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The mass production of antibiotics in the 1940s enabled their travel beyond Europe and America, but to date the significance of the ways in which these medicines co-constituted colonial regimes at the time has not been systematically described. Through a case study of yaws and syphilis, this research article traces arrivals of antibiotics in three countries of Eastern Africa—Malawi, Zimbabwe, and Uganda. We draw attention to the emergent roles of antibiotics at the intersection of colonial governance and humanitarianism in these different settings. Through this analysis of archival and ethnographic materials, we explore how antibiotics became ‘infrastructural’ in material, affective, and political ways. Achieving a better understanding of the entanglement of antibiotics with human systems and lives is crucial to address the pressing issue of antimicrobial resistance (AMR). With this article we join in the global multidisciplinary efforts to tackle AMR, pointing out the often-overlooked role of colonial history in the circulation of antibiotic drugs, and opening a line of research that will provide valuable insights for the development of effective measures to prevent and reduce the spread of antibiotic resistance.

Summary In early 2020, COVID-19 exposed differences in public health laboratory systems’ testing abilities. Focusing on Germany, the USA and the UK between 1900 and 2020, this article argues that studying the distinct evolution of laboratory infrastructures is critical to understanding the history of infection control and the limits of template-based reforms in global health. While each analysed laboratory infrastructure was shaped by a unique national context, neoliberal visions of lean public services and declining resources led to significant reform pressure from the 1970s. The US Center of Disease Control’s model of epidemic intelligence provided an attractive template to integrate resources and focus planning on preparedness scenarios. It also helped justify cuts to local laboratory infrastructures. Effects were uneven: in the USA and the UK, improved integration failed to compensate for local laboratory cuts and loss of autonomy. By contrast, Germany’s subsidiary principle allowed for limited federal integration while leaving local services mostly intact.

Despite being acknowledged as a major global health challenge, growing levels of antimicrobial resistance (AMR) in pathogenic and commensal organisms have proven an awkward fit for international health frameworks. This article surveys the history of attempts to coordinate international responses to AMR alongside the origins and evolution of the current international health regulations (IHR). It argues that AMR, which encompasses a vast range of microbial properties and ecological reservoirs, is an awkward fit for the ‘organismal’ philosophies that centre on the rapid control of individual pathogens that have characterised international policy-making since the 19th century.

This collection of papers addresses the gaps in research on the history of the global proliferation of microbiological research networks in the postcolonial era. It proposes that understanding the emergence of standards in microbiology and related public health fields - for instance phage typing or vaccine scheduling - requires an understanding of the colonial infrastructure that enabled the emergence of these standards in particular configurations. These infrastructures perform particularly difficult work, in making diverse and unruly set of organisms appear essentially similar, and therefore comparable and manipulable.

Bacteriophage-typing – using bacterial viruses to identify bacteria at the species and strain level – was the gold standard technology underlying the rapid expansion of international surveillance for major bacterial pathogens after 1945. The microbiological networks, taxonomies, and culture collections produced by phage-typers underpinned important advances in scientists’ understanding of microbial diversity and infection control efforts. However, embedded geopolitics, extractive microbial sampling, and cultural biases also distorted typing efforts and resulting findings in favour of high-income countries. Northern Normal merges classic historical research on phage-typing archives and publications with spatial analysis using ArcGIS to reconstruct the origins, rise, and biases of international phage-typing. Focusing on typing efforts for Salmonella enterica serovar Typhi (the cause of typhoid fever), it shows how (post)colonial phage-typing networks cemented the dominance of Northern microbiological hubs and led to an inverse reading of microbial prevalence and relevance. Whereas strains prevalent in the Global North were designated universal, those from endemic areas in the South were exoticized. The article tracks how taxonomic distinctions between ‘universal’ Northern strains and high-prevalence ‘exotic’ strains reinforced biosecurity concerns about the reimport of typhoid from Southern countries, led to the choice of non-representative strains to test typhoid vaccines, and facilitated growing neglect of typhoid at the international level. The article ends by reflecting on the persistence of (post)colonial microbiological infrastructures and resulting surveillance distortions in the genomic era.

