‘There is worse to come’: The biopolitics of traumatism in antimicrobial resistance (AMR)

Brown, Nicholas Gerard Francis; Nettleton, Sarah

doi:10.1111/1467-954x.12446

Cited by 30 publications

(27 citation statements)

References 35 publications

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“…This resistance is narrated as a looming catastrophe, the result of dangerous multi-drugresistant organisms ('superbugs') and of market failure (the 'empty pipeline' in antibiotic development). As Brown and Nettleton (2017) describe, UK versions reveal 'an economic imaginary' at the highest levels of government, hoping for technological fixes including new antibiotics from novel innovation models. This paper shows a different economic imaginary in play in the application of ideas from behavioural economics ('nudge') to the problem of AMR.…”

Section: Introductionmentioning

confidence: 99%

“…The paper adds to our understanding of responses to AMR by analysing public health strategies for encouraging 'antibiotic stewardship'. Though sharing Brown and Nettleton's (2017) interest in the framing of AMR, where they quote elite actors such as the Chief Medical Officer for England or the Prime Minister I look to the work of largely nameless public health workers seeking to reduce use of antibiotics for viral illnesses or minor infections. As most antibiotics are only formally available on prescription in the UK it might seem that this would lead to efforts to influence health professionals.…”

Section: Introductionmentioning

confidence: 99%

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The problem and the productivity of ignorance: Public health campaigns on antibiotic stewardship

Will

2019

The Sociological Review

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This article offers a critical account of efforts to engage people with the issue of antimicrobial resistance (AMR). It analyses how public health workers encourage what they understand as responsible antibiotic use or antibiotic stewardship, and how their efforts are shaped by different theories of ‘behaviour’ or social action. Discourse analysis of all major UK campaigns and their evaluations over the last two decades reveals how different versions of the citizen jostle for attention in a public health that draws on sociology, psychology, and increasingly behavioural economics. Rejecting an explanation which focuses solely on the appeal of emotion in new forms of governance, I deploy theories of expert and lay ignorance to show how public health is pushed towards new approaches as it struggles with an apparently recalcitrant public in the case of AMR. Here ignorance is both problematic and productive, prompting a shift to campaigns based on unreflective action, that are accompanied by decisions to work with potential misunderstandings about antibiotics and their effects. I suggest the term ‘shrug’ as a provocative counterpart to the ‘nudge’ of behavioural economics, drawing attention to the ways in which behavioural interventions may be linked to strategic retreats from engagement, when policy makers feel unable to affect or predict the understanding and views of non-experts. The article thus contributes to sociological and political critique of narrow forms of behavioural thinking and their effects on relations between governments and their citizens.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The problem and the productivity of ignorance: Public health campaigns on antibiotic stewardship

Will

2019

The Sociological Review

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“…These, they argue, are premised on the separation and purification of animal bodies and ecologies and the denigration of vernacular and non‐Western forms of expertise. They suggest that these generate ‘autoimmune’ tendencies, in which bodily (and by extension social) ecologies tip into a disease state when the immune system turns again itself in the absence of a co‐evolved antagonist (Hinchliffe and Ward ; see also Mutsaers ; Brown and Nettleton ).…”

Section: Relational Geographies Of Microbesmentioning

confidence: 99%

Parasites, ghosts and mutualists: a relational geography of microbes for global health

