Consubstantialities of resistance: Labor process, (bio)materialities, and pathogenicity

Abstract

As social science scholarship has historically documented, social structure and clinical practice are more commonly as contradictory or incoherent as they are often framed. The increasing emphasis on the rise of antimicrobial resistance (AMR) has drawn attention to how social realms of resistance are entrenched and interconnected through varied structural, political, clinical, biological, and ecological relations. In this study, set in São Paulo, Brazil, I sought to unpack relational consubstantialities of AMR within the healthcare labor process and their enfolded (bio)materialities and pathogenicity by drawing on a series of interviews with primary care-based health professionals, health services managers, and policymakers, completed between late 2021 and early 2023. Participants’ accounts reveal how the reproduction of the labor process in primary care foregrounds (bio)material relations in which antimicrobial resistance finds timely and proper coextensive social conditions of reproduction. In their turn, the study results highlight how work intensification relates to economies of scarcity, teamwork coerciveness, AMR virulence and pathogenicity, destabilizing ecological (bio)materialities amid structural and clinical practice interrelations. Building on renewed materialisms of the political economy of health, I propose an approach to complexify understandings of relational interconnectedness of resistance by instilling relational tension lines of objects against their pragmatic reification in health interventions and theory.