In the wake of COVID-19, antimicrobial resistance (AMR) has become termed the ‘silent pandemic’, with a growing number of editorials warning that international momentum for AMR mitigation is being lost amidst the global turmoil of COVID-19, economic crises and the climate emergency. Yet, is it sufficient to now simply turn the volume of the pre-existing AMR policy discourse back up? Although existing AMR initiatives have previously achieved high levels of international attention, their impact remains limited. We believe it is time to critically reflect on the achievements of the past 7 years and adapt our AMR policies based on the substantial literature and evidence base that exists on the socioecological drivers of AMR. We argue that developing a more sustainable and impactful response requires a shift away from framing AMR as a unique threat in competition with other global challenges. Instead, we need to move towards an approach that emphasizes AMR as inherently interlinked and consciously hardwires upstream interventions into broader global developmental agendas.

In this Personal View, we critically examine the wider context of international efforts to stimulate commercial antibiotic research and development via public-private initiatives. Despite these efforts, antibiotics remain a global resource without an international support structure that is commensurate to the risks from antibiotic-resistant infections and the long-term nature of required solutions. To protect this resource, we propose a two-pronged antibiotic research and development strategy based on a short-term strengthening of incentives (such as market entry rewards) to maximise the delivery of existing opportunities in the pipeline, and on a concurrent medium-term to long-term establishment of a global, publicly funded antibiotic research and development institute. Designed sustainably to deliver novel and first-in-class antibiotics targeting key human health gaps, the institute and its staff would become a global resource that, unlike the private pharmaceutical sector, would be managed as an open science platform. Our model of internationalised public research and development would maximise scientific synergy and cross-fertilisation, minimise replication of effort, acquire and preserve existing know-how, and ensure equitable and sustainable access to novel and effective antibiotics. Its genuinely global focus would also help counteract tendencies to equate donor with global health priorities. Our proposal is not radical. Historical precedent and developments in other research areas show that sustained international funding of publicly owned research can hasten the delivery of critically needed drugs and lower barriers to access.

We combine methodology from history and genetics to reconstruct the biosocial history of antimicrobial resistance (AMR) in the bacterium Salmonella enterica serovar Typhi (S. Typhi). We show how evolutionary divergence in S. Typhi was driven by rising global antibiotic use and by the neglect of typhoid outside of high-income countries. Although high-income countries pioneered 1960s precautionary antibiotic regulations to prevent selection for multidrug resistance, new antibiotic classes, typhoid’s cultural status as a supposedly ancient disease of “undeveloped” countries, limited international funding, and narrow biosecurity agendas helped fragment effective global collective action for typhoid control. Antibiotic-intensive compensation for weak water and healthcare systems subsequently fueled AMR selection in low- and middle-income countries but often remained invisible due to lacking surveillance capabilities. The recent rise of extensively drug-resistant typhoid bears the biosocial footprint of more than half a century of antibiotic-intensive international neglect.

There is an increasingly urgent need for new antibiotics, yet there is a significant and persistent economic problem when it comes to developing such medicines. The problem stems from the perceived need for a “market” to drive commercial antibiotic development. In this article, we explore abandoning the market as a prerequisite for successful antibiotic research and development. Once one stops trying to fix a market model that has stopped functioning, one is free to carry out research and development (R&D) in ways that are more openly collaborative, a mechanism that has been demonstrably effective for the R&D underpinning the response to the COVID pandemic. New “open source” research models have great potential for the development of medicines for areas of public health where the traditional profit-driven model struggles to deliver. New financial initiatives, including major push/pull incentives, aimed at fixing the broken antibiotics market provide one possible means for funding an openly collaborative approach to drug development. We argue that now is therefore the time to evaluate, at scale, whether such methods can deliver new medicines through to patients, in a timely manner.

This chapter examines the evolution of British farm animal welfare politics during the last two decades of Harrison’s campaigning. In 1979, the RSPCA boycotted the Thatcher government’s new Farm Animal Welfare Council (FAWC). The short-lived protest triggered a membership revolt and moderation of RSPCA policies. It also coincided with a weakening of agricultural corporatism in Westminster. FAWC was granted relative independence from the Ministry of Agriculture, Fisheries, and Food and explicitly acknowledged an updated version of the five freedoms. Ensuing British welfare reforms were also driven by the increasing involvement of European bodies in animal welfare. Now in her 60s, Ruth Harrison joined FAWC as a welfare member. Her increasing public recognition as a senior welfare campaigner enabled her to proactively push for reforms, expand her fundraising activities, and sponsor additional welfare research. By the late 1990s, most of her welfare positions had become part of mainstream politics.

