Ontology, difference, and the antimicrobial resistance timeline

Abstract

Despite warnings at the start of the industrial antibiotic era seventy years ago, antimicrobial resistance (AMR) is an increasingly intransigent health issue. AMR can be claimed as a social, political, technological, or economic problem. But multidisciplinary, co-evolutionary perspectives are necessary to trace the complexity allowing it to persist. We link the concept of difference to anticipatory systems theory to show how the AMR issue is a negotiation between representations and forces that destabilize them. Drawing from governmental publications and journal articles, we provide examples of representational and non-representational difference spanning the social and biological entanglements of AMR. Just as social theory and future studies recognize a tension between stabilized categories and the latent potentials for their disruption, so does biology in that organisms are adapting yet also robust, capable of change but also stable. We illustrate how the reification of one or the other of these two types of difference can contribute to AMR’s entrenchment, yet their interaction also forms the basis for strategies to address it. Difference illuminates how solving AMR is not likely, but knowledge to approach closure requires working simultaneously, even contradictorily, with representational ontologies that provide predictability and the instabilities that unsettle them.