There is a growing awareness that holistic and context-aware solutions are required in response to the technical and policy problems posed by AMR. However, there is little awareness of how to factor contextual components into policy processes. History, literary and critical studies, geography and environmental sciences possess key technical and methodological skills in discursive, spatial and ecological analysis of crucial contextual dimensions of anti-microbial resistance.
History, literary and critical studies, geography, and environmental sciences study the cultural, spatial and temporal dimensions of human activity. They investigate continuity and change in social and ecological relations, providing tools for understanding the intersections of politics, economics, epidemiology, and biology. Together, these disciplines help us to understand and assess the long history of social and technical interventions in human health, to outline recurrent patterns, trace the impact of shifting behavioural and policy responses, and highlight local contingencies.
Humanities and environmental sciences bring specific technical and methodological expertise to bear on social and ecological concerns with AMR. Environmental sciences foreground ecological consequences of human activity, and help us to reimagine AMR within a network of human relations with animals, plants, pathogens and terrains. Geography provides a critical and comparative lens on spatial inequality, and the often concealed or poorly understood spatial dimensions of health and environmental policy. History investigates our changing techniques, emphases, and politics in human health, both in particular locations and situations, and in global contexts. It links these changing politics to shifts in our understanding of poverty and in the social reproduction of inequality. Literary and critical studies demonstrate how discourse on health is deeply interwoven with culture-bound and culturally specific interpretations and expectations.
Consequently, these disciplines offer us new and politically salient explanations of AMR. Historians and geographers recognise that therapeutic failure is an emergent process, across time and space, in which technical, social, and biological processes are intermingled. Ecologists show us that our explanations for emerging AMR are often insufficient, and overlook specific deficits in our understanding of environmental factors. Taken in combination with history and geography, environmental sciences outline conceptual gaps which need to be addressed to fully engage with the politics and history, the distribution and emergence, as well as the biology and ecology of anti-microbial resistance.
The disciplines can also bridge science and policy. Geography has a long history of critical engagement with policy, while the Centre for History in Public Health at LSHTM has been a prominent participant in the History and Policy network, as well as leading discussion of relations between environment, health and history (see volume edited by Berridge and Gorsky). The field as a whole seeks to bring into prominence a critical awareness of broader ecological, spatial and temporal contexts and potential consequences of the policy process. From the perspective of impact, these disciplines are centrally concerned with open dialogue with policy makers, in the interest of developing sensitive, responsive and fair policy apparatus in response to what is a deeply-rooted, widely distributed, and often poorly understood environmental, social and biological problem.