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
9,900 CAFOs in U.S.
Flourished thanks to indirect federal subsidies
Not subject to Clean Air Act Standards

4. Factory Farming
1.4 billion tons animal waste generated/yr in U.S. (13 billion tons worldwide)
130 x human waste (in U.S.)
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

6. 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, Marine Life
Antibiotic-resistant infections
Carriage of antibiotic-resistant organisms
Antibiotic-resistant land-based pathogens increasingly found in marine organisms

9. Risks to Farm Workers
Aerosolized pig brains associated with immune polyradiculoneuropathy (progressive inflammatory neuropathy) in pork processing plant workers
?Other similar illnesses?

10. Food-Borne Infections in the U.S.
Each year:
1/6 Americans affected
128,000 hospitalizations
3,000 deaths
Salmonella = most common infection

11. Agricultural Antibiotic Use
Agriculture accounts for 80% (29 million lbs) of U.S. antibiotic use
Use up 50% over the last 15 years
Only 10% used to actually treat infections
Almost 9 billion animals per year “treated” to “promote growth”
Claim: Larger animals, fewer infections in herd

12. 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Arsenic used in chicken and pork feed (banned in Europe; roxarsone [major arsenic contributor] voluntarily withdrawn from U.S. market, but still sold overseas; Poison-Free Poultry Act pending in U.S. Congress)

13. 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
Linked to E.coli UTIs in humans
2009: Campylobacter found in 62%, Salmonella in 14%, and both in 8% of store-bought chickens

14. 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

15. 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
> $156 billion/yr in medical costs, lost wages, and lost productivity

16. 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

17. Alternatives to Agricultural Antibiotic Use
Organic farming
Decrease overcrowding
Better diet/sanitation/living conditions
Control heat stress
Vaccination
Increased use of bacterial cultures and specific antibiotic treatment in animals when indicated

18. 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

19. 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%

20. 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
Almost 9 million lbs of meat and poultry recalled in 2010

21. Agricultural Antibiotics
2010: AMA, AAP, APHA, IDS all oppose non-therapeutic antibiotic use in livestock
2010: FDA urges phasing out antibiotic use

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

23. 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

24. 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

25. 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

26. 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

27. 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.”

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. Bayer
Consists of Bayer HealthCare, Bayer MaterialScience, and Bayer CropScience
Pharmaceuticals
World’s leading pesticide manufacturer
One of world’s largest seed companies
Manufacters bis-phenol A (BPA)

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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)

41. 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

42. 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

43. History of Bayer
2001 – FDA-reported violations in quality control contribute to worldwide clotting factor shortage for hemophiliacs
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

44. 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

45. History of Bayer
Worldwide cost estimates range from $740 million to $1.3 billion
Bayer loses first three cases for total $53.5 million
Later agrees to pay up to $750 million to farmers in Missouri and 4 other states

46. 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

47. 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

48. 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 ft from blast area
Underground storage tank at plant site can store an additional 200,000 lbs

49. Comparison: Bhopal
50,000 to 90,000 pounds of methylisocyanate released in Union Carbide Bhopal, India explosion
,000 dead within 3 days, 15,000-20,000 more over next 10 years; tens of thousands injured
Persistent water and soil contamination

50. 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

51. 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
Failed to inform FDA and public re risks of VTE
Facing thousands of personal injury lawsuits

52. History of Bayer
2009: Oregon taxpayers on hook for ¾ of cleanup costs for one of Oregon’s most contaminated dump sites (pesticides)
2010: FSA orders Bayer to stop misleading advertising re its IUD Mirena

53. History of Bayer
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

54. History of Bayer
2010: Fire at BayerCropScience Plant in india caused by leaking ethoprophos (toxic pesticide ingredient) kills one worker
Late 1990s s: Bayer pesticides spirotetramat, imidacloprid, and clothianidin implicated in (honeybee) “colony collapse disorder”

55. 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

56. Bayer’s Corporate Agenda
Corporate Front Groups: “Global Crop Protection Federation”
Harrassment / SLAPP suits against watchdog groups
e.g., Coalition Against Bayer Dangers

57. 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

58. 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

59. 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

60. Reference
Donohoe MT. Factory farms, antibiotics, and anthrax. Z Magazine 2003 (Jan): Available at

61. Public Health and Social Justice Website
Contact Information
Public Health and Social Justice Website