Paper short abstract:

In spite of intensified global health initiatives, a global epidemic of drug-resistant tuberculosis (DRTB) has developed. Based on ethnographic explorations of multilayered and multispecies resistances driving development and spread of DRTB, I discuss the recently revised strategy to End TB by 2030.

Paper long abstract:

Apart from occasional visits to diagnostic facilities and regular visits to receive treatment, active tuberculosis (TB) disease in India is largely managed with outpatient ambulatory treatment and home care, based on the assumption that a well-treated TB disease is relatively quickly rendered non-infectious. In a context where initial treatment is often pursued in a largely commercial healthcare sector, where sporadic, insufficient and wrong treatment is common, rather than becoming non-infectious the disease may become resistant to first-line treatment and remain infectious. In this presentation, I will explore how a multispecies ethnography approach to the anthropological study of the development of drug-resistant tuberculosis may allow for a focus on multilayered and interrelated resistances across traditional species barriers. Forms of resistance at intracellular levels interact dynamically with resistances to pharmaco-toxicity, commercial exploitation and intersubjective rejection linked to diagnostic and treatment practices; all interlinked with the progression of disease/cure. The empirically informed part of my talk presents insights from ethnographic work-in-progress based on dialogues and other exchanges with people suffering from drug-resistant tuberculosis in India. The presentation discusses the feasibility of the WHO strategy to 'end TB' in view of its recent modifications.