The Multilateral Initiative on Malaria (MIM) – resisting

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Dear seminar attendees,

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The title of the seminar is “Who is the expert? Re-defining scientific quality standards as a

source of resistance towards colonially ascribed identities”, and it draws on the last chapters of my forthcoming (Dec. -09) dissertation in Theory of Science, Gothenburg University, Sweden.

My dissertation has so far not explicitly dealt with issues of resistance or used theories explicitly discussing resistance, and it is therefore my hope that the seminar is going to give useful comments on this theme as I can see its presence in every “corner” of my material, and this paper is therefore an introduction to my dissertation rather than a set presentation of resistance strategies, theories etc.

The empirical case in focus of my dissertation is the international research alliance

The Multilateral Initiative on Malaria (se below), but the aim has not been to evaluate the MIM, but instead to analyse it and present a background for why certain actors felt this kind of initiative was needed. The dissertation therefore studies activities carried out within the alliance and ideas expressed by researchers linked to this alliance in order to show in what ways micro-scientific events (fact making activities) are related to macro-phenomena such as historical and global discourses.

Also, I have struggled with questions regarding the gap between research and their sites of implementation (in this case: whether a philosophical and sociological analysis of malaria research can be of relevance to science policy entities, people working within organisations like the MIM, etc.), i.e. on a personal level the aim of this work has also been to investigate whether the “ivory tower syndrome” of such an abstract and theoretical discipline like Theory of Science is inescapable or not, and the seminar is therefore invited to comment also on this theme.

When reading the following text I ask you to kindly bear in mind that this is “work in progress”, that the text is meant to serve as a background for the seminar and that it therefore only very briefly presents a few aspects of an immensely complex topic. The text is thus a point of departure for a discussion and I welcome your input and critique, but disapprove of anybody quoting these embryonic thoughts of mine.

Kind regards, Gunilla Priebe

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Abstract, Presentation at the Resistance Studies Seminar 2008-12-04, School of Global

Studies, Gothenburg University, Sweden, author: gunilla.priebe@theorysc.gu.se

Who is the expert? Re-defining scientific quality standards as a source of resistance towards colonially ascribed identities

Background: Science & Technology in Africa

The mainstream narrative commonly treats science as if it developed as a consequence of events and activities taking place on the European continent only (e.g. Merton 1973, Popper 1972), but alternative research has now shown that what we today call Science & Technology (S&T, or technoscience) rather consists of knowledge and practices collected from all over the world, but recycled through European institutions (Harding 1993, D’Ambrosio 1992, Raina 1999).

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Apparently early encounters between African and European scientists were characterised by a mutual (but unorganised) exchange of knowledge, but this changed as the colonial project progressed and global knowledge production has since become increasingly subjugated to the cultures, politics, economics and military strategies of colonialism. Scholars have therefore described colonial S&T in Africa not only as “part of [the] oppressor’s baggage” but as the “very agency” that “enabled them to subdue and govern a subject people” (Palladino & Worboys 1993;

98).

2 Consequently, the purpose of colonial S&T-education (when it at all was open to Africans) varied from being part of the “civilizing mission” 3 to functioning as a preparation of “technicians to assist their … masters in subjects of immediate economic value” (ibid). It can therefore be stated that colonial S&T (even when it concernec “colonial problems”) seldom was directed by the needs and priorities of the African populations (Gaillard et al 2005). Part of the strategies after independence was therefore to nationalise research institutions (i.e. to develop these and to try and make sure that S&T now served the African peoples), 4 recognition of African science started to show.

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and around the 1970s a beginning

Though, by the end of the 1980s this took a halt

1 E.g. European intellectuals (”amateurs … who travelled … to satisfy their intellectual curiosity”, Mouton 2003) adopted both detailed and larger blocks of knowledge that served as the foundation of new scientific disciplines within the European university system.

2 See also Gaillard et al (2005; 178): “Many of the scientific pursuits in the colonies of Africa were confined to exploration, surveys, data collection and the application of techniques mainly to promote colonial economic policies”, Mouton (2003), Waast & Krishna (2003).

