AllergyKids Foundation AllergyKids Foundation Alliance for the Prudent Use of Antibiotics

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AllergyKids Foundation AllergyKids Foundation Alliance for the Prudent Use of Antibiotics Alliance to Save our Antibiotics American Grassfed Association Arizona PIRG Aspen Center for the Environmental Studies Breast Cancer Prevention Partners California Academy of Preventive Medicine CALPIRG California Public Health Association-North Catholic Health Association of the United States Center for Biological Diversity Center for Environmental Health Center for Urban Education About Sustainable Agriculture Certified Naturally Grown Chicago Physicians for Social Responsibility Clean Water Action Clinician Champions in Comprehensive Antibiotic Stewardship (CCCAS) Collaborative ConnPIRG CoPIRG Consumer Education and Research Centre Consumers International Consumers Union of Japan Fair Farms Maryland Family Farm Defenders Food & Water Watch FoodBabe.com Food Chain Workers Alliance Food Tank Grand Central Bakery Health Care Without Harm Hong Kong Consumer Council IFOAM - Organics International Illinois PIRG Institute for a Sustainable Future Jeremy Coller Foundation Johns Hopkins Center for a Livable Future Kewaunee Cares Organic Consumers Association Confederation of Consumer Societies (KONFOP) Lantern Restaurant League of United Latin American Citizens Lymphoma Foundation of America Maryland PIRG MassPIRG Mercy For Animals Midwest Environmental Justice Organization Michigan Antibiotic Resistance Reduction Coalition MRSA Survivors Network Northeast Organic Dairy Producers Alliance Northeast Organic Farming Association, Massachusetts Chapter Northeast Organic Farming Association of New York (NOFA-NY) Northeast Organic Farming Association of Vermont OSGATA : Organic Seed Growers and Trade Association OSPIRG PennPIRG ReAct Africa ReAct Asia Pacific ReAct Europe ReAct Latin America ReAct North America / ReAct Strategic Policy Program Real Food Media Roots of Change San Francisco Bay Area Chapter Physicians for Social Responsibility San Francisco Baykeeper San Francisco Marin Medical Society Science and Environmental Health Network Slow Food USA Slow Food California Society for Infectious Diseases Pharmacist Southern California Public Health Association Stop Foodborne Illness TexPIRG Universities Allied for Essential Medicines (UAEM) WashPIRG Western Nebraska Resources Council WISPIRG Women's Voices for the Earth February 14th, 2018 Steve Easterbrook McDonald's Corporation, CEO 2111 McDonald's Dr Oak Brook, IL 60523 Dear Mr. Easterbrook: We write you as representatives of organizations with millions of members to express our concerns about the overuse of antibiotics in livestock production, and ask McDonald s to establish a time-bound, meaningful, and verifiable policy that phases out the routine use of all medically important antibiotics from its pork and beef supply chains. McDonald s became an industry leader when in response to consumer demand, it eliminated all use of medically important antibiotics in its U.S. chicken supply chain in 2016. Extending this type of responsible antibiotics use policy to the company s pork and beef supplies is consistent with the goals included in the recently updated Global Vision for Antibiotics Stewardship in Food Animals (VAS) and warrants urgent attention. Many people today still assume that when we get an infectious illness, the antibiotics prescribed by doctors make us better. But medical experts, including from the World Health Organization and the Centers for Disease Control and Prevention, are warning that the overuse of these precious drugs is already reducing their effectiveness. A recent report concluded that by 2050, drug-resistant bacteria could kill 10 million people worldwide every year. In fact, the World Health Organization just released new guidelines for the use of medically important antibiotics in food animals, where they clearly recommend complete restriction of the routine use of antibiotics in healthy animals, whether for growth promotion or disease prevention. Despite this threat, many industrial farms are feeding large quantities of antibiotics to livestock unnecessarily. In the U.S. alone, 70 percent of medically important antibiotics are sold for use in food animals. In many cases, meat producers give antibiotics to animals that aren t sick on a routine basis in order to prevent disease brought on or spread by improper management practices or the unsanitary and overcrowded conditions on industrial farms.

Rather than using antibiotics routinely to prevent disease or promote growth, which can spur the spread of drug-resistant bacteria, McDonald s should require its producers to reserve antibiotics only to treat sick animals or control an identified disease outbreak. Antibiotic resistance is a global issue and if we are to preserve our ability to save lives and treat dangerous infections, we need global action. T he problem of antibiotic resistance cannot be fixed unless the livestock sector and large meat buyers, such as McDonald s, are part of the solution. We thank you for ensuring that McDonald s fulfilled its U.S. commitment to serve only chicken raised without antibiotics important to human medicine. We are also encouraged by your company s recently announced VAS, which includes important objectives such as phasing out routine antibiotic use throughout its meat supply chain globally. Now it is time to convert these goals into effective time-bound commitments for McDonald s beef and pork supplies. Given McDonald s size and scope, a meaningful commitment with concrete timelines to purchase only meat raised without the routine use of medically important antibiotics will send a clear signal to meat producers and consumers that preserving the efficacy of these precious medicines is a top priority. It will set the bar that your competitors, including Wendy s and Burger King, should strive to reach. We look forward to your response and continued leadership on this extremely important public health issue. Sincerely, Matthew Wellington, Antibiotics Program Director, U.S. PIRG Education Fund Laura Rogers, Deputy Director, Antibiotic Resistance Action Center, the George Washington University Lena Brook, Interim Director, Food & Agriculture Program, Natural Resources Defense Council Kari Hamerschlag, Deputy Director of Food and Technology, Friends of the Earth Jean Halloran, Director, Food Policy Initiatives, Consumers Union Cameron Harsh, Senior Manager for Organic and Animal Policy, Center for Food Safety Steven Roach, Food Safety Director and Senior Analyst for Keep Antibiotics Working, Food Animal Concerns Trust Supporting Organizations Robyn O'Brien, Founder, AllergyKids Foundation Michael Jawer, Deputy Director, Alliance for Natural Health Jane A. Kramer, Director, Alliance for the Prudent Use of Antibiotics Suzi Shingler, Campaign Manager Alliance to Save our Antibiotics Carrie Balkcom, Executive Director, American Grassfed Association Diane Brown, Director, Arizona PIRG