Lorimer

2017

Trans Inst British Geog

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Scientific research on the microbiome offers an ecological model of the human, comprised of myriad forms of microbial life. The composition and dynamics of this human microbiome are increasingly implicated in discussions of health. Attention has focused on missing microbes and their links to a range of inflammatory and autoimmune diseases. Pathological dysbiosis is understood to result from both the excessive presence and the absence of microbes. Microbial declines have been indexed to modern hygiene and healthcare practices and there is a growing interest in the therapeutic use of beneficial microbes. This reappraisal of the salutary potential of microbes challenges the negative associations prevalent in health geography and the field of global health. This paper develops relational and multispecies approaches to health geography to examine situations of microbial excess, absence and controlled reintroduction. The analysis focuses on human relations with hookworms. Hookworms are animal members of the microbiome. They co-evolved with humans, live in us and are understood to manage the human microbiome to enable immunological tolerance. Both the excessive presence and the absence of hookworms can be pathological. They are currently the subjects of concurrent, but spatially discrete, programmes to deworm and reworm a variegated world. Focusing on this seeming spatial paradox, the analysis examines three types of human-hookworm relation: the parasite, the ghost and the mutualist. The conclusion reflects on the implications of this analysis for the human and nonhuman subjects of global health and the microbiopolitics of prevalent forms of antibiotic and probiotic healthcare.

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“…'Economies of resistance' are evidence, we suggest, of the naturalisation of socio-economic structures in expert understandings of AMR. Another trajectory we have explored elsewhere (Brown and Nettleton, 2017) is concerned with the way microbial life is re-deployed in the large-scale reconfiguration of political agendas about the future of national economies, the public-private interface, and even migration and race. This can be expressed as the 'resistance of economies' and is empirically located in an analysis of high profile political interventions on AMR in the UK, spanning several decades into the present.…”

Section: Introductionmentioning

confidence: 99%

“…We have told some of this story elsewhere (Brown and Nettleton, 2017) but it is useful to sketch some elements of it here. The 'resistance of economies' counter-balances the crosscurrents between economy and biology found in the world of microbiology documented below.…”

Section: Introductionmentioning

confidence: 99%

Economic imaginaries of the Anti-biosis: between ‘economies of resistance’ and the ‘resistance of economies’

Brown

Nettleton

2018

Palgrave Commun

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This paper seeks to report on the way economic principles, formulae and discourse infiltrate biological research on antimicrobial resistance (AMR) in the life sciences. AMR, it can be argued, has become the basis for performing certain forms of 'economic imaginary'. Economic imaginaries are ways of projecting and materially restructuring economic and political orders through motifs, metaphors, images and practices. The paper contributes to critical social science and humanities research on the socioeconomic underpinning of biological discourse. The performance of economy in this context can be seen to follow two key trajectories. The first trajectory, discussed at length in this paper, might be described as 'economies of resistance'. Here the language of market economics structures and frames microbiological explanations of bacterial resistance. This can be illustrated through, for example, biological theories of 'genetic capitalism' where capitalism itself is seen to furnish microbial life with modes of economic behaviour and conduct. 'Economies of resistance' are evidence of the naturalisation of socioeconomic structures in expert understandings of AMR. The methodological basis of this paper lies in a historical genealogical investigation into the use of economic and market principles in contemporary microbiology. The paper reports on a corpus of published academic sources identified through the use of keywords, terms, expressions and metaphors linked to market economics. Search terms included, but were not limited to: 'trade-off', 'investment', 'market/s', 'competition', 'cooperation', 'economy', 'capital/ism' and 'socialist/ism', etc. 'Economies of resistance' complements a second distinct trajectory that can be seen to flow in the opposite direction from biology to economic politics (the 'resistance of economies'). Here, economic imaginaries of microbial life are redeployed in large-scale debates about the nature of economic life, about the future of the welfare state, industrial strategy, and about the politics of migration and race. 'Economies of resistance' and the 'resistance of economies' are not unrelated but, instead, they are mutually constituting dynamics in the co-production of AMR. In attempting to better understand this co-production, the paper draws upon literatures on the biopolitics of immunity in political philosophy and Science and Technology Studies (STS).

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‘There is worse to come’: The biopolitics of traumatism in antimicrobial resistance (AMR)

Cited by 30 publications

References 35 publications

The problem and the productivity of ignorance: Public health campaigns on antibiotic stewardship

The problem and the productivity of ignorance: Public health campaigns on antibiotic stewardship

Parasites, ghosts and mutualists: a relational geography of microbes for global health

Economic imaginaries of the Anti-biosis: between ‘economies of resistance’ and the ‘resistance of economies’

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