Letters to the Editor

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The importance of discussing race in veterinary medicine

It cannot be said that proponents of antiracism, one of the proposed ideological solutions to racism, mislead others about their ideas and intentions.

Quoting these proponents’ recent article, “Integrating the Multicultural Veterinary Medical Association actionables into diversity, equity, and inclusion curricula in United States veterinary colleges,”1 their purpose is to “provide a framework for how to integrate antiracism into the veterinary curriculum.” Antiracism is not politically neutral, aiming to solve the problem of racism by “mobiliz[ing trainees] for the correction of health and wealth inequalities in society.” The article calls for “dismantling” the “inherent hierarchy of power.” It says privileging “Western medical and scientific standards,” even when “allowing” other standards, is “learn[ing] white supremacy.”

I hope I do not need many words to convince most veterinarians that (1) students should be free from the burden of being trained to be the vanguards of politics and (2) Western medical and scientific standards are fine at what they do and should continue to be privileged. The new AVMA Council on Education Diversity, Equity, and Inclusion requirements state that colleges “must … integrate an understanding of the important influences of diversity and inclusion in veterinary medicine, including the impact of implicit bias.” There are many proposed solutions to racism that meet these requirements and do not entail the comorbidities highlighted here. Choose from the best parts of the lenses of colorblindness, antiracism, Dr. George Yancey’s mutual responsibility, Dr. Sheena Mason’s racelessness, and any other model you can find. Just do not allow veterinary institutions to lose legitimacy for their original purpose by being co-opted as organs of political goals. And, if we manage to retain use of Western medical and scientific standards, we can enjoy such fruits as understanding meaning from the rest of the articles in this journal and in the future discuss the research on implicit bias,2 if it is measuring what it is popularly understood to claim, and if it merits mandatory inclusion in all veterinary schools.

Taylor Gaines, DVM, MPH Catonsville, MD

References

  • 1.

    Milstein MS, Gilbertson MLJ, Bernstein LA, Hsue W. Integrating the Multicultural Veterinary Medical Association actionables into diversity, equity, and inclusion curricula in United States veterinary colleges. J Am Vet Med Assoc. 2022;260(10):11451151

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  • 2.

    Articles critical of the IAT and implicit bias. Open Science Framework. Accessed July 21, 2022. https://osf.io/74whk/

Should classroom time be dedicated to antiracist curricula or stay neutral?

We thank Dr. Gaines for their interest in our article discussing diversity, equity, and inclusion curricula in veterinary colleges.1 Due to space limitations, we are unable to address all of the letter, but know that we read it thoroughly and thoughtfully. We focus our response on Gaines’s first point: “Students should be free from the burden of being trained to be the vanguards of politics.” We rephrase this as, should classroom time be dedicated to antiracist curricula or stay neutral? The veterinary profession and its educational institutions are inherently political. We use “political” intentionally, defined as (a) relating to government, (b) concerned with governmental policy, or (c) engaged with politics.1 Veterinary students already learn about political topics within their veterinary training, including raw milk sales, antimicrobial stewardship, regulatory medicine, animal agriculture as it relates to climate change, and so on. The veterinary profession and the professional societies that represent us are also political. The AVMA and state veterinary associations advocate on the behalf of veterinary medicine on local, state, and federal levels of government. The evidence-based medicine that clinicians practice is informed by research using governmental funding. Governmental student loans often pay for veterinary education. Veterinary medicine is an institution of power that has been and will continue to be a non-neutral, political institution, with or without the mention or practice of antiracist education.

