Antibiotic resistance doesn’t get a ton of headlines, but it is one of the most critical threats to global health, enough so that the United Nations resolved to address the problem at a summit late in 2016. At the time, they estimated there would be 10 million deaths annually from resistant ‘superbugs’ by the year 2050, which doesn’t include people who would die indirectly from the scourge, such as people who can’t have surgery because the antibiotics that you receive before any operation are no longer effective. In a country where a third of the population rejects the truth of evolution, getting people to understand this issue – itself the product of evolutionary processes among bacteria – has been difficult, and never seems to rise very high on the priority lists for policymakers.

Maryn McKenna’s new book Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World Eats, the journalist and Schuster Institute fellow explains how we got here by way of the humble chicken, which took over our plates and menus thanks to the prodigious and reckless use of antibiotics, in turn leading to widespread antibiotic resistance in our food supply and outside of it as well. Chicken became an industrial product because someone realized that pumping birds full of antibiotics as part of their feed would make them grow faster, regardless of whether they had any need for these medications. While the chicken world consolidated and counted its profits, bacteria did what they do – evolved, through mutations and gene transfer, to become resist to one drug after another, spreading through and beyond our food supply, abetted by antibiotic residues that washed into the water supply from overuse.

McKenna builds the book around the narrative of one man who nearly died from salmonellosis, an infection caused by bacteria in the Salmonella genus (there are two species, and either can cause this illness), part of a widespread 2013 outbreak caused by unsanitary conditions at the Foster Farms chicken processing plant. The specific Salmonella strain in this outbreak, known as Heidelberg, was resistant to multiple antibiotics, sickened over 600 people, and resulted in at least 200 hospitalizations, although there were no reported deaths. Within the framework of this patient’s ordeal – he survived, but will have lifelong complications, which is common for people who develop these infections – McKenna walks through the history of the chicken as foodstuff, from its advent as an industrial product through changes to the bird to the very recent movement by major chicken producers and consumers to stop antibiotic use.

The very rise of this form of industrialized animal husbandry was an accident, which is one of the book’s most interesting sections (granted, I love history of science stories); there wasn’t any reason to think pumping healthy birds full of antibiotics would make them grow faster, but it did, to a shocking extent. What is infuriating, if not entirely surprising, is how government agencies responsible for ensuring public health rolled over and played dead for Big Chicken and the antibiotic manufacturers themselves even as scientists began to sound alarms about resistant bacteria in the 1950s. The manufacturers played the Big Tobacco game of demanding more proof, aided and abetted by Congressman Jamie Whitten, a Democrat from Mississippi, who abused his power to protect the two industries from proposed restrictions on antibiotic usage until his retirement in 1994. (Whitten wrote a pro-pesticide screed as a rejoinder to Rachel Carson’s Silent Spring, in case you were unclear on his stance on the matter.) Mckenna parallels this narrative with a walk through the tactics of the bacterial world to outflank our best drugs, most recently with the emergence of bacteria with the mcr-1 gene, conferring resistance to colistin, an antibiotic of ‘last resort’ that has been used for bacteria resistant to all other antibiotics.

Blaming the two industries of chicken and pharma, along with the complicity of useless government agencies (the FDA and the USDA), is easy, but the American consumer is also a major part of the problem here. We eat far more meat than we need to meet our dietary requirements, but we insist on meat being cheap, which encourages us to both eat and waste more of it. We’ve also decided we want lean meat, based on nutritional advice from the Useless Department of Agriculture that turned out to be mostly to entirely wrong, leading to greater demand for breast meat, and in turn for farmers to grow chickens with giant breasts and smaller legs, to the point that the broiler-fryer chickens you might get in an average grocery or warehouse store can’t walk or stand up normally. (I rarely see them in stores, but once did buy a pasture-raised whole chicken; it had less than half the breast meat of even a well-raised conventional bird.) McKenna goes into this in more detail – how the rise of ‘chicken fingers’ and the McNugget exacerbated this trend, how consumers prefer buying chicken parts rather than whole birds – while also pointing out how producers bred birds with these un-natural characteristics to suit the marketplace.

There is hope, at least in this book, on both the antibiotic resistance and the chicken-producing fronts. The UN has, at least, paid lip service to the cause of fighting antibiotic resistance. Several major chicken producers, led by Purdue, have stopped or pledged to stop using antibiotics in full, or to only use them to treat sick birds rather than as growth promoters or for prophylactic purposes. Many large chicken buyers, including Panera, Chipotle, and even McDonald’s, have also pledged to go antibiotic-free, or have done so already. Whole Foods has long been antibiotic-free as well. (One reason I buy organic milk and eggs, even though ‘organic’ itself isn’t that meaningful: It guarantees the cows/birds in question weren’t given antibiotics.) And slowing the use of antibiotics on animals should help in particular if and when researchers discover the next big class of antibiotic compounds. We may have gotten much farther with the drugs we had if we hadn’t given them in such huge quantities to the animals we raised and ate.

McKenna also visits chicken farmers who are operating outside of the main supply chain of industrial birds, raising heirloom varieties in the American heartland or raising certified Label Rouge birds in France, chickens that neither look nor taste like the bland if predictable American hybrids. Educating consumers with the disposable income to buy these birds is a challenge, but one that has plenty of precedent in the market for high-end foods. The bigger conundrum is how to provide enough meat, chicken or otherwise, to feed a world that increasingly demands it and doesn’t want to pay more for it, without the overuse of antibiotics that has led us to the edge of a bottomless pit of resistance.

Next up: Dan Simmons’ The Fall of Hyperion.