RESISTANT TO TREATMENT: drug-resistant disease as a medical, social, and public health problem.
Co-organizers: Johanna Crane
As pharmaceuticals evolve, so do diseases. One result of the global proliferation of pharmaceutical therapies has been the emergence of drug-resistant microbes: viruses and bacteria that have mutated to render the drugs used to treat them ineffective. Theorists of social suffering have focused on the interplay of poverty and pharmaceutical access in contributing to epidemiological patterns and the future specter of “super-bugs” (Paul Farmer). Policy-oriented anthropologists have noted that local patterns for attributing meaning and efficacy to pharmaceuticals have shaped differing consumption patterns that might ultimately lead to resistance (e.g. Mark Nichter). And anthropologists have recently begun to describe the off-shoring of clinical trials by pharmaceutical companies in search of “treatment-naïve” research subjects, untainted by previous exposure to drugs or the possibility of drug resistance (Adriana Petryna). These works address the problem of resistance as a consequence or cause of various social and political practices. In this panel, we invite papers that seek to problematize the concept of “ drug resistance”, as such. We take various historically and culturally specific constructions of “resistance” as sites for thinking through how power and knowledge remake the body and disease.
This AAA section will focus on the anthropology of drug resistance, broadly conceived. Possible paper topics might include:
•Ethnographies of drug-resistant epidemics such as multi-drug resistant tuberculosis (MDR-TB), drug-resistant malaria, or methicillin-resistant staph aureus (MRSA).
•Iatrogenesis and the role of medicine in the production of drug resistant disease.
•Social, economic, and technical elements that shape interactions between the medical and pharmaceutical industries, and local governments, around the production and management of resistance, both globally and locally.
•The relationship between adherence (“compliance”) to treatment and the development of drug resistance (including questions of risk, discipline, and biopower in relation to patient behavior). The emergence, reformulation, and politics of “local biologies” in the face of the question of resistance.
•The construction of scientific knowledge about drug resistance: its causes, definition, and consequences. What is resistance? What is adherence? What are the social, technical, and political arrangements through which resistance is “produced” and identified? How has the concept emerged across disease categories? When, where and how have these concepts (adherence, resistance) been standardized?
•Drug resistance and drug “refractoriness”in non-infectious diseases, such as cancer or epilepsy. What are the social and political lives of these concepts (refractoriness and resistance)? How and when have they been made useful to each other?
Johanna Crane and Alex Choby are Ph.D. candidates in the UCSF/UC Berkeley Joint Program in Medical Anthropology. Johanna Crane’s research focuses on the production of knowledge about drug-resistant HIV in the U.S. and in Uganda, and how Western fears of a drug-resistant epidemic have impacted efforts to expand access to anti-HIV medications in sub-Saharan Africa. Alex Choby’s research focuses on the role of pharmaceuticals in the social construction of the category of “refractory epilepsy”.
Please send abstracts to firstname.lastname@example.org or ADMChoby@aol.com by March 20.
Alexandra Choby and Johanna Crane
Joint Program in Medical Anthropology
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