This chapter uses Harrison’s personal archives to reconstruct the writing process leading up to Animal Machines. It argues that Animal Machines was as much an environmentalist and consumer-oriented book as it was about animal welfare. Harrison wrote Animal Machines between 1961 and 1964. During this period, she read scientific publications on animal behaviour, visited British farms, and corresponded with manufacturers, parliamentarians, and other campaigners—the most prominent of whom was the environmentalist Rachel Carson. Hardly any of her findings were novel. Animal Machines’ impact was instead based on Harrison’s ability to effectively stage existing concerns about intensive farming and technological alienation from nature alongside new ethology-informed concepts of animal welfare. Harrison mobilised anecdotal and scientific evidence as well as visual material to create a powerful moral contrast between a threatened romanticised countryside and a desensitised dystopian future characterised by the “factory farm.”

This chapter traces the evolution of welfare science and the marketisation of farm animal welfare between 1980 and 2000. During this time, dedicated welfare publications soared, and welfare scientists obtained prestigious university posts. The field’s growth was aided by assurance schemes for animal welfare, which enabled mutually beneficial cooperation between researchers, industry, and NGOs like the RSPCA, whose Freedom Foods Label enjoyed great popularity from 1994 onwards. Assurance schemes shifted welfare politics to the marketplace and generated funds for research and NGOs. They also deescalated frontstage welfare politics by restricting access to corporate- and expert-led discussions about standards and enforcement. Ruth Harrison was sceptical of label claims and welfare’s transition from a moral into an economic value. Meanwhile, researchers continued to disagree on how to define welfare. While most researchers remained confident in their ability to produce meaningful results, animal welfare science entered a prolonged phase of epistemic navel-gazing.

This chapter studies the post-war evolution of British animal campaigning. It shows how the 1950s and 1960s saw long-standing concerns about cruelty to animals and wartime tropes of Britain as a Nation of Animal Lovers merge with concerns about the impacts of new intensive animal husbandry systems. So-called factory farms were not ubiquitous. However, in popular discourse, the “factory farm” increasingly functioned as a dystopian sociotechnical imaginary of new and alien technological threats to the English countryside, animal welfare, “British values,” consumer health, and the environment.

This chapter analyses Harrison’s work on FAWAC and the committee’s wider impact. Agricultural officials had weighted FAWAC membership in favour of producer interests. Within the committee, there were significant tensions over how to define welfare and the status of ethological expertise. Officials, veterinary scientists, and agricultural interests favoured productivity-focused definitions of welfare and prioritised physiological measurements of stress and metabolic conversion. Harrison and other mostly female welfare representatives successfully resisted the passage of weak new welfare codes and called for an inclusion of ethological expertise and wider ethical considerations in FAWAC deliberations. The resulting stalemate between “scientific” and “ethical” factions soon led to a breakdown of FAWAC decision-making, a stagnation of British welfare reforms, and a polarisation of public welfare campaigning.

The conclusion reflects on Harrison’s achievements as a campaigner and analyses the wider changes of animal welfare politics, science, and activism that occurred during her life. Between 1920 and 2000, synthesist Edwardian campaigning gave rise to professionalised activism and new concepts of animal cognition, affective states, and welfare. The “backstage” of British corporatist welfare politics was similarly transformed by polarising “frontstage” public protest and animal rights thinking. Aided by the rise of a new “mandated” animal welfare science and European integration, the turbulent 1970s eventually resulted in a new world of British welfare politics characterised by transnational decision-making and market-driven assurance schemes, which relied on consumer citizens rather than citizen campaigners to drive change. Determined to bear witness to animal welfare, Harrison shaped and witnessed most of these changes even though the economic drivers of welfare were becoming divorced from the universalist moral framework she believed in.

This open access book is the biography of one of Britain’s foremost animal welfare campaigners and of the world of activism, science, and politics she inhabited. In 1964, Ruth Harrison’s bestseller Animal Machines triggered a gear change in modern animal protection by popularising the term ‘factory farming’ alongside a new way of thinking about animal welfare. Here, historian Claas Kirchhelle explores Harrison’s avant-garde upbringing, Quakerism, and how animal welfare debates were linked to concerns about the wider ethical and environmental trajectories of post-war Britain. Breaking the myth of Harrison as a one-hit wonder, Kirchhelle reconstructs Harrison’s 46 years of campaigning and the rapid transformation of welfare politics and science during this time. Exacerbated by Harrison’s own actions, the decades after 1964 saw a polarisation of animal politics, a professionalisation of British activism, and the rise of a new animal welfare science. Harrison’s belief in incremental reform allowed her to form ties to leading scientists but alienated her from more radical campaigners. Many of her 1964 demands gradually became part of mainstream politics. However, farm animal welfare’s increasing marketisation has also led to a relative divorce from the wider agenda of social improvement that Harrison once bore witness to. this is the first book to cast light on the interlinked and frequently uneasy histories of post-war British animal welfare activism, science, and legislation. Its unique scope allows it to go beyond limited existing accounts of modern British animal welfare and will be of interest to those interested in animal welfare, environmentalism, and the behavioural sciences.

