Regulation: A Gut Check

How do we get the word out that our underlying conception of how regulations should be designed and enforced needs to change?

The New York Times has an ominous article about the overuse of antibiotics by the livestock industry and its risks for animal health and ours.  Flooding our digestive system with these drugs damages the gut microbiome we depend on for nutrition and waste processing, and it promotes the evolution of resistant strains of bacteria.  The upshot, according to this piece, is that 23,000 Americans die of antibiotic resistance each year, and it adds:

A growing body of scientific research also shows that the antibiotics we take as medicine can disrupt our so-called gut microbiome, the bacteria that live happily in our stomach and intestines and that are the key to our ability to properly digest food and process fats. This disruption has been linked to the rise of noncommunicable diseases such as obesity, juvenile diabetes, asthma and allergies. Some researchers also believe that alterations in the gut microbiome have led to an increase in the incidence of autism, Alzheimer’s and Parkinson’s disease.

Ranchers lace their feed with antibiotics to speed up animal growth because it’s profitable.  The risks are difficult for the public to appreciate, and the externality of reducing the effectiveness of legitimate antibiotic treatment is unpriced.  This is a serious problem.

Regulation came to the rescue, sort of, in 2017 with the issuance of a rule by the Food and Drug Administration that requires livestock owners to get veterinary approval for administering antibiotics, with the criterion that the purpose has to be prevention of disease and not growth acceleration.  That sounds like it should have been a solution, right?  You don’t want to ban antibiotics altogether because sometimes there’s a valid reason for using them, so you require professionals to certify that only “good” uses are taking place.

The problem, as the article points out, is that it isn’t clear how much progress, if any, has been made in reducing the routine use of antibiotics in livestock feed.  Ranchers are under pressure to continue pumping up growth, and veterinarians are under pressure to give the ranchers what they demand.  An industry—any industry, including livestock—is an ecosystem, not a machine, with lots of unwritten rules and relationships, incentives, and local exigencies.  You can specify how it’s supposed to work, but it may not work that way.

Fortunately, we have a paradigm for this: adaptive management, which in this case means adaptive regulation.  Every regulation issued by an agency should have three components.  First, it should have a set of rules for people to follow, as all of them do.  But second, it should set up a system of data collection to assess how well the rules are working, and in what way.  And third, it should specify a regular cycle of review and revision to put accumulated knowledge into practice.

The FDA antibiotic regs did #1 but not #2 or #3.  It was a one-off, over-and-out performance, as most of our regulation tends to be.  Regulators did not set up a surveillance or sampling system to see how and where antibiotic use was changing, much less build in an ongoing process of evaluating and improving the regulation itself.  The upshot is that years have to go by, and the political forces for reform have to be assembled all over again to replace a defective rule by a better one.  The NYT article is part of that process, which is good, but it’s a lousy process.

So: how do we get the word out that our underlying conception of how regulations should be designed and enforced needs to change?

(Source for image: Dreamtime.com)