Paper short abstract:

Based on ethnographic fieldwork, and including microbiological, interpersonal and health systems scales of analysis, this presentation describes a configuration of contagious connections that currently facilitates transformation of TB into a multidrug-resistant TB epidemic.

Paper long abstract:

Tuberculosis (TB) can be classified as a 'social' disease due to its deep links with population density, malnutrition, and patterns of inequity more broadly, and it falls squarely in the category of 'communicable disease'. But how are we to understand the global acceleration of strains of TB that are resistant to standard treatment? This ongoing study follows a group of MDRTB patients in India and attempts to backtrack the opportunities that have arisen from the perspective of the mycobacterium Tuberculosis to develop drug resistance within the body of the patient and for the drug-resistant strain to spread between people as they have moved through various diagnostic and therapeutic options across offered by public and private healthcare providers. The project seeks to move beyond the simplified understanding of drug resistant TB as being caused by 'improper use of antibiotics' due to 'administration of improper treatment regimens and failure to ensure that patients complete the whole course of treatment', as described by the World Health Organization (http://www.who.int/tb/challenges/mdr/en/) through detailed ethnographies with patients. The paper outlines the configuration of TB treatment in India that currently favours development of drug resistance.