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I situate my research at the crossroads of history, philosophy, sociology and anthropology of science. In the past, I have focused on epigenetics, environmental research, empirical bioethics and environmental justice, within and outside the academia, as you can read here, or here. Now I am focusing on antibiotic resistance, and I use it as a lens to interpret the contradictions of the last century derived by industrial production, environmental degradation and biomedical cultures.

What interests me is the (at that time) new epistemic discourse that since the Forties has been produced to explain morphological changes of organisms produce when they experience new environmental conditions or perturbations. Through an important experiment at the base of the so-called concept of genetic assimilation, Conrad H. Waddington showed that a thermic shock can produce changes in wings’ veins of fruit flies, changes that can eventually be inherited across generations, without the environmental trigger that caused them.

This focus on production and (genetic) storage of biological differences elicited by the environment is nowadays coupled with the knowledge produced through microbiome research that explains the phenotypic patterns that recur across generations.

In a thought-provoking twist, with microbiome research, the focus shifts from production and inheritance of biological differences to production and inheritance of biological similarities. Microbiome research shows that some phenotypic patterns are allowed by ecological communities of microorganisms composing all animals. Bacteria allow the development and functioning of our bodies within an epistemic framework that is now key to understand biology. The network of vessels composing mammals’ stomach is formed through cellular differentiation and expression of genes coordinated by bacteria. The same is true for our immune system that is coordinated by gut bacteria. Food, which is an important aspect of our lives also impacts on this microecology and mediates between our biological functions and functioning of means of production whose parts dedicated to food production have immense importance for our biology and our internal and external ecologies. Antibiotic resistance is one of the crossroads where culture, biology, history and the Anthropocene meet. Indeed, Antibiotic resistance shows that means of production of our societies have an even more widespread, deep and allegedly unexpected impact on the biology of animals and plants. The microorganism can indeed adapt to resist the selective toxicity of antibiotics. Moreover, bacteria can transfer their genetic code horizontally, by touch, so that we can acquire antibiotic resistance by eating food that functions as a vector, by hosting lice on our heads and many other contacts. Bacteria that are resistant to antibiotics that have been used as growth factors in animal husbandry and to prevent diseases in livestock and aquaculture, spread in natural ecosystems and can be found in wild species. Rivers and estuarine waters are places hosting antibiotic resistance.

Searching on PubMed (the search engine for biomedical literature) titles of articles containing the terms ‘antimicrobial’ and ‘Louisiana’ I retrieved just one twelve-years-old article. No results with terms such as 'Mississippi' or 'New Orleans'. The authors collected and analysed Oysters from both waters of Louisiana Gulf and in restaurants and food retailers in Baton Rouge. In most of the samples gathered, scientists recognised the presence of bacteria (Vibrio parahaemolyticus and Vibrio vulnificus) resistant to specific antimicrobials. Food production is indeed the first factor in terms of the quantity of antibiotics used. This use and related antibiotic resistance impact all the living beings present in a specific area, and can easily travel around the globe through many channels. As Littman & Viens have highlighted, a sustainable future is a future without antibiotics as “there may be no truly sustainable way of using antibiotics in the long-run, as microorganisms have shown to be almost infinitely adaptable since the first introduction of antibiotics” (Littman & Viens 2015). But in the meanwhile, we need to use them and antibiotic resistance is a phenomenon that can be better studied through environmental research, by analysing wild species and emissions nearby livestock, for instance.

The study that I retrieved focuses on Oysters. But what about antibiotic resistance conveyed through food that is consumed by the most?

What about exposures of communities that are living in highly polluted areas?

And what is the additive value on antibiotic resistance for individuals who experience the presence of industrial pollutants and that live in areas where cancer epidemics are registered?

In this respect, there is a strategy to cope with the issue of antibiotic resistance promoted by the Center for Disease Control and Prevention. The document doesn’t mention any action to monitor and regulate the production and usage of antibiotics in livestock. Nevertheless, the CDC wants to scrutinise, through genome sequencing, “Listeria, Salmonella, Campylobacter, and E. coli and uploads sequence data into PulseNet for nationwide monitoring of outbreaks and trends.” Moreover, the document reports that “In Fiscal Year 2019, Louisiana will begin simultaneously monitoring these isolates for resistance genes. When outbreaks are detected, local CDC-supported epidemiologists investigate the cases to stop spread.”

The questions that I would like to ask (to local ppl, activists, researchers, practitioners..) are:

What could be the epidemiologic characteristics (socioeconomic status, gender, residence..) of the populations more vulnerable to antibiotic resistance?