3 Evidently the colonies were different in many ways, and so was the strategies of the colonial powers, but especially the dictum of French colonialism was “la mission civilisatrice” – a mission dependent on the idea that Europeans possessed valuable, objective and high quality knowledge while the colonised Africans possessed the opposite (trivial, subjective, etc. knowledge), (Azar 2001, Achebe in Brydon 2000).

4 The independence of many African countries coincided with a global – almost unquestioned – faith in science

(illustrated e.g. in the Truman-doctrine), and development agencies as well as international politics were thus at the time dominated by the catchphrase ”Put money into science and GNP will increase” (Elzinga 1988; 5, see also Ben-

David 1992).

5 Despite attempts to become independent a lot of postcolonial S&T has also been directed by the logic of colonialism. Landberg (1982; 32) wrote for example in a UNESCO-report that: “International – and bilateral – advice in science and technology has to a very high degree built on varying external patterns from the ex-colonial powers. Advice in science and technology policies has consequently been tied to structures and traditions alien to the cultures of the developing countries or imposed on them by the colonial powers. … Remainders of this structure are still to be found. … Research results gained therefore do not necessarily benefit developing countries but often

3 as a consequence of both internal political factors and external pressure and S&T in most African countries are still under resourced both in terms of human capacity and infrastructure (Waast &

Krishna 2003). Though, from the mid 1990s the (WB/IMF) wind started to change direction and national state capacity was again in fashion, and S&T again presented as the proper vehicle for

Africa on its road to development and prosperity. The WB/IMF, international development agencies and African governments are consequently again prioritising the strengthening of

African research capacity.

Empirical focus: The Multilateral Initiative on Malaria (MIM)

In 1995-96 representatives for major international research agencies and a couple of African scientists met at FIC/ NIH (the international section of the US National Institutes of Health) to discuss how research could help in improving the health situation in Africa. It was soon decided that a new research initiative should be launched focusing on malaria – The Multilateral Initiative on Malaria (MIM). Though, the present African scientists put forward that more research on malaria was not enough: if the malaria problem was going to be solved research had to be based in Africa. The reasons given were (in short) that North-driven research historically had privileged the malaria problems experienced by militaries and tourists temporarily visiting malaria endemic areas. In addition, science in the North was said to be driven by “academic considerations” and professional recognition to be measured in relation to internal criteria (for scientific excellence), rather than in relation to the usefulness of knowledge (whether it was relevant for solving practical problems experienced in malaria endemic regions), something one of my informants have commented on as follows:

And one of the world’s leading malaria researchers made a similar comment at a MIMconference:

It is one thing to work in a laboratory in the US, you know, in Bethesda, or in London or, you know, Paris. It is another thing to actually have an understanding of the complexity of the disease in its actual setting. … [In the US etc. scientist are driven by] …scientific curiosity. It’s the complexity of a system. … the overriding force for a lot of people is the innovative science and curiosity. I think in the background of course, these are major public health problems, but academic scientists very often are driven by innovation and not by taking the next step – difficult step – of taking it in advance; of translating it into an intervention. (informant 7)

…it is very sobering to reflect on how much clinical research has had any real effect on practice in the ordinary hospitals all over Africa that deal with severe malaria on a day to day basis. … unless we know what is going on [in the hospitals] and probably more importantly what is not happening, we start from a pretty unrealistic position if we want our research to have a real impact … one of the reasons why we often don’t have a clear picture is that this kind of research, whether one calls it audit or operational research or applied health systems research, is very difficult. Unfortunately, it is also seriously unattractive, there are not many papers in Nature or the New England Journal to be had from it (Marsh 1999).

The Northern driven research is thus contrasted with African based research, which is said to have closer connections with local malaria control programmes, a better understanding of “the complexity of the disease in its actual setting”, and a higher interest in policy relevant research as contribute rather to the ‘general scientific development’ dominated by the developed countries. No systematic efforts have been made by international agencies or bilateral aid-donors to ‘untie’ science and technology from these bands”.