This chapter assesses the growing importance and institutionalisation of animal welfare science after 1965. It also analyses the science’s status as a “mandated discipline” tasked with establishing welfare definitions and evaluating production systems. The institutionalisation of welfare science benefited from new official funding streams and sponsorship from non-governmental bodies like the RSPCA and Ruth Harrison’s FACT. Although early hopes for universal welfare indicators were disappointed, three distinct welfare approaches emerged: (1) a first approach evaluated classic physiological indicators of animals’ basic health and biological functioning, (2) a second approach employed a mix of physiological and behavioural methods to study how animals cope with farm environments, and (3) a third approach focused on the “naturalness” of different production systems. Disagreements over how to weight welfare factors coincided with challenges to scientists’ authority by animal rights campaigners. Scientists also faced the challenge of meeting funder expectations without compromising research integrity.

This chapter reconstructs the events following the publication of Animal Machines. Skilful media promotion and Animal Machines’ fusion of contemporary animal welfare, health, and environmental concerns turned it into a bestseller. Critics tried to downplay Harrison’s allegations by drawing on sexist stereotypes and characterising her as a misguided and overemotional female. However, the public outrage triggered by Animal Machines soon forced officials to convene the so-called Brambell committee to review welfare on intensive farms. The committee’s 1965 report acknowledged the importance of animals’ affective states and proposed concrete welfare improvements alongside basic animal freedoms. Officials subsequently committed to installing a dedicated Farm Animal Welfare Advisory Committee (FAWAC) but only implemented some of the other Brambell proposals. Concerned about stalling momentum, Harrison successfully used her status as a charismatic but “moderate” public figure to gain access to FAWAC and the political backstage of British welfare consultation.

This chapter explores scientific thinking about animal behaviour and welfare from the late nineteenth century onwards. After a period of unsystematic investigations of animal cognition and feelings (affective states), many researchers abandoned allegedly anthropomorphic approaches in favour of new mechanistic behaviourist models. Interest in the evolutionary roots and purpose of behaviour was gradually revived by ethologists from the interwar period onwards. While senior continental ethologists shied away from research on animal feelings, a growing number of Anglo-American ethologists questioned supposed divides between animal and human cognition and anthropomorphic taboos associated with studying affective states. In post-war Britain, the University Federation of Animal Welfare and ethologists Julian Huxley and William Homan Thorpe used research on behaviour and stress to call for improved welfare. Their actions were strongly influenced by Edwardian concepts of science as a progressive force for the moral and spiritual improvement of human society.

There is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an ‘implementation gap’. At a policy level, the design of internationally salient solutions that are able to address AMR’s interconnected biological and social (historical, political, economic and cultural) dimensions is not straightforward. This multidisciplinary paper responds by asking two basic questions: (A) Is a universal approach to AMR policy and antibiotic stewardship possible? (B) If yes, what hallmarks characterise ‘good’ antibiotic policy? Our multistage analysis revealed four central challenges facing current international antibiotic policy: metrics, prioritisation, implementation and inequality. In response to this diagnosis, we propose three hallmarks that can support robust international antibiotic policy. Emerging hallmarks for good antibiotic policies are: Structural, Equitable and Tracked. We describe these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR.

Antimicrobial resistance is one of the greatest public health crises of our time. The natural biological process that causes microbes to become resistant to antimicrobial drugs presents a complex social challenge requiring more effective and sustainable management of the global antimicrobial commons—the common pool of effective antimicrobials. This special issue of Health Care Analysis explores the potential of two legal approaches—one long-term and one short-term—for managing the antimicrobial commons. The first article explores the lessons for antimicrobial resistance that can be learned from recent climate change agreements, and the second article explores how existing international laws can be adapted to better support global action in the short-term.