Chris R. Lane, Director, Aspen Center for the Environmental Studies Janet Nudelman, Director of Program and Policy, Breast Cancer Prevention Partners Ronald P. Hattis, MD, MPH, Secretary-Treasurer, California Academy of Preventive Medicine Emily Rusch, Director, CALPIRG Adele Amodeo, Executive Director, California Public Health Association-North Julie Trocchio, Senior Director of Community Benefit and Continuing Care, Catholic Health Association of the United States Jonathan Evans, Environmental Health Legal Director, Center for Biological Diversity Michael Green, Executive Director, Center for Environmental Health Marcy Coburn, Executive Director, Center for Urban Education About Sustainable Agriculture Alice Varon, Executive Director, Certified Naturally Grown Sarah Lovinger, Executive Director, Chicago Physicians for Social Responsibility Andria Ventura, Toxics Program Manager, Clean Water Action Stacia Clinton, Committee Chairperson National Director Healthy Food in Health Care Program, Clinician Champions in Comprehensive Antibiotic Stewardship (CCCAS) Collaborative Chris Phelps, Director, ConnPIRG Danny Katz, Executive Director, CoPIRG Dr. Dolly A. Jani, Senior Manager, Consumer Education and Research Centre Amanda Long, Director General, Consumers International Michiyo Koketsu, Secretary General, Consumers Union of Japan Alicia LaPorte, Campaign Manager, Fair Farms Maryland John E. Peck, Executive Director, Family Farm Defenders Wenonah Hauter, Executive Director, Food & Water Watch Vani Hari, Author & Activist, FoodBabe.com Joann Lo, Executive Director, Food Chain Workers Alliance Danielle Nierenberg, Co-Founder, Food Tank Laura Ohm, Product Director, Grand Central Bakery Stacia Clinton, Health Care Program Coordinator, Health Care Without Harm Gilly Wong, Chief Executive, Hong Kong Consumer Council Gábor Figeczky, Head of Global Policy, IFOAM - Organics International Abe Scarr, Director, Illinois PIRG Jamie Harvie, Executive Director, Institute for a Sustainable Future

Rosie Wardle, Programme Director, Jeremy Coller Foundation Bob Martin, Food System Policy Director, Johns Hopkins Center for a Livable Future Nancy Utesch, Founder, Kewaunee Cares Katherine Paul, Associate Director, Organic Consumers Association Confederation of Consumer Societies (KONFOP) Andrea Reusing, Chef-Owner, Lantern Restaurant Brent Wilkes, Chief Executive Officer, League of United Latin American Citizens Belita Cowan, President Lymphoma Foundation of America Emily Scarr, Director, Maryland PIRG Deirdre Cummings, Legislative Director, MassPIRG Vandhana Bala, General Counsel, Mercy For Animals Elaine Bailey, Executive Director Michigan Antibiotic Resistance Reduction Coalition Maria Powell, President, Midwest Environmental Justice Organization Jeanine Thomas, Founder, MRSA Survivors Network Edward Maltby, Executive Director, Northeast Organic Dairy Producers Alliance Laura Davis, Certification Assistance Coordinator, Northeast Organic Farming Association, Massachusetts Chapter Elizabeth Henderson and Jane Winn, Northeast Organic Farming Association of New York (NOFA-NY) Maddie Kempner, Advocacy Coordinator, Northeast Organic Farming Association of Vermont Jim Gerritsen, Board President, OSGATA Organic Seed Growers and Trade Association Charlie Fisher, Director, OSPIRG Michael Roles, Director, PennPIRG Mirfin Mpundu, Coordinator, ReAct Africa Sujith Chandy, Coordinator, ReAct Asia Pacific Anna Zorzet, Head, ReAct Europe Arturo Quizhpe, Coordinator, ReAct Latin America Anthony So, Director, ReAct North America / ReAct Strategic Policy Program Anna Lappe, Founder and Director, Real Food Media Michael R. Dimock, President, Roots of Change Robert M. Gould, MD, President, San Francisco Bay Area Chapter Physicians for Social Responsibility Sejal Choksi-Chugh, Executive Director, San Francisco Baykeeper John Maa MD, President, San Francisco Marin Medical Society

Ted Schettler MD, MPH, Science Director, Science and Environmental Health Network Taylor Pate, Slow Food USA Fellow, Slow Food USA Brenda Ruiz, Co Chair Policy Committee, Slow Food California Political Action Committee, Society for Infectious Diseases Pharmacist Cherise Charleswell, MPH, President, Southern California Public Health Association Deirdre Schlunegger, CEO, Stop Foodborne Illness Bay Scoggin, Director, TexPIRG Merith Basey, Executive Director, Universities Allied for Essential Medicines (UAEM) Elise Orlick, Director, WashPIRG Buffalo Bruce, Research Ecologist, Western Nebraska Resources Council Peter Skopec, Director, WISPIRG Erin Switalski, Executive Director, Women's Voices for the Eart