Understanding this, we move on to should classroom time be dedicated to antiracist curricula? Our answer here is also yes. We reiterate our article: “By only training students in biology-based curricula, veterinary students and the profession as a whole lose sight of the fact that medicine is a ‘biosocial phenomenon.’”2,3 The structural competency framework used in human medical education trains students to recognize how economic, social, and political structures lead to downstream health-care inequalities and stigma.4 Structural competency uses antiracist pedagogy and fosters the development of an “extra-clinical” language to help students navigate structures of influence that health-care professionals and clients encounter daily.4,5

Additionally, we address the role of advocacy as it relates to our veterinary oath. We caution that neutrality does not equate to veterinary professionalism. Antiracist pedagogy is vital in developing a compassionate and socially conscious veterinary identity. Given that the AVMA and accredited veterinary colleges have published statements committed to diversity, equity, and inclusion work, we highlight Sharda et al6:

“If advocating for racial justice is in line with our professional values, how can there be any hesitation in doing so? Yet in practice, the role of professional can undermine that of advocate for physicians [veterinarians] because our current understanding of professionalism is not race neutral … Professional accountability to society demands our commitment to a more just, and thereby more healthy, society.”

We end by raising 2 important ethical questions by Colón5 to veterinary colleges and the wider veterinary community: “Will the health-care [veterinary] professions be explicit and conscious about the political power they wield already? What will they do with the power in these times of profound conflict?”

Marissa S. Milstein, DVM, PhD Department of Veterinary and Biomedical Sciences University of Minnesota College of Veterinary Medicine St. Paul, Minnesota

Lauren A. Bernstein, MVB, MPH Department of Veterinary Clinical Sciences University of Minnesota College of Veterinary Medicine St. Paul, Minnesota

Marie L. J. Gilbertson, DVM, PhD Department of Veterinary Population Medicine University of Minnesota College of Veterinary Medicine St. Paul, Minnesota

Weihow Hsue, DVM Smilow Center for Translational Research University of Pennsylvania Philadelphia, Pennsylvania

References

  • 1.

    Political. Merriam-Webster. Accessed August 10, 2022. https://www.merriam-webster.com/dictionary/political

  • 2.

    Milstein MS, Gilbertson MLJ, Bernstein LA, Hsue W. Integrating the Multicultural Veterinary Medical Association actionables into diversity, equity, and inclusion curricula in United States veterinary colleges. J Am Vet Med Assoc. 2022;260(10):11451152

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  • 3.

    Farmer PE, Nizeye B, Stulac S, et al. Structural violence and clinical medicine. In: Oberlander J, Buchbinder M, Churchill LR, et al., eds. Differences and Inequalities. Duke University Press; 2019:156169. The Social Medicine Reader; vol 2.

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  • 4.

    Metzl JM, Hansen H. Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126133.

  • 5.

    Colón ER. This ain’t no tool, this ain’t no toolbox. In: Hansen H, Metzel JM, eds. Structural Competency in Mental Health and Medicine: A Case-Based Approach to Treating the Social Determinants of Health. Springer; 2019:2733.

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  • 6.

    Sharda S, Dhara A, Alam F. Not neutral: reimagining antiracism as a professional competence. CMAJ. 2021:193(3):E101E102. doi:10.1503/cmaj.201684

The risk of feed ingredient imports as vehicles for the transport and transmission of viral pathogens

We read with interest the interview entitled “APHIS marks 50th anniversary” with Mr. Kevin Shea, APHIS Administrator, conducted by Mr. R. Scott Nolen and published in the AVMA News section of the July 2022 JAVMA. In the interview, Mr. Shea was asked a question regarding what the USDA is doing to prevent foreign animal diseases such as African swine fever from entering the US. In his answer, he was quoted saying “We have strict regulations on what can enter the country, and for any country where such diseases exist, we prohibit imports of their product.” 

If quoted correctly, we believe Mr. Shea’s reply was inaccurate. We have been studying the risk of feed and feed ingredient imports as vehicles for the transport and transmission of viral pathogens of veterinary significance for the past 8 years. This effort is based on field observations of pathogen movement that matched feed deliveries and scientific discovery that documented this fact. What motivates us to write this letter is that during our investigations, we have learned from the US International Trade Commission Harmonized Tariff Schedule that numerous feed ingredients (ie, soy-based products, pet food, pork products, amino acids, and vitamins), many of which have been documented to support the survival of pathogens including African swine fever virus, foot-and-mouth disease virus, and classical swine fever virus, regularly enter the US from endemically infected countries.15

Therefore, we conclude that, based on science, feed importation is a risk to US agriculture, there is no regulation of the importation of products from endemically infected countries, and in contrast it appears to be an ongoing process. Fortunately, the science of feed risk has been embraced by US swine producers, the outcome being the use of Responsible Import programs for entry of high-risk imports from high-risk countries.

