From The Archers to Antibiotic Resistance – Has BBC Radio 4 Lost the Plot?

ResistanceAfter some excellent commentaries on future food production and Brexit on Farming Today last week, it seems that, not content with domestic violence, miscarriage and admitting women to the Ambridge cricket team (the horror of it!) on The Archers, BBC Radio 4 has dived into modern agricultural issues with a vengeance. However, their latest venture has all the balance and perspective of Nigel Farage faced with a chicken vindaloo and a team of migrant NHS workers.

Developed through the Wellcome Trust Experimental Stories Unit and written by Val McDermid, well-known for her crime novels, “Resistance” describes the impact of an outbreak of antibiotic-resistant swine erysipelas, which passes swiftly from contaminated sausages at a music festival to the general public exhibiting dreaded “purple spots” and collapsing at the supermarket checkout.

Alas, having listened to the first two episodes with more than a passing interest (after all, antibiotic resistance is a huge issue for our industry, both from an animal and human health perspective), it’s clear that an aluminium helmet and a “meat is murder” sign may be required listening accessories. The main protagonist is a slightly holier-than-thou vegetarian who was turned away from meat by the animal rights activists with whom she worked on a story and is currently scratching around to find freelance work after her editors became afraid of “real investigative journalism.”

Cue a cliched storyline, lined up in true pantomime fashion with neon signs alerting the listener to every plot development. The contaminated meat is traced back to a “factory” farm in an urban location, with pigs kept in “tiny pens with no room to lie down or turn around.” A specialist (non-local) vet throws antibiotics at the animals and a surly, secretive, Eastern-European-accented farm manager doesn’t seem keen on a journalist sniffing around.

The  racial stereotyping is unfortunate given how much UK agriculture relies on workers from Europe and beyond, and the farm portrayed as secretive, polluting water and soil, and utterly lacking transparency. By contrast, organic systems with “humanely-farmed” animals, and “well-scrubbed, rare breed pigs” are the dramatic ideal. Yet in real life, farm assurance schemes such as Red Tractor (which covers >80% of UK pork) ensure that pigs are kept in environments that provide sufficient space; are given suitable, healthy feed; and that waste is managed to prevent water or soil contamination. Does that mean that every pig farm is perfect? No. So does it mean that poor husbandry, environmental pollution and rampant overuse of pharmaceutical drugs is the norm? Absolutely not.

The casual listener might be horrified by the implications of antibiotic resistance for human health, but never fear, the drama suggests all will be well as long as your sausage comes from an organic Berkshire pig hand-raised on acorns. However, bacterial resistance to antibiotics occurs naturally and can be maintained or increased by any antibiotic use – in people, livestock or companion animals – not simply by use on conventional farms. Indeed, it’s vital to remember that organic operations are permitted to use antibiotics (as per the Soil Association organic standards), especially if they are the “best way to reduce suffering, save life or restore your animal’s health.” There is no blanket antibiotic prohibition on organic operations, as is often assumed.

Still more rhetoric invades the human health side of the drama – doctors try to dismiss and cover-up the public health implications, antibiotic researchers are hampered by lack of funds (possibly the most crucial but least discussed issue of the entire drama) and “big pharma” is lambasted for being more interested in developing drugs that generate long-term profit (e.g. diabetes or high blood pressure medication) than antibiotics that only need to be used once.

There is an immediate and definite need to develop new antibiotics both for animal and human health, yet if effective new drugs are found they’re unlikely to be distributed widely, but stored in case of an epidemic. Livestock farmers and vets have a huge responsibility in protecting both animal and human health, but so do doctors, food processors and ultimately all of us – simple hygiene measures, including effective hand-washing, are key to preventing the spread of disease.

Both national and global programs have been implemented to quantify, assess and reduce antimicrobial use; veterinary scientists are actively involved in on-farm research and interventions to reduce both antimicrobial use and resistance; and animal health companies (so-called”big pharma”) have joined with food processors, retailers, charitable foundations and human/veterinary medicine associations in taking a One Health approach (incorporating the health of people, animals and their environments) to making sure that antibiotics that are critically important for human medicine are withdrawn from animal use, and that the speed and spread of antibiotic resistance is reduced. Unless the rabid journalist has a serious epiphany in the third episode (to which I have not yet listened) it seems that facts are going to be overwhelmed by fiction as the efforts and advances made by global livestock producers are ignored.

