The politics of knowledge in the biomedical sciences: South/African perspectives

An impressive new book, The politics of knowledge in the biomedical sciences: South/African perspectives intervenes within long-standing critical conversations about the political dimensions of knowledge production. Edited by Jonathan Jansen and Jess Auerbach, this compelling volume offers an African perspective on the intricate interplay of power, race, coloniality, and empire within biomedical knowledge production and legitimation. Far from accepting biomedical knowledge as inherently neutral and benevolent, the book interrogates knowledge as an instrument, site, and mode of power, exposing and challenging assumptions and hierarchies around who can produce authoritative knowledge and where it comes from.

Hosted by the EthicsLab, the book event took place on February 29, 2023, and aimed to spark debate around the knowledge-power nexus in the biomedical sciences. The audience heard from co-editor Jess Auerbach, Susan Levine, Fanidh Sanogo, Itumeleng Ntatamala, and Victoria Gibbon who contributed to some of the book’s chapters. The three chapters discussed traversed notions of “anticrisis” and “unblinding”, offering a closer look at vaccine trials, the co-occurrence of health crises, and the use of racial terminologies in health research.

Introducing the book project, Jess Auerbach outlined its framing within global and local conversations around the interplay between knowledge and power. It was written in the context of the COVID-19 pandemic, which exposed how colonial and racial logics continue to inform ideas about Africa and science in Africa. In addition, the book is also in conversation with contemporary debates around intellectual decolonisation and the coloniality of knowledge.

The discussions were kickstarted by Susan Levine's chapter, Unblinding: Politics, care and J&J vaccine trial in South Africa, and co-authored with Lenore Manderson. The chapter employs "unblinding"— the clinical process of revealing which participants received the active treatment and which received the control (placebo)— as a metaphor and conceptual tool for unpacking the politics of knowledge in producing medical and social scientific knowledge about Sars-CoV-2. Reflecting on the South African clinical trial for the ENSEMBLE Johnson & Johnson (J&J) Janssen COVID-19 vaccine candidate, unblinding is used to think through and shed light on the colonial and racialised logics that shape vaccine production and deployment, foregrounding the coloniality of extractive science and the workings of global inequality in determining health priorities and vaccine distribution. For example, when contrasted with HIV and TB research alongside other diseases of poverty, the fast-tracking of the coronavirus vaccine demonstrates the inconsistencies of political will and raises critical questions about which lives merit such a swift and collaborative global response. The chapter also points to the co-occurrent HIV crisis, suggesting that the prioritisation of COVID-19 research led to the negligence of other pressing local public health concerns. The trial also shows how COVID-19 exploited and compounded existing crises of precarity along racial and class fault lines. These trials were mostly carried out on working-class black South Africans, who would receive a small financial compensation in exchange for the data they provided. Given the effect of the pandemic on socio-economic livelihoods, clinical trials nonetheless offered some financial relief and an early path towards vaccination.

This conversation set the tone for Fanidh Sanogo’s chapter, Covid-19 anticrisis: The masked vaginas of Zongo, which reflects on research fieldwork conducted in Zongo, a market situated in the periphery of the city of Ouagadougou in Burkina Faso. Much like Susan Levine’s observation around the co-occurrence of health crises and the resulting hierarchy of crises and priorities, this chapter notes the disconnect between international and local health priorities, which was characterised by a total disregard for the COVID-19 pandemic in many people’s everyday lives. Instead, the women the author worked with were more concerned about a "strange disease", cervical cancer (the anti-crisis of COVID-19). In that light, she argued that moments of health crises often lead to portals of ontological truths, thereby unblinding us to dominant value systems. The author argued that instead of wearing face masks, women in Zongo wore a psycho-social mask called "serre serre", a vagina-tightening agent. This product was believed to improve sexual relations with one's partner but was also known to create genital liaisons that made women more vulnerable to HPV. This chapter offers a fascinating account of several different sites of power, including gender and geopolitics, while illuminating the hierarchies of authoritative knowledge, considering the epistemological merit of rumours as a legitimate source of knowledge about the social world.

The seminar was concluded by Itumeleng Ntatamala and Victoria Gibbon, who discussed their chapter, Tackling the persistent use of racial terminology in South African health sciences research and training, co-authored with Olufunke Alaba and Leslie London. Recalling the controversial and subsequently retracted study on the intellectual abilities and personal hygiene of coloured women by scientists at Stellenbosch University, they probe the structures of reasoning that inscribe racial thinking and essentialism in the training of health sciences professionals. The authors also shed light on several examples revealing the pervasiveness of racial bias at all levels of experience, from students to professors. Far from remaining at a diagnostic level, their chapter offers several useful reflective questions for carefully evaluating research outputs where race is one of the main variables. 

See the book: The politics of knowledge in the biomedical sciences: South/African perspectives (Springer, 2023).