Food Animals: Lessons from Europe,” Microbe 6, no. 6 (2011): 274–279.

European Medicines Agency, European Surveillance of Veterinary Antimicrobial Consumption, “Sales of Veterinary Antimicrobial Agents in 26 EU/EEA Countries in 2012,” Fourth EVSAC Report (2014); Wegener H. Aarestrup F. Jensen L. Hammerum A. Bager F. , “Use of AGPs in Food Animals and Enterococcus Faecium Resistance to Therapeutic Antimicrobial Drugs in Europe,” Emerging Infectious Diseases 5, no. 3 (1999): 329–335.

Maron D. Smith T. Nachman K. , “Restrictions on Antimicrobial Use in Food Animal Production: An International Regulatory and Economic Survey,” Globalization and Health 9:48, (2013): 1–11.

U.S. Food and Drug Administration, “Guidance for Industry #213: New Animal Drugs and New Animal Drug Combination Products Administered in or on Medicated Feed or Drinking Water of Food-Producing Animals: Recommendations for Drug Sponsors for Voluntarily Aligning Product Use Conditions with GFI #209,” Center for Veterinary Medicine (2013).

Nachman K. Smith T. Martin R. , “Antibiotics: Call for Real Change,” Science 343, no. 6167 (2014): 140.

Diaz F. , “OIE Initiative to Collect Quantitative Data on the Use of Antimicrobial Agents in Animals to Establish a Global Database,” European Surveillance of Veterinary Antimicrobial Consumption Stakeholders meeting, London, UK, 2014.

Le Hello S. Hendricksen R. Doublet B. , “International Spread of an Epidemic Population of Salmonella Enterica Serotype Kentucky ST198 Resistant to Ciprofloxacin,” Journal of Infectious Diseases 204, no. 5 (2011): 675–684.

World Health Organization, WHO Global Principles for the Containment of Antimicrobial Resistance in Animals Intended for Food (2000).

WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance, Integrated Surveillance of Antimicrobial Resistance (2013): 1–93.

Codex Alimentarius Guidelines for Risk Analysis of Foodborne Antimicrobial Resistance CAC/GL 77–2011, 4; Adams D. Cooper R. Hahn M. Kahan J. , eds., Food and Drug Law and Regulation (Washington, D.C.: FDLI, 2011): At 911–918.

World Organization for Animal Health, Factsheet on Antimicrobial Resistance (2013).

World Trade Organization, Understanding the WTO Agreement on Sanitary and Phytosanitary Measures (1998).

World Trade Organization, “Article 5: Assessment of Risk and Determination of the Appropriate Level of SPS Protection,” WTO SPS Agreement, 5, no. 6 (1998).

Russia Federal Veterinary and Phytosanitary Surveillance Service Press Release (December 5, 2014), Translated by USDA; FDA Import Alert, “Detention without Physical Examination of Aquacultured Catfish, Basa, Shrimp, Dace, and Eel from China-Presence of New Animal Drugs and/or Unsafe Food Additives,” (2015).

World Health Organization, AMR: Global Report on Surveillance (2014): At 61.

See Diaz , supra note 21.

President's Council of Advisors in Science and Technology, Report to the President on Combating Antibiotic Resistance , Executive Office of the President (2014); see World Organization for Animal Health, supra note 26.

Hammerum A. Heuer O. Emborg H.-D. , “Danish Integrated Antimicrobial Resistance Monitoring and Research Program,” Emerging Infectious Diseases 13, no. 11 (2007): 1633–1639.

Bager F. , “Glycopeptide Resistance in Enterococcus Faecium from Broilers and Pigs Following Discontinued Use of Avoparcin,” Microbial Drug Resistance 5, no. 1 (1999): 53–56.

Grave K. , “Usage of Veterinary Therapeutic Antimicrobials in Denmark, Norway and Sweden Following Termination of AGP Use,” Preventive Veterinary Medicine 75, no. 1 (2006): 123–132.

Aarestrup F. , “Sustainable Farming: Get Pigs off Antibiotics,” Nature 486, no. 7404 (2012): 465–466.

Korsgaard H. Agersø Y. Hammerum A. Skjøt-Rasmussen L. , eds., DANMAP Annual Report: Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Food and Humans in Denmark (2013).

Kates J. Katz R. , “The Role of Treaties, Agreements, Conventions, and Other International Instruments in Global Health,” Infectious Disease Clinics of North America 25, no. 2 (2011): 455–475.

Gostin L. Sridhar D. , “Global Health and the Law,” New England Journal of Medicine 37, no. 18 (2014): 1732–1740.

Murphy S. , “Concentrated Market Power and Agricultural Trade,” EcoFair Trade Dialogue (2006).

Analysis based on UN Comtrade data from International Trade Center Statistics.

Codex Alimentarius, Code of Practice to Minimize and Contain Antimicrobial Resistance, CAC/RCP 61-2005.

Fidler D. Gostin L. , “The WHO Pandemic Influenza Preparedness Framework: A Milestone in Global Governance for Health,” JAMA 306, no. 2 (2011): 200–201.

Hollis A. Ahmed Z. , “The Path of Least Resistance: Paying for Antibiotics in Non-human Uses,” Health Policy 118 no. 2 (2014): 264–270.