The one drug RFK Jr. should actually ban

Vox

a day ago

is a senior reporter for Vox's Future Perfect section, with a focus on animal welfare and the future of meat.
Pigs fed ractopamine has been linked to their inability to stand up, difficulty breathing, and even death. It also carries a number of environmental and human health concerns.Before becoming secretary of the US Department of Health and Human Services and leader of the Make America Healthy Again movement, Robert F. Kennedy Jr. was a swashbuckling environmental attorney who regularly took aim at the meat industry. He sued large meat companies and the Environmental Protection Agency over water pollution from factory farms, and criticized factory farming for its 'unspeakable' animal cruelty and overreliance on feeding animals hormones and drugs.
For over a decade, a group of food safety, environmental, and animal welfare nonprofits has petitioned the US Food and Drug Administration — which Kennedy now oversees — to ban the use of one of the most controversial of those drugs: ractopamine hydrochloride.
Fed to pigs in the final weeks of their lives, ractopamine speeds up muscle gain so that pork producers can squeeze more profit from each animal. But the drug has been linked to severe adverse events in pigs, including trembling, reluctance to move, collapse, inability to stand up, hoof disorders, difficulty breathing, and even death. It also carries a number of environmental and human health concerns.
Earlier this year, the FDA denied the petition to ban the drug, arguing that current regulations ensure a 'reasonable certainty of no harm to consumers.' While the agency doesn't dispute that ractopamine can harm animals, and it halved the maximum dose in pigs in 2006, it has argued welfare issues can be mitigated by simply asking meat producers to handle ractopamine-fed animals more carefully — a response that the petitioning organizations called 'toothless.'
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The FDA didn't respond to a request for comment in time for publication. Elanco, the pharmaceutical company that developed ractopamine, didn't respond to an interview request for this story.
While 26 countries have approved ractopamine use in livestock, more than 165 have banned or restricted it, and many have set restrictions on or have altogether prohibited the import of pork and beef from ractopamine-fed animals — actions that have set off trade disputes. The bans stem primarily from concerns that the trace amounts of the drug found in meat could harm consumers, especially those with cardiovascular conditions, since ractopamine belongs to a class of drugs (beta-agonists) that can increase people's heart rates.
There's only been one tiny study on ractopamine in humans who took the drug directly, which European regulators — prone to taking a precautionary approach with new food additives — say is insufficient to prove its safety. Chinese scientists are concerned about the drug because its residues concentrate at higher rates in pigs' organs, which are more commonly consumed in Chinese diets.
The heated international debate led one team of biotechnology researchers to call ractopamine 'the most controversial food additive in the world.'
An inflatable pig has the words 'I am a ractopamine pig' written on it during a march in Taipei, Taiwan, in November 2020, as thousands demand the reversal of a decision to allow US pork imports into the country, citing food safety issues. Chiang Ying-ying/Associated Press
Daniel Waltz, managing attorney of the Animal Legal Defense Fund — one of the organizations petitioning the FDA to ban ractopamine — told me it seems like just the kind of thing Kennedy would want to prohibit. 'So why isn't the FDA jumping at the opportunity to do something about ractopamine?' Waltz said.
Kennedy and the broader MAHA movement have long elevated fears over pharmaceuticals and food chemicals, and it can sometimes be difficult to parse their valid concerns from their dangerous conspiracy theories. But he doesn't appear to have ever publicly criticized ractopamine, and it's unknown whether it's even on his radar.
Given the lack of trials, ractopamine's threat to human health is unclear, and reasonable people can disagree on how government agencies should handle it. But there's a clear case to be made that ractopamine ought to be banned because of its awful effects on animals. The FDA's decision to continue to allow it in meat production represents a missed opportunity to challenge the factory farm system that Kennedy has long railed against, and to ban a chemical that no one — except the industry — really wants.
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'Ractopamine divides the world'
There's ample real-world evidence that ractopamine can be terrible for pigs.
Over an 11-year period, the FDA received reports that over 218,000 pigs fed ractopamine suffered adverse events, like trembling, an inability to stand up, hoof disorders, and difficulty breathing. That's a relatively small share of the billion or so pigs raised and slaughtered for meat during that time period, but the number only includes adverse events reported to the FDA — many more could've occurred without being reported. The next most reported drug had a little over 32,738 cases spanning 24 years.