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African based scientists to a higher extent were believed to be driven by consideration of the malaria afflicted children and pregnant women in Africa (whom according to the WHO carry

>95% of the world’s malaria burden). Another of my informants discussed the relation between high profile academic science and the science needed for solving problems, like this:

…it is not always that you can try and do that kind of science that will reach Nature and so on, but if we want recognition, the recognition should be in solving the problems we have. Not in having a

Science Citation Index. Because, I respect all that, the people who have high journals, high citations, they have their agenda: they want things to be studied which has an impact on their own perception of the problems affecting them. If you write a paper on geriatrics, on diabetes, on cancer or on those things, you are more likely to get to those high hit journals. Write one on hook worm: God bless you! But 80% of the school children in our rural areas carry hook worm in one way or the other, and it has actually been shown that this has an impact on their school performance. OK? But it is not a hot topic. OK, so I think we need to brake away from that colonial part. The only thing we need is to do the science, and to do it well: correctly, rigorous. … So I think that the African scientists should be courageous enough: when the work is of international nature, publish it internationally. But if it is not, publish it in your own local journal, but get [it]… circulated. … Most of my colleagues, African scientists, are caught within this web of trying to satisfy the western science and it is not realistic. I do some molecular biology, but if I sit here and try to beat Professor

Baltimore in New York I am wasting my bloody time. … So, it is a question of refocusing, a question of absorbing the science, but to maintain uncompromising when it comes to rigor – scientific rigor. You know, once we fulfil this, we shouldn’t be ashamed of the results that we get, because if those results are really correct, we should not wish they were other (informant 11).

The idea behind the formation of the MIM was thus that African based malaria research would take the reality of people living in malaria endemic Africa as its point of departure, and therefore produce scientific facts relevant to these populations as well as local disease control programmes.

But, as many countries in Africa lacked the means to conduct high quality research, research capacity building became one of the main tasks of this new initiative, and it has therefore focused on (1) developing and strengthening African malaria research capacity, (2) promoting global communication between different “malaria actors”, (3) enhancing links between research and control programmes, (4) enhancing international awareness of the suffering caused by malaria, and (5) increasing international and national research funding. Since the inception of the MIM,

Pan-African malaria conferences, specialised seminars, leadership training etc. have been organised; information technology devises have been installed at African research centres; free research reagents have been made available to African laboratories; research funding mechanisms specifically directed towards internationally cooperative malaria research projects have been established, etc. (www.mimalaria.org).

Chapters in focus: Identities and Discourses Acted Out at a Malaria Conference

The last chapters of my dissertation on which the seminar presentation is based, is a conference ethnography, i.e. this (second) part of the dissertation does not focus on the MIM in general but the text is organised around events that took place during the fourth MIM Pan-African malaria conference (“New Strategies Against An Ancient Scourge”) in Yaoundé, Cameroon, 2005.

6 The

6 The empirical material of this part consists of qualitative interviews with eleven malaria researchers of different disciplines, private video- and sound recordings from plenary sessions, seminars, symposia, coffee breaks etc. at the conference venue, the conference’s book of abstracts, programme, participant list, and web material from the official conference website, including video recordings, power point-presentations and written reports from various conference events (available at www.mimalaria.org and www.kaisernetwork.com

).

5 four chapters of this part thus present conference actors and themes from plenary sessions, poster- and seminar presentations, symposia discussions, which are then analysed in relation to the concept of “the co-production of science and social order” (Janasoff 2004) and (postcolonial) theories specific to the theme of each chapter (see below).

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In the two chapters that are the focus of the seminar, the purpose of the MIM is further concretized. Here it is discussed in detail what kind of research MIM promotes – both in terms of disciplines (molecular biology or sociology?) and topics, i.e. what kind of research is carried out when it is directed by the needs of malaria endemic Africa.

8 This brings the identity of the patient to the foreground and two patient categories (the permanent resident and the temporary visitor) are identified, and it is shown how the definition of malaria and research focus change depending on what patient is in focus. Following this, the participant list is investigated in relation to the issue of identity and expertise (i.e. in relation to what has been said about the motivation of Northern and African based scientists). Thus, the MIM-projected is here related to work regarding the stability/ hybridity of identities (i.e. what it means to be African vs.

