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

198 Pages·2019·0.933 MB·English

by  Anne Pollock

Synthesizing Hope

Synthesizing Hope
Matter, Knowledge, and Place in
South  African Drug Discovery
ANNE POLLOCK
The University of Chicago Press
Chicago and London
The University of Chicago Press, Chicago 60637
The University of Chicago Press, Ltd., London
© 2019 by The University of Chicago
All rights reserved. No part of this book may be used or reproduced in any
manner whatsoever without written permission, except in the case of brief
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University of Chicago Press, 1427 E. 60th St., Chicago, IL 60637.
Published 2019
Printed in the United States of America
28 27 26 25 24 23 22 21 20 19 1 2 3 4 5
ISBN- 13: 978- 0- 226- 62904- 9 (cloth)
ISBN- 13: 978- 0- 226- 62918- 6 (paper)
ISBN- 13: 978- 0- 226- 62921- 6 (e- book)
DOI: https:// doi .org/ 10 .7208/ chicago/ 9780226629216 .001 .0001
Library of Congress Cataloging-in-Publication Data
Names: Pollock, Anne, 1975– author.
Title: Synthesizing hope : matter, knowledge, and place in South African drug
discovery / Anne Pollock.
Description: Chicago ; London : The University of Chicago Press, 2019. |
Includes bibliographical references and index.
Identifi ers: LCCN 2018051002 | ISBN 9780226629049 (cloth : alk. paper) |
ISBN 9780226629186 (pbk. : alk. paper) | ISBN 9780226629216 (e-book)
Subjects: LCSH: iThemba Pharmaceuticals. | Pharmaceutical industry—
South Africa. | Drugs—Research—South Africa.
Classifi cation: LCC HD9673.S64 I74 2019 | DDC 338.7/6161510968—dc23
LC record available at https://lccn.loc.gov/2018051002
This paper meets the requirements of ANSI/NISO Z39.48–1 992
( Permanence of Paper).
CONTENTS
INTRODUCTION / Hope in South African Drug Discovery / 1
ONE / Questioning the Bifurcations in Global Health Discourses / 23
TWO / In the Shadows of the Dynamite Factory / 40
THREE / Science for a Post- apartheid South Africa / 57
FOUR / “African Solutions for African Problems” / 75
FIVE / Im/materiality of Pharmaceutical Knowledge Making / 94
SIX / Hope in Flow / 114
EPILOGUE / The Afterlives of Hope / 129
Acknowledgments / 137
Notes / 139
Bibliography / 165
Index / 183

