The fast-food industry has played a critical role in the fight against drug resistance in developed countries. But their attitude changes when it comes to India
Life will hardly remain the same when we get to the other side of the novel coronavirus disease (COVID-19) pandemic. Among the few things that are likely to remain unchanged is the popularity of fast food and the fear of a looming antibiotic apocalypse.
The two are, in fact, linked. Chicken, considered a staple on fast-food menus, are routinely administered antibiotics throughout their short lifecycle of 35-42 days, even in the absence of any clinical sign of infection. Poultry keepers say it prevents diseases while helping the birds easily gain weight with less feed.
In 2014, a laboratory test conducted by Delhi non-profit Centre for Science and Environment (CSE) found residues of multiple antibiotics in chicken samples. In its subsequent surveys, CSE researchers found that even poultry feed manufacturers, whether selling in open market or online, add antibiotics liberally to the feed.
Several of these, such as erythromycin, tylosin, ciprofloxcin and enrofloxacin, belong to antibiotic classes that are critically important for humans. They are the sole or one of the limited therapies available to treat infections caused by bacteria from non-human sources. Ciprofloxacin that belongs to antibiotic class fluoroquinolone, and erythromycin that belongs to class macrolide are used in treating common respiratory and urinary tract infections.
The World Health Organization (WHO) categorises these classes as “highest priority critically important antimicrobials” (HPCIAS). Any irresponsible use of these antibiotics can accelerate the emergence of resistant strains of bacteria, which can then easily find their ways into the human body through direct contact with live or dead animals, consumption of meat or exposure to contaminated environment, making the person resistant to antibiotic treatment.
In fact, fluoroquinolones are increasingly becoming ineffective worldwide. The impact of such growing antimicrobial resistance (AMR) is particularly huge for India, where public healthcare is highly inadequate and regulatory enforcement weak.
The fast-food industry, which is a major buyer of chicken meat in India, can be a game-changer in this fight against AMR. But a recent CSE assessment exposes their double standards for India.
Internationally, fast-food chains are under pressure from consumers, investors and civil society to play their part in ending the misuse of medically important antibiotics for food-animal production by not using chicken raised with antibiotics. In response, they have been serving chicken raised without antibiotics in the United States, Canada and some European countries for the past few years or have made commitments to eliminate antibiotics from their supply chains within a time frame.
Yet, when it comes to India, these fast-food chains, mostly owned by multinational corporations, are vague about their reduction or elimination frameworks and time frames. Worse, there has been little improvement in their practice since CSE did its first survey and exposed their double standards.
In 2017 when CSE researchers reached out to leading fast-food brands in India to assess their commitment towards reducing or eliminating antibiotics from the chicken supply chain, most had no plans or vague elimination frameworks. The list included brands run by multinationals that were already performing responsibly in other countries.
Jubilant FoodWorks Ltd (JFL), which holds the franchise for Domino’s Pizza and Dunkin’ Donuts in India, was the first one to release its policy on the “usage of antibiotics in poultry birds’ health management” soon after CSE started discussing the parochial attitude of fast-food giants.
Two years later, when CSE revisited the industry, JFL was still the only one with India-specific policy. In its latest assessment, conducted during the last three months of 2019, CSE researchers wrote to 11 companies managing 14 fast-food brands in India. These include nine foreign multinationals operating 12 brands and two Indian multinational brands managed by domestic companies.
The researchers asked the companies if they have any existing India-specific policy or future plans for reducing or eliminating the use of antibiotics in chickens they source and if they have any policy to test the sourced chicken meat and their food products for the presence of resistant bacteria and antibiotic residues. Only five of the 14 responded. Eight of the nine brands that did not respond are foreign multi nationals with either global overarching policies encouraging responsible antibiotic use in animals or have eliminated antibiotics from their chicken supply chains in the US. Consider Pizza Hut, Kentucky Fried Chicken (KFC) and Taco Bell.
These are managed by America’s Yum! Brands, a Fortune 500 corporation. It has a global antimicrobial stewardship policy that focuses on responsible and judicious antimicrobial use. All the three brands have removed antibiotics important to human medicine from their poultry supply chains in the US. But with no response received and no information on public domain, these brands do not seem to have any India specific plan or commitment to eliminate or reduce antibiotic misuse in supply chains.
KFC on its India website, under the “Frequently Asked Questions”, says, “Chicken supplied to KFC India is free from any antibiotic residue, as our chicken supplies are subjected to a withdrawal period specific to each medicinal treatment. Additionally, our poultry suppliers follow the standards set by who and only use antibiotics that are approved for veterinary use or dual use.” But focus on eliminating antibiotic residues is only half of the solution.
It should be on eliminating antibiotic use at farm level. Moreover, the use of antibiotics approved for dual use is not the best practice. Besides, KFC’s statement on its India website is different from what it says on websites for other countries. On its UK website, KFC mentions not allowing the use of growth promoters and antibiotics for disease prevention in raising chicken whose meat they procure. On Australia website, it claims to be following all laws and regulations related to judicious antibiotic use outlined in Yum! Brands’ policy and is working with suppliers to reduce the use of antibiotics important to human medicine in its chicken supply.
