Dissonant Harmonies: Agency and Vulnerability in AMR Response

• In Event: New Social Forms of the Post-Antibiotic Era: More-than-Human Hybrids, Governance and Knowledge of Human-Microbe Relations - I

Abstract

AMR as a global challenge is defined by the WHO’s 2015 Global Action Plan for AMR as the result of unregulated or imprudent antibiotic use that puts every nation at risk. This framing sanctions a “harmonised and immediate action on a global scale” through the development of National Action Plans, reducing the AMR challenge to a set of technically achievable objectives conforming to a particular standard. Affectively, harmonisation invokes the image of complementary melodies playing in unison. In practice, harmonies are deployed to support a governing tune.

The Global Action Plan arguably, if unintentionally, represents a top-down, expert led implementation underpinned by market and liberal governance mechanisms that provide security for the developed rather than the developing. In social science terms, the framework promotes behaviour change for managing use, assuming use to be a simple matter of choice among actors with equivalent capacities to choose. Drawing upon fieldwork from South Asia and West Africa, I examine the implications of this assumption for the healthcare provision, food security and livelihood security of already vulnerable populations. I test the limits of harmonisation by following the circulation of antimicrobial compounds and genes in uneven socioeconomic structures and gendered power dynamics that individuals, organisations and communities may lack the agency to manipulate, or that produce environments supporting AMR evolution that are not reducible to use. In global preparedness discourse, harmonisation symbolises unity of purpose, obscuring the uneven capacities of participating government agencies, and of the populations they govern, to achieve the standards so defined.

Author

• Andrea Butcher, University of Helsinki