ABSTRACT
Antibiotics and antiretrovirals, two examples of immunity technology that together counterpose fear and hope, provide the case material for this chapter. Global policy efforts have called for urgent attention to the ‘antibiotic apocalypse’ threat to health produced by the rise of antimicrobial resistance. ‘Treatment as prevention’ is a policy paradigm that uses early HIV diagnosis and antiretroviral pharmaceuticals to reduce transmission of the virus and thus portends the ‘end of AIDS’. The chapter reveals, however, that the nexus of economy and immunity in both these cases is fragile. The economic systems of antimicrobial discovery, production and marketing have failed to keep pace with the rise of antimicrobial resistant organisms. In response, policymakers have called for public investment in the pharmaceutical industry and loosening of the regulatory environment to stimulate pharmaceutical discovery and profit. The treatment as prevention paradigm for HIV, in the era of austerity, is witnessing de-investment in social public health approaches that have supported individuals and communities to access treatments and curb the transmission of the virus. These divergent currents in policy are examined for what they reveal about the assemblage of economic rationality, immunity technology and fragility as the foundation for public health.
