Capitalism is reason for AMR

In July 2014, the then British Prime Minister publicly articulated his fears of a ‘return to the dark ages of medicine’, an ‘unthinkable scenario’ in which antibiotics would become useless in tackling even the most common of minor infections. Cameron sketched out the dystopian prospect of a ‘return’ to the past, the unravelling or ‘undoing’ of modernity’s promissory progress. Exactly a decade earlier, Cameron’s predecessor as leader of the British Conservatives (Michael Howard), presented ‘superbugs’ as symptomatic of a fundamental cultural and economic contaminant at the heart of British politics and institutional life. Britain had become ‘the sick man of Europe’, he argued, and only liberal market economic reforms could restore Britain once again to health. This paper focuses on these and other aspects of the recent politics of antimicrobial resistance (AMR) examining the seemingly dystopian capacity of infectious diseases to evolutionarily adapt to and ‘outpace’ the toxins developed to keep them at bay. In so doing, we explore the promissory work of ‘traumatism’ (Derrida, 1999, 2003) and the politics of fear through which the debate has become expressed. Conceptually, we locate AMR in recent biopolitical literature on immunity, anticipatory biopolitics and the sociology of futures. We will argue that the debate has become a significant vehicle for the expression of an ‘economic imaginary’ (Jessop and Oosterlynck, 2008) where microbial resistance is projected onto the ideal operations of neoliberal markets. We bring this focus on economic imaginary together with writing on anticipation and an immunitary perspective on biopolitics. Immunitary theory allows us to recognize the importance of the immune system in configuring, and being configured by, the cross-currents of politics and life science debate. Some perspectives articulate the affirmative prospect of a ‘co-immunity’ between the self and the immunitary other, the human and the microbial (Cohen, 2009). Sloterdijk (2011) reflects on the consequences of the fortified immunitary microspheres of contemporary technological securitization. In following the economic imaginaries of AMR, we document an ongoing traffic in meanings by which biology and the juridical, immunology and economic politics, restructure one another (Martin, 1994; Cohen, 2009; Jamieson, 2016). Our focus here is to trace the transformation of one epistemology (biological resistance) into another (the political economy of markets). This, we suggest, can be expressed as the ‘resistance of economies’. Less explored here are what we have called ‘economies of resistance’, or the way principles of economy are borrowed into biological explanations of AMR. Biological models of ‘genetic capitalism’ in AMR, for example, nicely illustrate the flow of political economy into biology. The wider task to which this critique contributes is to puzzle through the mutually constituting flows between ‘economies of resistance’ and the ‘resistance of economies’ in the politics of AMR. Our key anchor point for thinking about the anticipatory dimensions of the AMR debate is Derrida and his reflections on the links between immunity and terror (2003). For Derrida, our present protections create the circumstances for an inescapably destructive future autoimmunity. His thinking is focused on the role of the imagination and chimes with the dystopian catastrophism underpinning many recent political and policy interventions on AMR. He reflects on an ‘anticipatory catastrophism’ and an ‘immunitary imagination’ that feeds a projected future cycle of excess recoiling destructively back upon our current protections and defences. Our point is to consider the different kinds of futures being constructed through the politics and policy of antimicrobial resistance, especially in its catastrophist formulations (see also Nerlich and James, 2009; Brown and Crawford, 2009). We will explore the very different accounts of ‘resistance’ expressed at different moments in the development of the AMR Brown and Nettleton 495 debate and interrogate to what extent AMR is a site for the continuation or transformation of an immunitary politics at the intersections of the human and the microbial. We use the political interventions of Howard and Cameron to consider the different kinds of futures being constructed through the promissory performance of biotic resistance.