Biomedicine in Africa – an anthropology of law, organization, science and technology

Axis 4: Biomedical experimentation and health interventions

The fourth axis is primarily concerned with the research aspect of biomedicine, epidemiology, and pharmacology. As in other sciences, experiments in biomedicine are the central and standard form of knowledge production. The context of an experiment inevitably influences the process of experimentation, as is evident in the case of Randomized Clinical Trials (RCT) of herbal remedies in Africa. On a more dramatic level, humanitarian medical interventions can also be regarded as forms of experimentation that differ in specific ways from conventional forms of carefully controlled and demarcated scientific experiments. The same is true for experimentation with medical solutions for particularly devastating diseases, in which treatment and experiment tend to overlap to a greater extent than is usually the case. In the African context, humanitarian medical interventions are often interventions in crisis zones involving life-threatening diseases and epidemics (such as AIDS and malaria), in various kinds of disaster (such as drought, flooding, and famine), and in states of emergency caused by wars and the failure of political institutions. These extreme conditions force and enable health care institutions and professionals to rapidly develop strategies both nationally and internationally to contain the crises and their devastating consequences. The emergency approach gives rise to a new form of governmentality that can be glossed here as “experimentality”, in which new strategies are tested, research and policies are re-ordered, and provisional solutions are often transformed into robust forms of health care and “therapeutic domination”. Experimentation, however, presupposes a certain degree of standardization. In order to experiment, a number of factors have to be held constant. Crisis interventions therefore normally follow a blueprint that was previously used in similar conditions supplemented by the experience gained from past “lessons learned.” In an inversion of the classical modernist model – according to which evidence of efficacy permits intervention – in the newly arising scenarios exceptional intervention drives the need for evidence demonstrating that the intervention was effective and that important lessons have been learned for the next occasion.

General questions of axis 4

What factors are assumed to be constant and unchanging and therefore to permit the application of traveling models of humanitarian emergency interventions?
What are the dimensions that are experimented with?
What type of governance emerges as a result of the normalization of humanitarian intervention?
How does the work of medical science shape the conditions of crisis and states of emergency, and how in turn is it shaped by these conditions and states?