Project Title: Promoting Use and Non-Use: Medicines for TB and other Bacteria in an Era of AMR
Main supervisor: Dr Justin Dixon, Department of Global Health and Development, London School of Hygiene & Tropical Medicine
Co-supervisor: Prof Martin Gorsky, Department of Health Services Research, London School of Hygiene & Tropical Medicine
Host institution: London School of Hygiene & Tropical Medicine
The containment of resistance in tuberculosis has historically been premised on the very tight control of TB medicines, yet in many countries such as South Africa this has been unsuccessful. With blame for resistance often being cast onto patients for ‘defaulting’ on treatment regimens, social research has contested this blame by highlighting the broader social and economic inequalities that lead to treatment failures. However, with antimicrobial resistance (AMR) increasingly recognised as a global threat, it is important to find what lessons might be learned from TB control programmes for attempts to damage-limit AMR for ‘ordinary’ antibiotics, as well as how potentially conflicting imperatives between getting/keeping people on antibiotics and scaling-back medicines use play out in local worlds.
Drawing on ethnographic, survey and documentary archival analyses, and on oral history, this PhD project asks: what are the roles of TB medicines in South African society in relation to broader patterns of antimicrobial prescription and use? Relatedly, how has TB changed as a policy object over time including now in the era of AMR, and what might we learn from previous (often failed) attempts to contain resistance in TB for other antibiotics? We are interested to explore historically the changing nature of health system responses to TB, to understand how legacies of the past bear upon contemporary treatment policies and behaviours. The successful candidate will have latitude to define the historical period and the regional focus of the study. The PhD will contribute to an expanding body of interdisciplinary work on AMR and critically situate the role of TB medications in this emergent field of policy and practice.
Potential applicants wishing further information are encouraged to contact Justin Dixon or Martin Gorsky. For details of how to apply please use the 2019-20 Medical Research Foundation Antimicrobial Resistance PhD Studentship page.
Medical anthropology, history of health services, systems and policy-making, documentary research and oral history