In closing, the risk of feed and feed ingredients for the spread of viruses is a relatively new discovery, previously thought not to occur and therefore ignored at the level of the classroom, the farm, government administration, global animal health organizations, and elected officials. We seek to raise awareness of the risk of feed and urge application of appropriate feed-based interventions to keep our animals free of pathogens.

Thank you for the opportunity to bring clarity to your readership, and congratulations to APHIS on 50 great years of service. 

Scott Dee, DVM, MS, PhD, DACVM Gordon Spronk, DVM Pipestone Veterinary Services Pipestone, Minnesota

References

  • 1.

    Dee SA, Bauermann F, Niederwerder MC, et al. Survival of viral pathogens in animal feed ingredients under transboundary shipping models (Erratum published in PLoS One. 2019;14[3]:e0214529). PLoS One. 2018;13(3):e0194509. doi:10.1371/journal.pone.0194509

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  • 2.

    Stoian AMM, Petrovan V, Constance LA, et al. Stability of classical swine fever virus and pseudorabies virus in animal feed ingredients exposed to transpacific shipping conditions. Transbound Emerg Dis. 2020;67(4):16231632. doi:10.1111/tbed.13498

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  • 3.

    Patterson G. An analysis of select swine feed ingredients and pork products imported into the United States from African swine fever virus affected countries. Transbound Emerg Dis. 2020;69(1):128136. doi:10.111/tbed.14265

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  • 4.

    Blomme AK, Jones CK, Gebhart JT, Woodworth JC, Paulk CB. Assessment of soy-based imports into the United States and associated foreign animal disease status. Transbound Emerg Dis. 2022;69(1):137148. doi:10.111/tbed.14284

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  • 5.

    Dee S, Spronk G. Feed: a new pathway for the domestic and transboundary spread of viral pathogens of veterinary significance. Transbound Emerg Dis. 2022;69(1):13. doi:10.1111/tbed.14349

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APHIS responds:

In response to Pipestone Veterinary Services’ Letter to the Editor regarding the interview entitled “APHIS marks 50th anniversary” with Mr. Kevin Shea, APHIS Administrator, published in the July 2022 JAVMA, APHIS has spent the past 50 years safeguarding US agriculture and preventing the introduction and threat of foreign animal diseases such as African swine fever (ASF). We take this responsibility very seriously, and to date, ASF has never been detected in the US. It is true that APHIS has strict regulations on what can enter the country, and for any country where such diseases exist, we prohibit imports of their respective and related product. It is also true that APHIS requires permits for the importation of any product, including animal feed, containing material derived from animals, such as dairy products, rendered materials, and raw or processed meat, etc, from countries with foreign animal diseases such as ASF. The permit process includes requirements specifically designed to prevent such products from bringing foreign animal diseases into the US. Additionally, the US FDA is responsible for regulation of imported animal food products and food additives used in animal food.

With these safeguards in place, APHIS does not consider US swine to be at risk for ASF from imported feed. However, we remain vigilant and continue to work closely with federal agencies, like US Customs and Border Control, and industry partners to protect against ASF, including evaluating any other pathways that present risk such as non–animal-origin feed ingredients. Additional information on preventative safeguards is available on the USDA website: https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/swine-disease-information/african-swine-fever/seminar/african-swine-fever

It’s critical for all of us to work together to keep this disease out of the US and its territories, and we appreciate the efforts made by organizations and researchers to protect US agriculture and the livelihoods of Americans working in the industry.

Kevin Shea, JD APHIS Administrator Washington, DC

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