What is the additive role of antibiotic resistance for people living in highly polluted areas?

What is the impact of antibiotic resistance for people and patients living in areas where cancer incidence is high?

And on the long run I am interested in imagining possible strategies to not only living with the problem but also to tackle the problem itself, which means to develop strategies to answer the questions:

Why antibiotic resistance, which is known since a century, it’s a problem on the rise?

What is the role and interest of capitalism, in terms of profit-making of corporations, knowledge production and environmental degradation, in not being able to resolve antibiotic resistance?

What can be strategies of local communities to tackle the problem and to promote environmental justice in terms of alliances with ecologists, doctors, epidemiologists and other activists?

The article includes multiple in-person interviews, including with Canadian officials (such as the Nunavut Premier), a professor of psychiatry at the University of Saskatchewan, and several prominent figures in the Native community.

The arguments of this article are supported by the following discussions:

1. The authors discuss changes in response and preparation policies for both public health and private organizations, domestically and internationally.
2. The authors discuss the importance of innovation in scientific research and development and how they have affected the way response and preparation to health crises are conducted
3. The authors provide specific aspects of international health emergencies and cite ways in which countries or organizations have dealt with them in the past and in what ways they succeeded and failed. 

Much of the data gathered by Dr. Schmid comes from reports occuring in the aftermath of Fukushima. Additionally, Dr. Schmid appears to use multiple reviews of past nuclear emergencies and protocols. She uses these articles, international statements, policies, and current treaties to build her argument.

The article centers on how social and political factors effected access to care for citizens in the wake of the Chernobyl nuclear disaster. Additionally, the author discusses how "at-risk" populations emerge; far too often, these populations are only noted after a disaster occurs, and are often ignored until that point. This creates a dependence on healthcare and illness for these populations, something that can be highly effected based on economic and social status. The author also discusses how technologies and government involvement dictated the situation post-disaster, and includes extensive information from resettled families and workers exposed to radiation

The author of this article drew on first hand accounts of the WTC attacks from fire, police, and EMS personel, as well as witnesses to reconstruct the events that transpired on the morning of 9/11/01 with regards to the response. The author also conducted and cited interviews with high ranking active and retired members of the Police and Fire Departments, such as FDNY Chiefs and officers and NYPD Commissioners. Based on this, the author examines specific shortcomings, such as lack of coordination between Fire and Police, comminication barriers, and the overwhelming and uncoordinated response by both on and off-duty firefighters.

"Third, we have seen that structural interventions can have an enormous impact on outcomes, even in the face of cost­effectiveness analyses and the flawed policies of international bodies"

"These are not the tasks for which clinicians were trained, but they are central to the struggle to reduce premature suffering and death. The importance of structural interventions for the future of health care means that practitioners of medicine and public health must make common cause with others who are trained to intervene more proximally."

"Pioneers of modern public health during the nineteenth century, such as Rudolph Virchow, understood that epidemic disease and dismal life expectancies were tightly linked to social conditions"

The bibliography is not included in the PDF uploaded, most likely because this a chapter excerpt from a larger work. However, there are several citations within the article, most of which are elaborated on. These descriptions indicate the works follow similar lines of thought and provide similar information to supplement Dr. Good's assertions. This includes his description of Dr. Evelyn A. Early's works (discussed earlier--ha), and several other prominent medical anthropologists. 

• “Sometimes the foreigner, too, is no more than his body, but this body is no longer the same: useless to the political economy, it now finds its place in a new moral economy that values suffering over labor and compassion more than rights.”
• “Deontologically, the medical officers were caught between the duties mandated to them by the public institution that employed them and those their profession required them to respect…”
• “The logic of state sovereignty in the control of immigration clearly prevailed over the universality of the principle of the right to life. The compassion protocol had met its limit.”

1) "Approaches based on preparedness may not be guided by rigorous cost-benefit analysis. Rather, they are aimed at developing the capability to respond to various types of potentially catastrophic biological events"

2) "This analytical approach, when turned to the field of biosecurity, makes neither broad prescriptions for the improvement of health and security, nor blanket denunciations of new biosecurity interventions. Rather, it examines how policymakers, scientists, and security planners have constituted potential future events as biosecurity threats, and have responded by criticizing, redeploying, or reworking existing apparatuses"

3) "But increased attention and funding to health preparedness by no means implies consensus around a single approach. The existing institutions of public health are not easily reconciled with the new demands and norms of health preparedness and there is considerable disagreement about the appropriate way to achieve preparedness."