European), and to work regarding scientific expertise (specifically to how the links between S&T and other societal orders have influenced who can receive the status of a scientific expert).

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Finally, the analysis (chapter 10) discusses “MIM as a spokesperson” and “MIM as a Third Space”. Firstly, as the MIM is speaking for certain categories of scientists and patients, this analysis deals with what it takes to be a legitimate spokesperson for somebody (specifically for scientists, children and women living in malaria endemic Africa). The work of Spivak on the possibility to speak for somebody else, is here set to meat with the ANT-discussion on the role of spokespersons in scientific networks, i.e. this chapter discusses scientists’ possibility to speak for the biological body of the Other (Spivak 2000 etc., Callon 1983). secondly, the MIM-activities are analysed in relation to the concept of Third Space, developed by Homi Bhabha (1999), i.e. the final analysis also deals with in what ways the MIM destabilises historical social orders and enables new positions to emerge, and how creates spaces that at the same time carries and breaks away from history.

Questions for the seminar:

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What resistance themes do you see in this material?

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What would the contribution be of an explicit focus on resistance?

7 The concept of “the co-production of science and social order” handles the mutuality of scientific products and their societal context: “co-production is shorthand for the proposition that the ways in which we know and represent the world (both nature and society) are inseparable from the ways in which we choose to live in it. Knowledge and its material embodiments are at once products of social work and constitutive of forms of social life; society cannot function without knowledge any more than knowledge can exist without appropriate social support. Scientific knowledge, in particular, is not a transcendent mirror of reality. It both embeds and is embedded in social practices, identities, norms, conventions discourses, instruments and institutions – in short, in all the building blocks of what we term the social (Jasanoff (2004; 2 f, emphasis in original).

8 Research focuses that will be presented and discussed in this chapter is for example the development of acquired immunity, the relation between malaria and other diseases (e.g. HIV/AIDS, TB), the relation between malaria and anaemia, how malaria is handled at the household level, herbal remedies used for treating malaria, etc.

9 This discussion is inspired by what for example Achebe (e.g. “Europe’s reliance on its own experts would not worry us if it did not, at the same time, attempt to exclude African testimony … a real European is someone that is educated and cultivated. A real African is someone that lives in the bush”, Achebe in Brydon 2000), and Mudimbe

(1988 and 1994).

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3.

Is there a risk when “imposing” the theme of resistance on actors that do not themselves talk about their actions in term of resistance?

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How does the resistance theme go together with descriptive approaches?

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What is the difference between resistance and a general strive for change?

Summary of chapters 6-7

The seminar presentation will focus on the above, but in case somebody is interested I will also introduce its preceding parts. Chapter 7 presents symposia and discussion seminars dealing with research capacity building strategies, it shows how the motives, methods and strategies for building research capacity vary between different international organisations, and it discusses what the tension between research agendas and aid agendas means for the work and organisation of the MIM. Chapter 6 presents the speeches made at the conference’s welcome and opening ceremonies, speeches that to their larger part focused on the relation between science and other societal institutions, i.e. on the “social contract of science”; on the social responsibilities of science and scientists; the potential for change through scientific work, and so forth. This topic is not unique to the MIM or malaria research, and the project has therefore been to show how these speeches both have linkages to historical and mainstream science policy negotiations, and what the specific implications of “contract”-talk are for the network where MIM is active. A pair of concepts that are commonly used for analysing the social contract of science are scientific autonomy vs. heteronomy (Blomqvist 1992, Baldursson 1999), 10 whereas autonomy has been the

11 This ideal is based on the belief that leading ideal of Northern science policy since app. WWII.

nobody but scientists understand the works of science and that they therefore are the ones that can and should make decisions regarding the direction of science. In addition, as the usefulness of research often cannot be predicted specified goals are believed to only hamper innovative thought.

