Evidence Ethos And Experiment

Medical research has been central to biomedicine in Africa for over a century, and Africa, along with other tropical areas, has been crucial to the development of medical science. At present, study populations in Africa participate in an increasing number of medical research projects and clinical trials, run by both public institutions and private companies. Global debates about the politics and ethics of this research are growing and local concerns are prompting calls for social studies of the 2trial communities3 produced by this scientific work. Drawing on rich, ethnographic and historiographic ­­­material, this volume represents the emergent field of anthropological inquiry that links Africanist ethnography to recent concerns with science, the state, and the culture of late capitalism in Africa.

Medical research has been central to biomedicine in Africa for over a century, and Africa, along with other tropical areas, has been crucial to the development of medical science. At present, study populations in Africa participate in an increasing number of medical research projects and clinical trials, run by both public institutions and private companies. Global debates about the politics and ethics of this research are growing and local concerns are prompting calls for social studies of the “trial communities” produced by this scientific work. Drawing on rich, ethnographic and historiographic material, this volume represents the emergent field of anthropological inquiry that links Africanist ethnography to recent concerns with science, the state, and the culture of late capitalism in Africa.

This book is intended to communicate current best practice in pediatric clinical pharmacology and clinical pharmacy with special consideration of the prevailing circumstances and most pressing needs in developing countries. It also addresses measures that may be taken in countries with emerging economies through organizational and political adjustments to reduce unacceptable levels of morbidity and mortality among children and pregnant women with treatable diseases.

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries. Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans have perceived research differently than researchers do and that the active participation of subjects led to the creation of a hybrid ethical form. By writing an ethnography of the past and a history of the present, Graboyes casts medical experimentation in a new light, and makes the resounding case that we must readjust our dominant ideas of consent, participation, and exploitation. With global implications, this lively book is as relevant for scholars as it is for anyone invested in the place of medicine in society.

In the domain of health, the relation between bodies, citizenship, nations and governments has changed beyond recognition over the past four decades, especially in Africa. In many regions, populations are now faced with a total lack of medical care, and the disciplinary regimes of modernity are faint memories. In this situation, new critical insights beyond the critique of old »modernization« and the »disciplinary regimes« of imperial times are needed. How can we keep up our sophisticated criticism of knowledge regimes and our doubts with regard to narratives of development, when so many people in Africa are dreaming about modernity and are envisioning their own renaissance?

What is the value of medical research? With contributions from anthropologists, sociologists and activists, this approach brings into focus the forms of value – social, epistemic, and economic – that are involved in medical research practices and how these values intersect with everyday living. Though their work covers wide empirical ground –from HIV trials in Kenya and drug donation programs in Tanzania to industry-academic collaborations in the British National Health Service – the authors share a commitment to understanding the practices of medical research as embedded in both local social worlds and global markets. Their collective concern is to rethink the conventional ethical demarcations betwweenpaid and unpaid research services in light of the social and material organisation of medical research practices. . Rather than warn against economic incursions into medical knowledge and health practice, or, alternatively, the reduction of local experience to the standards of bioethics, we hope to illuminate the array of practices, knowledges, and techniques through which the value of medical research is brought into being. This book was originally published as a special issue of Journal of Cultural Economy.

In Research as Development, Salla Sariola and Bob Simpson show how international collaboration operates in a setting that is typically portrayed as "resource-poor" and "scientifically lagging." Based on their long-term fieldwork in Sri Lanka, Sariola and Simpson bring into clear ethnographic focus the ways international scientific collaborations feature prominently in the pursuit of global health in which research operates "as" development and not merely "for" it. The authors follow the design, inception, and practice of two clinical trials: one a global health charity funded trial and the other a pharmaceutical industry-sponsored trial. Research as Development situates these two trials within their historical, political and cultural contexts and thus counters the idea that local actors are merely passive recipients of new technical and scientific rationalities. While social studies of clinical trials are beginning to be an established niche in academic writing, Research as Development helps fill important gaps in the literature through its examination of clinical research situated in cultures in low-income settings. Research as Development is noteworthy for the way it highlights the critical and creative role that local researchers play in establishing international collaborations and making them work into locally viable forms. The volume shows how these clinical and research interactions bring about changes in culture, technologies and expertise in Sri Lanka, contexts that have not previously been written about in any detail.

Set in the context of the processes and practices of human reproduction and reproductive health in Northern India, this book examines the institutional exercise of power by the state, caste and kin groups. Drawing on ethnographic research over the past eighteen years among poor Hindu and Muslim communities in Rajasthan and among development and health actors in the state, this book contributes to developing analytic perspectives on reproductive practice, agency and the body-self as particular and novel sites of a vital power and politic. Rajasthan has been among the poorest states in the country with high levels of maternal and infant mortality and morbidity. The author closely examines how social and economic inequalities are produced and sustained in discursive and on the ground contexts of family-making, how authoritative knowledge and power in the domain of childbirth is exercised across a landscape of development institutions, how maternal health becomes a category of citizenship, how health-seeking is socially and emotionally determined and political in nature, how the health sector operates as a biopolitical system, and how diverse moral claims over the fertile, infertile and reproductive body-self are asserted, contested and often realised. A compelling analysis, this book offers both new empirical data and new theoretical insights. It draws together the practices, experiences and discourse on fertility and reproduction (childbirth, infertility, loss) in Northern India into an overarching analytical framework on power and gender politics. It will be of interest to academics in the fields of medical anthropology, medical sociology, public health, gender studies, human rights and sociolegal studies, and South Asian studies.