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Current accounts of antimicrobial resistance: stabilisation, individualisation and antibiotics as infrastructure

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  • Clare I. R. Chandler

    (London School of Hygiene & Tropical Medicine)

Abstract

Antimicrobial resistance (AMR) is one of the latest issues to galvanise political and financial investment as an emerging global health threat. This paper explores the construction of AMR as a problem, following three lines of analysis. First, an examination of some of the ways in which AMR has become an object for action—through defining, counting and projecting it. Following Lakoff’s work on emerging infectious diseases, the paper illustrates that while an ‘actuarial’ approach to AMR may be challenging to stabilise due to definitional and logistical issues, it has been successfully stabilised through a ‘sentinel’ approach that emphasises the threat of AMR. Second, the paper draws out a contrast between the way AMR is formulated in terms of a problem of connectedness—a ‘One Health’ issue—and the frequent solutions to AMR being focused on individual behaviour. The paper suggests that AMR presents an opportunity to take seriously connections, scale and systems but that this effort is undermined by the prevailing tendency to reduce health issues to matters for individual responsibility. Third, the paper takes AMR as a moment of infrastructural inversion (Bowker and Star) when antimicrobials and the work they do are rendered more visible. This leads to the proposal of antibiotics as infrastructure—part of the woodwork that we take for granted, and entangled with our ways of doing life, in particular modern life. These explorations render visible the ways social, economic and political frames continue to define AMR and how it may be acted upon, which opens up possibilities for reconfiguring AMR research and action.

Suggested Citation

  • Clare I. R. Chandler, 2019. "Current accounts of antimicrobial resistance: stabilisation, individualisation and antibiotics as infrastructure," Palgrave Communications, Palgrave Macmillan, vol. 5(1), pages 1-13, December.
  • Handle: RePEc:pal:palcom:v:5:y:2019:i:1:d:10.1057_s41599-019-0263-4
    DOI: 10.1057/s41599-019-0263-4
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    1. Ruobing Wang & Lucy Dorp & Liam P. Shaw & Phelim Bradley & Qi Wang & Xiaojuan Wang & Longyang Jin & Qing Zhang & Yuqing Liu & Adrien Rieux & Thamarai Dorai-Schneiders & Lucy Anne Weinert & Zamin Iqbal, 2018. "The global distribution and spread of the mobilized colistin resistance gene mcr-1," Nature Communications, Nature, vol. 9(1), pages 1-9, December.
    2. Nik Brown & Sarah Nettleton, 2018. "Economic imaginaries of the Anti-biosis: between ‘economies of resistance’ and the ‘resistance of economies’," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-8, December.
    3. Scott H. Podolsky, 2018. "The evolving response to antibiotic resistance (1945–2018)," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-8, December.
    4. Marc Mendelson & Manica Balasegaram & Tim Jinks & Céline Pulcini & Mike Sharland, 2017. "Antibiotic resistance has a language problem," Nature, Nature, vol. 545(7652), pages 23-25, May.
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    Cited by:

    1. Alexandra Waluszewski & Alessandro Cinti & Andrea Perna, 2021. "Antibiotics in pig meat production: restrictions as the odd case and overuse as normality? Experiences from Sweden and Italy," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-12, December.
    2. Lenore Manderson, 2020. "Prescribing, care and resistance: antibiotic use in urban South Africa," Palgrave Communications, Palgrave Macmillan, vol. 7(1), pages 1-10, December.
    3. Broom, Alex & Kenny, Katherine & Kirby, Emma & Davis, Mark & Dodds, Susan & Post, Jeffrey & Broom, Jennifer, 2021. "The modern hospital executive, micro improvements, and the rise of antimicrobial resistance," Social Science & Medicine, Elsevier, vol. 285(C).
    4. Samuel O. Abimbola & Melvine Anyango Otieno & Jennifer Cole, 2021. "Reducing the Use of Antimicrobials as a Solution to the Challenge of Antimicrobial Resistance (AMR): Approaching an Ethical Dilemma through the Lens of Planetary Health," Challenges, MDPI, vol. 12(2), pages 1-12, September.
    5. Andrea Butcher & Jose A. Cañada & Salla Sariola, 2021. "How to make noncoherent problems more productive: Towards an AMR management plan for low resource livestock sectors," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-10, December.
    6. Dixon, Justin & Manyau, Salome & Kandiye, Faith & Kranzer, Katharina & Chandler, Clare I.R., 2021. "Antibiotics, rational drug use and the architecture of global health in Zimbabwe," Social Science & Medicine, Elsevier, vol. 272(C).

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