This view has been questioned, 12 and the voices heard at the MIM-conference challenge it in several and specific ways: firstly, the argument behind research capacity building

(that Northern driven research had neglected issues of crucial importance to malaria endemic settings) illustrates how non-science actors (actors representing economic, military etc. interests) seem to have had almost a free play in malaria research, i.e. the ideal of scientific autonomy seem to have dispersed when research agendas met with military and other agendas, and the ideal was therefore never principal to malaria research. Secondly, this argument shows that scientific autonomy does not necessarily refer to academically external actors, but also to geographically distant ones, i.e. the scientific autonomy African based scientists are advocating for is not primarily formulated in opposition to national governmental institutions, but to Northern based research agendas which are perceived as non-significant to people living in malaria endemic settings. In short, this chapter shows that the formulation of scientific facts is inseparable from

10 Autonomy signifies a situation where scientific goals are separated from societal goals, while heteronomy signifies a situation where societal goals are superior to scientific goals (Baldursson 1999).

11 These discussions have been going on since the middle ages and was first focused on the tension between the church and free intellectuals, later on (enlightenment period) on political authorities and intellectuals, and more recently (WWI and II and after) on political ideologies (in Nazi-Germany, Stalinist Soviet etc.) and science.

12 As negative effects of S&T have become visible and because science in many Northern countries are state funded both the public and government authorities have increasingly started to question the self-regulative doctrine. In addition, social studies of science have shown that an autonomous science possibly can be an ideal but never a reality, and that the question therefore not seem to be whether or not science should be influenced by politics, religion, ideologies but what ideology etc. should be allowed to direct scientific work (Longino, Jasanoff, Latour, etc.).

7 social orders, i.e. that changes in fact making activities go hand in hand with changes in social orders (ranging from the organisation of scientific projects, to changes in national sovereignty and military power balances).

Summary of chapters 1-5

The first part (chap. 1-5, presented as a licentiate thesis in June 2007) is empirically focused on the launch, the formation and the work carried out within the MIM 1995-2005 13 It describes the actor negotiations that took place in the malaria research system where MIM was established and carried out its work, but the analysis is directed towards theoretical issues of importance to my own discipline. As I had noticed that empirical references within Theory of Science almost exclusively were made to S&T in Europe and North America, I wondered what this meant (for the focus of these theories and for their relevance for the analysis of S&T in Africa) and the analysis of this part is therefore explicitly dealing with one of the leading theoretical frameworks within Theory of Science (Actor Network Theory and its model “The Circulatory System of

Scientific Facts”, Latour 1999). As some features of S&T-work are similar wherever they take place the result of this “tryout” was that some aspects of the theories showed to be relevant for the analysis of MIM and the situation MIM has tried to deal with. E.g. the study showed that

ANT and its model could be used for identifying relevant actors and for following them in many of the negotiations they were engaged in when trying to translate various interests. But – the limited empirical base also meant that ANT was blind to and incapable of handling some of the societal conditions that are crucial to S&T-work in Africa. Discussions within ANT, for example, take a critical mass of science students, a high societal status of S&T and scientists, research infrastructure of high quality etc. for granted. In addition, the descriptive approach of ANT and its focus on “effects of the present”, meant that it fails to handle what has been excluded from the network and power inequalities which are one of the leading themes within the network in focus. It thus fails to capture that a system in practice can exclude references to actors that on a theoretical level are assumed present in the system (i.e. references to small children and women in malaria endemic Africa), and that science is constituted not only by what is present, but also by what has been made absent by the system. The general conclusion of the first part of my dissertation was therefore, in short, that ANT, as an example of a Theory of Science, need to deal with the consequences of its Eurocentric distortion, extend its empirical base to global S&T, and formulate its studies, conclusions etc. in awareness of the workings of larger macro-phenomena such as historical, economical, geopolitical etc. power afflicted discourses (Priebe 2007).

13 The empirical material for this part consists of various texts: meeting protocols, conference reports, web pages, reports from workshops, etc., newsletters, mailing lists, evaluations, scientific and other MIM-related articles, etc.

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