In 2009, South African scientists, with the help of American colleagues, formed the small start-up tech company iThemba Pharmaceuticals with the aim to discover new drugs for the treatment of tuberculosis, HIV and malaria. In the world of postcolonial technoscience, this was in many ways a new departure, one which promised to overcome time-honored forms of far-reaching exclusion of Africa from the map of places that mattered in scientific innovation, and one that broke away from the forms of scientific organization that serviced South Africa’s resource extraction industry and the modern apartheid state. Although the promise was short-lived and ultimately unsuccessful – the company closed its doors in 2015 – the effort to not only produce but actually discover and develop new pharmaceuticals reveals just what it takes to even begin to imagine a different global political and economic order of technoscience.
Anne Pollock’s book explores this effort with a view towards how the material processes scientists in the laboratories of iThemba were engaged in are linked to the historical legacies of settler colonialism and contemporary frameworks of Global Health. Pollock is professor of global health and social medicine with a background in chemistry and the book clearly reflects her interdisciplinary scholarly location. It contributes to the Latourian tradition of studies on scientific laboratories that have been central to the formation of the field of science and technology studies.
The book consists of six chapters. In the introduction, Pollock spells out how science geared towards drug discovery makes visible and at the same time disrupts dominant structures of, and ideas about, Global Health thereby opening up her field of investigation, a field she describes as “African knowledge-making beyond diffusion and translation” (p. 38). The subsequent chapters focus on the analysis of specific historical, political and epistemological disruptions with which iThemba intersects. Chapter 2 explores the postcolonial situatedness of iThemba, built as it was on the ruins of a former dynamite factory; chapter 3 asks questions about the political visions on how post-apartheid science in the service of the people should look like and be managed and how these visions informed iThemba scientists’ practices; chapter 4 examines the meanings of place for the scientists that were encapsulated in the slogan “African solutions for African problems” and identifies the stakes involved in the claims to science being rooted in personal experience, democratic citizenship, and in working “at home”(as opposed to working in Northern research universities, p. 85); chapters five and six look more closely into how the chemical processes involved in drug discovery and the ingredients and reagents required for pharmaceutical research are linked to both path-dependent forms of knowledge-making and to global supply chains as well as locations therein. The author skillfully unpacks how the intellectual property of pharmaceuticals is bound up with lab-based materializations: “For pharmaceutical information to become drugs, it much be materialize with ingredients and processes that are unevenly distributed in space” (p. 95).
Pollock’s book must be lauded for two major achievements. The first is the way she is able to situate South African drug discovery research in what she calls “bifurcations in global health discourses” (p. 23), bifurcations which work to separate the Global North and the Global South in relation to pharmaceutical research and drug supply and consumption and in which South Africa is uneasily situated due to its hybrid status as something like a center in the periphery. She identifies three such discourses: global access-to-medicine campaigns; bioprospecting and clinical trials. Access-to-medicine campaigns focus on how to get medicine to populations most in need, on incentivizing researchers in the North to develop drugs for diseases of the poor, and thus on the redistribution of products of research, not the research itself. Such efforts, benign as they are, tend to reproduce existing bifurcations between Global North and Global South, not least because they foster existing distributions of profit hinging as they do on global patent laws in which the major profits accrue from drug discovery, not manufacturing. In critical research on bioprospecting – the utilization of plants and related indigenous botanical knowledge for pharmaceutical research – knowledge-making in the Global South is conceptualized as local knowledge that still needs to be translated to become or matter for global science. Similar to the access-to-medicine campaigns there is a bifurcation here in which the South remains on a lower position in the hierarchies of global knowledge production. Finally, debates on clinical trials – the stage in drug development in which drugs are tested on human subjects under controlled conditions – focus on the global inequalities that drive them and the divergent forms of therapeutic domination and epistemological power involved in them. These are palpable in the fact that African researchers’ participation often reduces their status to that of “field workers” (p. 36) and that African settings only come to matter as places of trial, not in the much more fundamental stage of drug discovery. In all of these debates, Africa is the recipient rather the producer of knowledge. Towards the end of the book, Pollock redraws the map as follows: “There is a sense that the places of the pharmaceutical industry are already fixed: innovation will occur in Europe, North America, Australia and Japan; copies of those innovations will be made in India, China and Brazil; the rest of the world will have no role at all as producers, only as consumers of what those few places decide to produce and share (p. 128). The book most excels where it shows how exceptional iThemba actually was in such a context.
The second major achievement is the way Pollock renders productive the concept of “sociotechnical imaginaries” (p. 16), which she takes from the work of Jasanoff and Kim. Sociotechnical imaginaries are sets of ideas about how particular forms of technoscience and scientific practice and innovation embody collective goods and visions. Technoscientific projects that represent such imaginaries involve normative claims about what should be done as well as materializations of these visions in space and time. Pollock shows the reader just how extensive the range of ideas, goals and political ambitions is in which iThemba and drug discovery differ from other technoscientific projects such as mining, nuclear power or biometrics. She demonstrates how pharmaceuticals and pills become sites of hope – hope for a different kind of science, a different form of economic production and a different global order of knowledge-making. As the author self-critically admits one can question the usefulness of the concept given that the limited economic traction South African drug discovery efforts finally yielded.
The main weakness of the book is that, unfortunately the two main lines of inquiry – one focused on the political geographies of global pharmaceutical knowledge production, the other addressing the entanglements of these with chemical processes in STS fashion – remain often disjointed. It is difficult to see how discussions on the philosophy of chemistry and the relational ontological status of molecules (chapters five and six), useful as they are for understanding laboratory live, really bear on global health frameworks. With its elaborations of flow chemistry, of scientific intimacies (among scientists and materials), the scientists’ subject positions and ideational frameworks and global health geographies it sometimes seemed the book aims to bridge too many topics.
In spite of this criticism, the book is a fantastic introduction into the stakes of technoscience in societies in transformation. I highly recommend it for scholars of science and technology studies, students interested in global health geographies and everybody with an interest in science in the Global South.