Abstract
Rather than ‘superbugs’ signifying recalcitrant forms of life that withstand biomedical treatment, drug resistant infections emerge within and are intricate with the exercise of social and medical power. The distinction is important, as it provides a means to understand and critique current methods employed to confront the threat of widespread antimicrobial resistance. A global health regime that seeks to extend social and medical power, through technical and market integration, risks reproducing a form of triumphalism and exceptionalism that resistance itself should have us pause to question. An alternative approach, based on a postcolonial as well as a ‘post-colony’ approach to health and microbes, provides impetus to challenge the assumptions and norms of global health. It highlights the potential contribution that vernacular approaches to human and animal health can play in altering the milieu of resistance.
Highlights
Rather than ‘superbugs’ signifying recalcitrant forms of life that withstand biomedical treatment, drug resistant infections emerge within and are intricate with the exercise of social and medical power
‘Local populations present obstacles not because of incommensurate belief systems or cultural differences, but because of incomplete integration into the modern projects of total surveillance and seamless exchange’ (King, 2002: 782). This account of global health integration is useful, though it is worth noting that the ‘irrelevance’ of incommensurable health knowledges has turned out to be slightly wide of the mark
At the outset of this paper I suggested that the tendency to treat drug resistance as material and social recalcitrance, and to assume that its very singularity provides the basis for a unified approach to the antimicrobial resistance problem, irrespective of milieu, health practices or ecologies, risks reproducing a form of human exceptionalism and triumphalism that resistance itself should have us pause to question
Summary
Resistance, whether understood as counter-repressive opposition to a dominant order or as agonistic process inherent to the exercise of power, is normally associated with intentional and emergent political acts (Hughes, 2019; Sharp et al, 2000; Foucault, 1990; Lilja and Vinthagen, 2018; Scott, 1985; Featherstone, 2008). Resistance is, in that sense, a matter to be overcome (with improved pharmaceuticals, greater awareness and behavioural change as means to manage the social-microbiological interface) These mobilizations of resistance, which imply matters to be extrinsic to medical order, suggest a narrative of mastery and eventual control; there is a tone of ‘we’re not quite there yet’ as innovation and improved governance seek to tame more and more of their social and material environs. Another possibility, and perhaps more in keeping with the material politics that Foucault and others started to trace, is to refuse to see microbial resistance as extrinsic to any exercise of power. I finish with cases from health care and food production as a means to illustrate where a reanimated resistance politics, alive to social and microbial difference, might take us
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