I’m not suggesting that all drama should be absolutely true to life, but when real-life, topical, scientific issues are discussed, surely broadcasting agencies have a responsibility to be factual rather than alarmist? It’s unfortunate that this drama, written by a famous author and advised by a Professor of Microbiology at the University of Warwick, seems to have been developed without input from experts in veterinary science, animal production or on-farm antibiotic use. Furthermore, given the Wellcome Trust’s role as a global medical charity, one would assume that they have a responsibility to provide factual information, especially when their sponsorship must ultimately have been publicly funded. Instead, as with so many sensationalist dramas, it seems the world is going to end and we are the innocent victims of others greed for profit. Better switch to the organic sausage, or better still, the tofu surprise.

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If We Can Replace Antibiotics with Homeopathy, then Cheese is the New Miracle Cure!

IMG_1903 cropIn the Guardian this week, HRH Prince Charles proposed homeopathy as a solution to antibiotic resistance, citing his “agro-ecological” farm as an example of one that has cut antibiotic use by using homeopathic treatments.

Given the concern over bacterial resistance to medically-important antibiotics, it is vital that we find alternatives. Yet they also must have a biologically sound mode of action and be proven to be effective. It is difficult to conceive how a solution so dilute that not one molecule of active ingredient remains, where the premise of the mode of action depends on water having a “memory” of the ingredient (as opposed to all the other contaminants within that water), can possibly have any verifiable impact on disease. Indeed, there are no studies to date that show positive, replicable effects of homeopathy compared to conventional treatment.

Personally, I have no issue with any alternative therapy has been shown to be an effective alternative to conventional drugs (note that homeopathy does not fall into this category). When I underwent chemotherapy for breast cancer, I had some reiki sessions. Did I believe that energy was being channeled by the reiki healer and making me better? Honestly, no. Would I have ever considered giving up the chemotherapy? Absolutely not. But the focused breathing and relaxation certainly helped with pre-chemo anxiety. Would taking Rescue Remedy or a similar homeopathic preparation have helped? If I’d believed that it would – yes, probably. But that is biased by the placebo effect – it’s not the same as the treatment being independently effective. One of the claims made for using homeopathic treatments in animals is that they are independent of the placebo effect – they don’t have the expectation that the tincture administered is going to cure their lameness or mastitis. Yet when we assess the results, it’s not the animal who’s reporting the success or failure of the homeopathic treatment, it’s the farmer.

So let’s examine a scenario. A farmer has two mildly sick cows (e.g. slightly lame, or unwilling to eat with a raised temperature) within the herd. Both are moved to the hospital pen, given fresh bedding, water and feed plus a homeopathic remedy. Cow A gets better – hoorah for homeopathy!  Cow B doesn’t and has to be treated with antibiotics – boo! Does this mean homeopathy works in 50% of cases? No. There’s no control treatment here, no evidence that Cow A wouldn’t have got better without homeopathy – some diseases just need time, TLC and the cow’s own immune system for recovery. Did the farmer cut antibiotic use? Yes – Cow A didn’t receive it. Yet again there is no evidence that this is due to the homeopathic treatment. How many times have we as humans debated whether to go to the doctor because of a minor ailment, then have found that it’s cleared up without medical treatment? It’s not miraculous, it’s simply our immune systems functioning as they are intended to.

In the absence of controlled experiments that compare homeopathic treatments to both conventional antibiotics and no veterinary treatment (save for good animal husbandry), it is disingenuous to claim that homeopathy is successful in treating bacterial disease or can effectively be used to replace antibiotics. We need to look to veterinarians and scientists when making decisions about animal care and treatment rather than relying on anecdotal data from those with royal connections. After all, HRH Prince Charles may have reduced antibiotic use on his farm, but I can also claim to have reduced antibiotic use in my household through dairy consumption – my toddler has a serious cheese addiction and has never had to take antibiotics. Hoorah – cheese is the new homeopathy!!*

(*obviously I am being sarcastic here for those who missed it, though the extent of cheese consumption and fact that she’s never had antibiotics are both entirely true)