The FDA has said that reports of adverse events don't establish that the drug caused the effects — essentially that it's correlation, not proof of causation. But shortly after the drug came onto market, the FDA also received reports of an uptick in ractopamine-fed pigs unable to stand or walk at slaughterhouses.
Some studies, including a couple conducted by the drugmaker — Elanco — have shown that ractopamine is associated with a number of issues in pigs, including hoof lesions, fatigue, increased aggression, and metabolic stress. Over the years, Elanco has added warning labels that ractopamine-fed pigs are at an increased risk of fatigue and inability to walk.
A 'downer pig' — a pig unable to walk or stand — is dragged at a slaughterhouse that supplies to Hormel. When ractopamine first came onto the market, the FDA received reports of an uptick in ractopamine-fed pigs unable to stand or walk at slaughterhouses. Animal Outlook
At the same time, a literature review by Elanco employees and university researchers looking at ractopamine studies found it had minimal effect on pig mortality, inconsistent effects on aggression and acute stress, and mixed results on a number of physiological responses, like cortisol and heart rate, with some research showing little to no effects, and others showing moderate effects. The size of the dose — and how workers handle the animals — were often important factors. Elanco has updated its label to clarify that there's no benefit to feeding pigs more than the lowest dose.
There's also some evidence to suggest ractopamine negatively impacts the welfare of cattle, some of whom are fed the drug.
Even more than concerns over animal welfare, the uncertainty over ractopamine's effect on consumers' health has courted international controversy. Those concerns have led to countries rejecting shipments of US pork and beef; Taiwanese lawmakers throwing pig intestines at one another and mass protests in a dispute over the country's decision to allow US pork imports from ractopamine-fed pigs; and a highly contentious, multiyear debate at the United Nations-run Codex Alimentarius Commission, which sets food standards important for international trade.
By the late 2000s, numerous countries had restricted imports of meat from ractopamine-fed animals, which posed a financial threat to the US meat industry. So the US Department of Agriculture spent five years advocating for the Codex commission to approve maximum residue levels of ractopamine in beef and pork as safe, which would give the US more legal leverage to challenge other countries' import bans.
The commission's fight over ractopamine was 'really, really ugly,' Michael Hansen, a senior scientist at Consumers Union — the publisher of Consumer Reports — who attended commission meetings, told me.
European Union officials argued there wasn't enough data to ensure consumers would be safe from ingesting trace amounts of ractopamine. While the drug had been tested on various animal species, only one human clinical trial had been conducted in 1994, which included just six healthy young men taking the drug, one of whom dropped out after complaints that his heart was pounding.
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In response to the trial, an FDA official at the time stated that 'the data from this study do not provide adequate assurance that the expected ractopamine levels in meat products will be without cardiovascular pharmacological effects in man.'
In 2012, the UN commission narrowly voted to set maximum safe ractopamine residue levels in beef and pork by a margin of just two votes — an unusual outcome for a commission that historically ran on consensus. China and EU representatives, Hansen told me, were furious. US meat industry groups and the USDA secretary at the time, Tom Vilsack, cheered the decision.
Writing about the commission fight, trade lawyer Michael Burkard wrote that ractopamine 'divides the world.'
However, ractopamine remains controversial and the subject of trade disputes; just last year, China blocked shipments of US beef that contained traces of the drug.
Make animals suffer less
The fight over ractopamine is a microcosm of a broader problem in the meat industry: The government's reluctance to regulate it.
Over the last century, meat companies have transformed how animals are raised for food. They've packed animals into crowded, sprawling warehouses; bred them to grow bigger and faster to the detriment of their welfare; stored vast amounts of their manure in open-air lagoons that leach into the environment; and designed complex drug regimens to keep them alive in unsanitary conditions or, like in the case of ractopamine, make a little more money off each animal.
Whenever consumers and advocacy groups raise concerns over the problems factory farming has created, more often than not, a government agency tasked with regulating it takes action to defend the meat industry, not reform it.