INTRODUCTION
Hope in South African Drug Discovery
Pharmaceuticals are pleasingly tangible, tiny technoscientifi c objects that
can be held in the hand, injected, or swallowed. At the same time, they are
opaque representatives of a global pharmaceutical industry that is daunt-
ingly complex.
Synthesizing Hope opens up the materials and processes of pharmaceu-
ticals by starting in a distinctive place: iThemba Pharmaceuticals, a small
South African start-u p pharmaceutical company with an elite international
scientifi c board, which was founded in 2009 with the mission of drug dis-
covery for the treatment of tuberculosis (TB), human-i mmunodefi ciency
virus (HIV), and malaria. “iThemba” means “hope” in Zulu. iThemba was
ultimately unsuccessful in fi nding new drugs, and the company closed its
doors in 2015. Yet this particular place provides an entry point for explor-
ing how the location of the scientifi c knowledge component of pharma-
ceuticals— in addition to their raw materials, production, licensing, and
distribution— matters. I will explore why it matters for the scientists them-
selves and why it matters for those interested in global health and post-
colonial science.
What if South Africa were to become a prominent place not just of raw
materials, test subjects, and end users but of the basic science of pharma-
ceutical knowledge making? Synthesizing Hope is unusual in combining at-
tention to global health and attention to postcolonial science, two spheres
that are not often thought about together. In global health literature, sci-
entists working in postcolonial contexts like Africa receive scant attention.
Most global health research assumes that rich countries are the main, if
not unique, source of knowledge making and that this knowledge fl ows
“south.” This exemplifi es what anthropologists Jean Comaroff and John
Comaroff have called the “epistemic scaffolding” of “Euromodernity,”
2 / Introduction
in which the West is the locus of “refi ned knowledge” and the rest of the
world merely provides “reservoirs of raw fact.”1 Synthesizing Hope tracks a
group of ambitious scientists’ efforts to subvert that scaffolding.
In comparison with vast literatures on perspectives of patients and phy-
sicians, perspectives of pharmaceutical makers generally have been given
insuffi cient attention.2 There is a rich ethnographically engaged literature
of global health research in Africa,3 but not of pharmaceutical scientists
there. This has some empirical justifi cation: as anthropologist Kristin Peter-
son points out, the continent’s pharmaceutical capacity has been in impor-
tant ways “emptied out” in the processes of dispossession of biocapital.4
More broadly, it is generally much more diffi cult for anthropologists and
other social researchers to get access to pharmaceutical industry informants
than to those positioned later in the pharmaceutical life cycle, such as pre-
scribers and consumers.5 The global pharmaceutical companies that make
up “Big Pharma” are notoriously focused on controlling information,6 and
most start- up pharmaceutical companies follow suit. As a small company
at the periphery of the global pharmaceutical industry, iThemba provided
an intimate yet far-r eaching perspective on preclinical pharmaceutical re-
search, an understudied phase of pharmaceutical development.
Most scholarship of science in Africa has been of fi eld sciences, agri-
cultural sciences, and of labs that seek to isolate and verify fi eld fi ndings.
In contrast, iThemba was a synthetic- chemistry- based company. The sci-
entists there wanted to participate in global science as peers of elite scien-
tists elsewhere. That is, they did not want to be limited to providing the
Global North with problems to be solved, raw materials, or clinical trial
subjects: rather, they wanted to participate in global knowledge creation.
At the same time, the problems and possibilities they faced were rooted in
their local context. Analysis of their project thus provides an opportunity
for distinctive engagement with place.
South Africa is prominent in discussions of global health, but the coun-
try plays a peripheral role in conversations about global pharmaceutical
science. Aspirations for scientifi c knowledge making are inextricably inter-
twined with infrastructures. The complex infrastructures used in most pre-
clinical pharmaceutical research and development (R&D) today are highly
geographically concentrated in what is variously called the “West” or the
“Global North.”7 However, South Africa’s specifi c history has left it with
a scientifi c infrastructure that is much more developed than that in other
parts of Africa, with well-r egarded research universities, a robust electri-
cal grid, and good transportation within the country and abroad. Just as
Europe itself has always had “major centers, minor centers, and peripher-
Hope in South African Drug Discovery / 3
ies” of science,8 Africa is not merely undifferentiated periphery: South Af-
rica (Johannesburg in particular) is a node in networks of global science.
iThemba itself was situated on the grounds of a historic dynamite factory—
the largest in the world in its early twentieth- century heyday— and thus
enjoyed robust and reliable access to electricity. This scientifi c and indus-
trial infrastructure is the legacy of an oppressive history—c olonialism and
a system of legally enforced racial segregation and discrimination known
as apartheid, which deprived the black-m ajority population of full citizen-
ship. Now that South Africa is a couple of decades into an imperfect de-
mocracy, iThemba provides an opportunity to ask: could that infrastructure
be turned to the service of the people?
iThemba scientists were inspired by the mission of creating new phar-
maceutical treatments by and for South Africa and its region. They believed
that it was important that this research be done in South Africa, and one
common reason that they gave was that South Africa needed to recognize
HIV (and TB) as its own problem and to take care of its problems itself.
Self- reliance is in some senses an illusion: the small Johannesburg bio-
tech company had an international board, as well as license agreements
with international companies and universities, and anything developed
there would also be part of global fl ows of knowledge production. But self-
reliance was also an important component of how these chemists in South
Africa understood the terrain of raising the profi le of their scientifi c com-
munity and their country.
Post- apartheid South Africa is an illuminating site for analysis of the
allure and the diffi culty of the creation of science (universally applicable
knowledge) that is democratic (accountable to particular publics). If, as his-
torians and science and technology studies (STS) scholars Paul Edwards
and Gabrielle Hecht argue, nuclear and computer systems were key in the
technopolitics of apartheid, the iThemba project might be conceptualized
as a gesture toward a potential technopolitics of post-a partheid.9 For Ed-
wards and Hecht, computer systems functioned as a tool and as a symbol
of apartheid South Africa, both within the country and as a focal point for
outsiders. iThemba’s project of drug discovery for TB, HIV, and malaria can
be understood to play an analogous role for a democratic South Africa, al-
beit in a limited way in light of that effort’s small scale. For both South Afri-
can political leadership and the range of national and international actors
who came together to found iThemba, science and technology generally,
and drug discovery science in particular, became sites for nation building.
Since iThemba means “hope,” how to account for its eventual failure?
The small company might be understood to play the role of the hero of a