Synthesizing Hope: Matter, Knowledge, and Place in South African Drug Discovery

University of Chicago Press
Free sample

Synthesizing Hope opens up the material and social world of pharmaceuticals by focusing on an unexpected place: iThemba Pharmaceuticals. Founded in 2009 with a name taken from the Zulu word for hope, the small South African startup with an elite international scientific board was tasked with drug discovery for tuberculosis, HIV, and malaria. Anne Pollock uses this company as an entry point for exploring how the location of scientific knowledge production matters, not only for the raw materials, manufacture, licensing, and distribution of pharmaceuticals but also for the making of basic scientific knowledge.

Consideration of this case exposes the limitations of global health frameworks that implicitly posit rich countries as the only sites of knowledge production. Analysis of iThemba identifies the problems inherent in global north/south divides at the same time as it highlights what is at stake in who makes knowledge and where. It also provides a concrete example for consideration of the contexts and practices of postcolonial science, its constraints, and its promise.

Synthesizing Hope explores the many legacies that create conditions of possibility for South African drug discovery, especially the specific form of settler colonialism characterized by apartheid and resource extraction. Paying attention to the infrastructures and laboratory processes of drug discovery underscores the materiality of pharmaceuticals from the perspective of their makers, and tracing the intellectual and material infrastructures of South African drug discovery contributes new insights about larger social, political, and economic orders.
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About the author

Anne Pollock is professor of global health and social medicine at King’s College London. She is the author of Medicating Race: Heart Disease and Durable Preoccupations with Difference.
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Additional Information

Publisher
University of Chicago Press
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Published on
May 8, 2019
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Pages
208
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ISBN
9780226629216
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Language
English
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Genres
History / Africa / South / Republic of South Africa
Medical / General
Medical / History
Medical / Pharmacology
Science / History
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Content Protection
This content is DRM protected.
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Eligible for Family Library

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In The Antibiotic Era, physician-historian Scott H. Podolsky narrates the far-reaching history of antibiotics, focusing particularly on reform efforts that attempted to fundamentally change how antibiotics are developed and prescribed. This sweeping chronicle reveals the struggles faced by crusading reformers from the 1940s onward as they advocated for a rational therapeutics at the crowded intersection of bugs and drugs, patients and doctors, industry and medical academia, and government and the media.

During the post–World War II "wonder drug" revolution, antibiotics were viewed as a panacea for mastering infectious disease. But from the beginning, critics raised concerns about irrational usage and overprescription. The first generation of antibiotic reformers focused on regulating the drug industry. The reforms they set in motion included the adoption of controlled clinical trials as the ultimate arbiters of therapeutic efficacy, the passage of the Kefauver-Harris amendments mandating proof of drug efficacy via well-controlled studies, and the empowering of the Food and Drug Administration to remove inefficacious drugs from the market. Despite such victories, no entity was empowered to rein in physicians who inappropriately prescribed, or overly prescribed, approved drugs.

Now, in an era of emerging bugs and receding drugs, discussions of antibiotic resistance focus on the need to develop novel antibiotics and the need for more appropriate prescription practices in the face of pharmaceutical marketing, pressure from patients, and the structural constraints that impede rational delivery of antibiotics worldwide. Concerns about the enduring utility of antibiotics—indeed, about a post-antibiotic era—are widespread, as evidenced by reports from the Centers for Disease Control and Prevention, academia, and popular media alike. Only by understanding the historical forces that have shaped our current situation, Podolsky argues, can we properly understand and frame our choices moving forward.

-- John E. Lesch, University of California
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