Similar is the approach of Wendy’s, a popular US-based burger chain. It has played a pioneering role in reducing antibiotic misuse in the US and has an “animal antibiotic use policy” in place since 2006. By 2017, it eliminated the use of all medically important antibiotics from its supply chains in the country. When approached by CSE, Wendy’s India refused to divulge information. Usman Moin, managersupply chain, Wendy’s India wrote: “The information being asked falls under the confidentiality clause that has been agreed as a part of master license agreement with the brand and hence cannot be shared”. Café Coffee Day (CCD), a popular coffee chain in India that serves chicken based dishes, also did not share its plans for eliminating antibiotic use in supply chain.
REST OFFER LOW RELIEF
All the four multinationals and one national brand that responded to CSE’s queries, recognised AMR as an area of concern. But it appears from their responses that their efforts are nowhere closer to what their counterparts have achieved in other countries. Only one has a clear elimination strategy for India (see ‘Half-hearted effort’).
McDonald’s, the world’s largest fast-food chain, has stopped serving chicken treated with antibiotics important to human medicine in its restaurants in the US since 2016. It has also eliminated the use of HPCIAS in broiler chicken for Brazil, Canada, Japan, South Korea, US, Australia, Russia, China and Europe. Responding to CSE’s queries, Hardcastle Restaurants Pvt Ltd (HRPL) that operates over 300 Mc- Donald’s outlets across west and south India, said that it does not use antibiotics for growth promotion or disease prevention. “Such antibiotics are used strictly in accordance with labelled and veterinary direction for dose, duration, route, frequency, withholding period and withdrawal times. Appropriate withholding periods ensure that there is no antibiotic residue in the chicken,” it notes.
Though McDonald’s antibiotic use policy for broiler chickens has a time frame for eliminating HPCIAS used in all the other designated markets worldwide by 2027, the list does not mention India. While HRPL said the policy applies to India, its response does not mention HPCIAS. It also did not share laboratory reports on testing of antibiotic residues in sourced meat, despite referring to a periodic and comprehensive testing programme to ensure zero residue, nor did it specify monitoring of resistant bacteria in the sourced meat.
Subway India, which has about 660 outlets and provides some 26 chicken dishes in its menu, in its response said it has a “global responsible use of antibiotics policy”. “We are working with our suppliers across the globe to align sourcing standards with who recommendations,” said Ranjit Talwar, country director (South Asia), Subway Systems India Pvt Ltd. However, it is not clear from the response whether Subway, which has been serving chicken raised without antibiotics in the Us since 2016, has any specific commitment for India. It also did not disclose about testing for resistant bacteria and antibiotic residues in chicken meat. In its 2017 response to CSE, Subway mentioned working on possible transition plans for each region, including India. It seems this is yet to happen.
Barista, the oldest coffee house chain in India which also offers chicken dishes, shared that its suppliers have been advised about nil antibiotic usage and supplying antibiotic- free chicken. This, however, does not negate the possibility of antibiotic use in supply chain. Moreover, its response was based on the feedback from only one of its suppliers which does not reflect the practice followed across India. It also did not provide any laboratory or audit reports to back up its claims.
JFL is the only company that could provide laboratory evidence to show that its raw chicken samples are devoid of antibiotic residues. Avinash Kant Kumar, executive vice president, JFL, says, “It has been a difficult journey as the [poultry] industry was not ready for our tasks on this front two years ago. However, our persistence has paid off.” Kumar is referring to the company’s policy, which requires poultry keepers to first eliminate the use of antibiotics for growth promotion and group-level disease prevention by 2018; end hpcia use by 2019; and limit the use of cias to the second line of treatment in birds. Though JFL claims to be on track in implementing its policy, the company is yet to publicly announce it.
TIME TO ACT IS NOW
The fast-food industry in India appears to be reluctant to come out with their commitments and time frames for addressing the issue of antibiotic misuse in the supply chain despite the fact the country’s National Action Plan for AMR, released in April 2017, highlights the role of the food industry in containing AMR. Delhi, in its action plan to fight AMR, has particularly called on select fast-food industry players to commit to eliminate antibiotic misuse in their supply chain.
CSE researchers say it’s time the industry issued time-bound public commitments specific to India to eliminate non-therapeutic use of all medically important antibiotics, and use of HPCIAS for treatment in their supply chains. It should aim to achieve these commitments like their international counterparts and share progress periodically in the public domain along with third-party supply chain audits and laboratory testing reports on antibiotic residues and resistant bacteria. The Food Safety and Standards Authority of India which now provides tolerance limits for antibiotics in food, including chicken meat, must also monitor these products.
Unless the animal aspect of AMR is addressed effectively, it would be difficult to deal with the burden of antibiotic resistance growing day by day.
(The authors work with Food Safety and Toxin unit of Centre for Science and Environment, New Delhi. They thank Divya Khatter for her support)
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