WAAW 2024: As many Indians as Netherlands’ population drink milk containing antibiotics. Expert proposes solutions

Contamination in the dairy supply chain can occur at various stages, introducing hazards such as toxins, pesticides, heavy metals, veterinary drugs and organic pollutants into milk.

Antibiotic residues in milk often result from mastitis treatments, injections or contaminated feed. Improper drug use, especially for mastitis control, has been identified as a major source of such residues, leading to antimicrobial resistance, intestinal flora disorders and allergic reactions in humans.

Beyond health concerns, antibiotic residues cause significant issues in dairy processing, including poor curdling in dahi and yogurt, inadequate cheese ripening, reduced flavour in fermented products and diminished activity of starter cultures.

These effects not only compromise product quality but also lead to economic losses for the industry and threaten human health.

The antibiotics used in veterinary medicines belong to six major groups: Beta-lactams (eg: penicillin), aminoglycosides (eg: gentamycin), tetracycline (eg: oxytetracycline), macrolides (eg: erythromycin), quinolones (eg: fluroquinolone) and sulphonamides (eg: trimithropin). Any of the drugs belonging to these groups can appear in milk.

In 2016, this author had the opportunity to collaborate with the Food Safety and Standards Authority of India’s (FSSAI) team in designing and implementing the National Milk Adulteration Survey. The scope of the survey expanded in 2018 to include contaminants, reflecting a more comprehensive approach to ensuring milk safety.

The survey showed that 77 (out of 6,432) samples, or 1.2 per cent of the samples, had residues of antibiotics above the permissible limits. Among the top three states with the highest levels of antibiotics residues were Madhya Pradesh (23 out of 335 samples), Maharashtra (9 out of 678 samples) and Uttar Pradesh (8 out of 729 samples). Only one raw milk sample in Kerala was found to contain pesticide residue above the permissible level.

A similar survey was conducted by FSSAI in 12 states / Union territories of India during the post-Covid-19 period in 2022 when the the country was also witnessing a Lumpy Skin Disease outbreak.

The milk samples were tested for all the 26 antibiotics specified in Food Safety and Standards Regulations for milk & 15 as specified for food commodities other than milk, according to the authors of the report. “Only 0.4 per cent (3 / 798) raw milk samples from the two States (two samples from Tamil Nadu and one from Karnataka) were reported to contain antibiotics specified for milk, namely sulfadimidine in one sample and meloxicam in two samples more than the prescribed limit.”

Considering a total production of 670 million litres of milk per day in current times, the level of 1.2 per cent contaminated milk with antibiotics accounts for around 8 million litres of milk per day, thety added.

Assuming per capita availability of milk as consumption, around 180 million persons are consuming this milk on a daily basis, which is almost equivalent to the whole of Netherlands. We need to understand this problem and find appropriate solutions to counter the issue. 

Driving factors

Primary milk production area is the major contributor of contaminants like drug residue or aflatoxin M1. There has not been any direct intervention by the food regulator FSSAI in this part of the dairy value chain since the beginning.

However, after the 2018 survey, a scheme of testing and inspection was introduced by the regulator for all plants involved in processed liquid milk sales.

This intervention introduced the testing protocol with frequency for both raw milk sources as well as finished goods with frequency. The six monthly reports submission to the food regulator also mandated regular testing of contaminants.

There may be three reasons for lack of regular antibiotic testing of raw milk and finished goods: Minimal surveillance and enforcement for contaminant’s residues in milk; the perception that this is not a major problem in processed milk sold by commercial dairies in our country and; the cost of testing of these contaminants particularly antibiotics residue is very high due to highly fragmented milk production and collection in India. 

The dairy industry follows the principle of prevention through dilution. In India, milk is collected from 80 million small and marginal farmers in small quantities.

The contaminated milk from treated animals would be pooled with very large volumes of uncontaminated milk, resulting in undetectable amounts of antibiotic residues in bulk milk. There are several other reasons for presence of antibiotics in milk.

• Unregulated use of antibiotics by veterinary doctors as well as quacks, including prophylactic use of antibiotics to prevent diseases
• Lack of awareness at the farmers level about usage of antibiotics and their after effects in human beings
• Supply chain issues related to mixing of contaminated milk with clean milk during collection at the aggregator level
• Farmer’s losses due to discarded milk of treated animals. No buyer is ready to compensate the farmers for the milk produced from under-treatment animals
• Limited and costlier methodologies for confirmatory tests of complete spectrum of antibiotics across the country

Way forward

India's regulations for testing antibiotics in milk and dairy products are among the most stringent globally. In some instances, these standards are even more rigorous than those in developed countries.

Indian regulations for commonly used cattle antibiotics, such as tetracycline, sulfadiazine and sulfonamide, are more rigorous than those of the European Union, and in some instances, surpass the standards of Singapore and the FAO-WHO's Codex. However, New Zealand has stricter maximum residual limits for tetracycline compared to India. 

Despite the stringent regulations, the issue of antibiotic residues in Indian milk necessitates a paradigm shift through capacity building, access to quality infrastructure, grassroots interventions and alternative treatment strategies for animals.

FSSAI has recently taken steps to register all milk producers. This initiative could serve as a starting point for enrolling them in capacity building programs and raising initial awareness about good farming practices. These practices aim to produce antibiotic-free milk and promote alternative treatments for cattle, such as ethno-veterinary methods or homoeopathy.

Certain proactive steps like doing California Mastitis Test and catching animals at pre-clinical stage have been very helpful in avoiding use of antibiotics for mastitis. In India, a fourth of milk producers are enrolled with around 200,000 primary milk producers cooperative under the National Dairy Development Board. A national-level program for incentivising farmers for contaminant free milk may be implemented. A large number of states offer milk subsidy from Rs 2-5 per litre. These subsidies may be made to contaminant free milk only as a policy. 

The government should promote new-age startups as well as research institutions to develop technologies for low-cost rapid testing of antibiotics in milk and feed. This will simplify decision-making at farmers' level.

Some large multinationals with deep pockets are purchasing antibiotics-free milk at a premium of Rs 1-2 per liter from various members of the dairy value chain. However, handling the problem at its root by eradicating the need for antibiotics at farms through safe practices is a better option.  

Finally, there must be stricter regulation of veterinary medicines. Prophylactic use of antibiotics to prevent diseases by doctors must be made illegal and all practicing veterinarian must be asked to keep records of Aadhar cards of cattle on which the antibiotics were used. The regulator to identify hotspots for the usage of these medicines through regional tracking of sale of these medicines. 

Establishing regulatory standards and management practices to minimise antibiotic residues is crucial for food safety. Screening milk can prevent contaminated supply from reaching consumers. Many countries have adopted approved tests and implemented good practices on farms to reduce antibiotic residues effectively.

Last but not the least, all stakeholders should come together to solve this problem in an inclusive manner, by safeguarding public health at one hand and farmer’s sustainability at the other hand. 

Kuldeep Sharma is chief thinking officer at Suruchi Dairy Advisor, an initiative of Suruchi Consultants, Noida. Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth.