The world’s largest animal drugs company has been accused of double standards and of fuelling the development of superbugs by selling antibiotics to farmers in India for purposes now banned in Europe and America.

Zoetis, a former subsidiary of the drugs giant Pfizer, is supplying farmers in India with antibiotics to help them artificially fatten up livestock including chickens.

The World Health Organization (WHO) has called for the practice to be banned worldwide because it increases the prevalence of resistant bacteria that can infect humans and cause deadly and untreatable infections.

The American company stopped advertising antibiotics as growth promoters to American farmers nearly two years ago. Zoetis publicly supported new laws in the US banning this abuse of antibiotics as part of its “continued commitment to antibiotic stewardship”. However, Zoetis is continuing to sell antibiotics directly to Indian farmers with claims on the company’s Indian website that it will make animals grow bigger and faster.

This is not currently against Indian law although the Indian government has called for it to end and the second biggest state, Maharastra banned the indiscriminate use of antibiotics in agriculture after a Hindu/Bureau story earlier this year.

Dr Abdul Ghafur, a professor in infectious diseases who brought together medical societies and the Indian government in 2012 to create a plan to tackle antibiotic resistance, known as the Chennai Declaration, said Zoetis is using “double standards”.

“If an American company follows one policy in America, they should follow the same policy in India,” he said.

Dr Thomas Van Boeckel, a researcher at the Swiss Federal Institute of Technology (ETH Zurich) who has mapped antibiotic use in agriculture, said: “It is blatantly clear that Zoetis is using a double standard in the way it is willing to expose consumers in India to higher levels of risk than in the United States.” Zoetis says it complies with the law in each location where it operates.

Over the counter sales

In veterinary drug stores in Hyderabad, the Bureau found a number of antibiotics manufactured by Zoetis which are used to fatten animals being sold over the counter without a prescription. A Bureau reporter, posing as a veterinary drug store owner, also spoke to a member of Zoetis’ Indian sales team who said it typically sold these antibiotics directly to farmers.

Ahead of new laws introduced last year in the US banning the use of antibiotics as growth promoters, Zoetis voluntarily began to remove such claims from its products there. In 2013, Zoetis said it “supports the FDA’s [US Food and Drug Administration] efforts to voluntarily phase-out growth promotion indications for medically important antibiotics,” adding that it “has already taken action”.

Meanwhile in India Zoetis is selling Neftin-T, which contains the antibiotic tylosin. Zoetis recommends feeding Neftin-T to chickens to “improve weight gain and FCR [feed conversion rate]”.

Tylosin is not only critically important to animal health, it has been banned for use as a growth promoter in the EU since 1998 because of fears it fuels resistance to erythromycin, which is used to treat chest infections and other human diseases. WHO classes erythromycin as critically important to our health.

Billion dollar profits

The practice of using antibiotics to make animals grow faster was banned completely in the EU in 2006.

Pharmaceutical companies earn about $5 billion a year from worldwide sales of antibiotics for livestock, according to analysts Animal Pharm. As one of the world’s leading producers of medicated feed additives - many of which contain antibiotics - Zoetis takes a significant slice of this.

Zoetis faces a dwindling market in the US since the ban last year for these products but expects that increased sales elsewhere will more than compensate in the future. Speaking to investment analysts in February, Zoetis chief financial officer Glenn David said, despite the downturn in the US, he still expects to see sales of medicated feed additives rise “as the emerging markets become more industrialised”.

Animals reared for meat in the major emerging economies of Brazil, Russia, India, China and South Africa are expected to consume double the amount of antibiotics in 2030 than they did in 2010.

In contrast, one of Zoetis’ major competitors, Elanco, stopped advertising medically important antibiotics as growth promoters for animals. In 2016, it removed such claims from all its product labels worldwide, even in countries where antibiotic growth promoters are legal.

Responding to the Bureau’s findings, Zoetis said: “Each country enacts regulations appropriate for their market needs and standards, and we work with the national regulatory authorities in various countries, including India, to understand, respect and comply with local regulatory interpretation and oversight.”

Experts are particularly concerned about the widespread use of a ‘last hope’ antibiotic on Indian poultry farms. Colistin is often used to treat seriously ill people with infections that have become resistant to almost all other drugs and is deemed one of the “highest priority, critically important” antibiotics by WHO as it is so crucial to human medicine.

Although none of Zoetis’ growth promoters contain colistin, a number of major Indian poultry companies have been found to use the drug, spreading fears about how much longer one of our last lines of defence against highly resistant infections will be effective.

Links to fast food chains

A Bureau investigation earlier this year found Venky’s, one of the country’s biggest chicken producers which supplies Indian branches of fast food chains KFC, McDonald’s, Pizza Hut and Dominos, to have been providing colistin to farmers to help their birds grow bigger. Venky’s has since removed these growth promotion claims from the packaging, which also now says a veterinary prescription is needed. But the Bureau was still able to purchase it recently in an Indian drug store without a prescription.

Venky’s said it is “manufacturing Colis-V (colistin sulphate) with due approval from the Food & Drug Administration, Government of Maharashtra, India. The usage of Colis-V (colistin sulphate) in poultry farming is based on advice from Registered Veterinary Practitioners only.”

Similarly, another leading Indian poultry producer, Simran Group Farms, sells a colistin growth promoter under the brand name Vetline India. Simran Group Farms did not respond to multiple requests to comment.

Fears about growing resistance to a drug crucially important to human health has led some to call for an outright ban of colistin use on farms. The discovery of a colistin-resistant gene that can pass between bacteria, conferring resistance to bugs never exposed to the drug, sent shockwaves through the medical community in 2015. This transfer will likely accelerate the spread of resistance to colistin, further boosted by the rampant use of the antibiotic on farms in many countries. Scientists believe the gene originated in bacteria in Chinese livestock, but it has since been found across five continents.

Timothy Walsh, a professor at Cardiff University who made the discovery in 2015, called for a worldwide ban on colistin use in agriculture.

“I’ll be OK, but my children and my children’s children are seriously going to grow up in a world where we have no viable antibiotics because of unrivalled stupidity” he said.

Different policies in different parts of the world

In 2016, the British government published a major review of the global threat of superbugs, which called for vast reductions in the use of antibiotics in agriculture worldwide. While colistin can still be prescribed on British farms, its use has dramatically reduced in recent years.

But growth promoting antibiotics, including colistin, remain widely available to Indian farmers through a number of international and domestic pharmaceutical companies. The Bureau found multiple of examples of Indian drug manufacturers selling colistin as a growth promoter for chickens, including Neospark, Kaizen Bio Sciences and Vet-Needs Labs. While relatively unknown abroad, their products are widely available online in India, where farmers are given unrestricted access to some of the most important antibiotics to human health.

Neospark said: “Officially there is no ban in India for the specified usage of colistin in farm animals… As law abiding company, Neospark never deviates the law of the land.”

Kaizen Bio Sciences and Vet-Needs Labs didn’t respond to multiple requests for comment.

Since the Bureau’s earlier investigation into the use of colistin in Indian poultry farms, Maharastra state has ruled all animal drug stores should stop selling antibiotics to farmers without a prescription, after a court order. But in other states, no such regulations are in place.

Talking of the continued use of the last hope antibiotic on farms worldwide, Walsh said: “I predict that colistin as a drug will be dead in 10 years time. And given what is in the pipeline - which is next to nothing - and given the plasticity of bacteria and their ability to evolve and adapt and survive and prosper, I see no good end to this story at all.”

This article was published in partnership with the BMJ VetRecord journal. You can find its version here along with an editorial.