London School of Hygiene & Tropical Medicine

Abstract: This paper reflects on the way antibiotic resistance (AMR) is historically situated at a particular juncture or ‘threshold’ in what we might call ‘biotic politics’. To what extent, for example, has AMR become a medium for the expression of cultural ambivalence about hygiene, dirt, nature, infections, bugs and the non-self or immunitary ‘other’? How is the nature and politics of AMR reshaping the problematic thresholds between ‘working with’ and ‘working against’ the biotic?

Is it possible to see in AMR the potential for reconfiguring the political and material thresholds of hygienism, pre-hygienism and post-hygienism? What, we might ask, are the limits and tipping points between infective safety and endangerment, between a positive immunity and damaging autoimmunity? I want to explore this question of thresholds in two very loosely interconnected contexts.

The first is that of British economic politics spanning the last decade or so in which AMR becomes an opportunity to advance a particular kind of ‘working against’. The second context locates AMR in the precarious world of cystic fibrosis treatment where survivability depends upon certain kinds of ‘working with’ the biotic.