Anne Pollock

Places of pharmaceutical knowledge-making: Global health, postcolonial science, and hope in South African drug discovery

This article draws on ethnographic research at iThemba Pharmaceuticals, a small South African startup pharmaceutical company with an elite international scientific board. The word ‘iThemba’ is Zulu for ‘hope’, and so far drug discovery at the company has been essentially aspirational rather than actual. Yet this particular place provides an entry point for exploring how the location of the scientific knowledge component of pharmaceuticals – rather than their production, licensing, or distribution – matters. The article explores why it matters for those interested in global health and postcolonial science, and why it matters for the scientists themselves. Consideration of this case illuminates limitations of global health frameworks that implicitly posit rich countries as the unique site of knowledge production, and thus as the source of unidirectional knowledge flows. It also provides a concrete example for consideration of the contexts and practices of postcolonial science, its constraints, and its promise. Although the world is not easily bifurcated, it still matters who makes knowledge and where.

Resisting Power, Retooling Justice Promises of Feminist Postcolonial Technosciences

This special issue explores intersections of feminism, postcolonialism, and technoscience. The papers emerged out of a 2014 research seminar on Feminist Postcolonial Science and Technology Studies (STS) at the Institute for Research on Women and Gender, University of Michigan. Through innovative engagement with rich empirical cases and theoretical trends in postcolonial theory, feminist theory, and STS, the papers trace local and global circulations of technoscience. They illuminate ways in which science and technology are imbricated in circuits of state power and global inequality and in social movements resisting the state and neocolonial orders. The collection foregrounds the importance of feminist postcolonial STS to our understandings of technoscience, especially how power matters for epistemology and justice.

Pharmaceutical Meaning-Making Beyond Marketing: Racialized Subjects of Generic Thiazide

In contrast to discussions of BiDil, this paper explores racial meaning-making processes around an old generic hypertension drug. By unpacking a vignette about race and thiazide outside marketing or medicine, it shows that racialization of drugs exceeds those spheres and moves in unpredictable ways.

On the Suspended Sentences of the Scott Sisters Mass Incarceration, Kidney Donation, and the Biopolitics of Race in the United States

In December 2010, the governor of Mississippi suspended the dual life sentences of two African American sisters who had been imprisoned for sixteen years on an extraordinary condition: that Gladys Scott donate a kidney to her ailing sister Jamie Scott. The Scott Sisters’ case is a highly unusual one, yet it is a revealing site for inquiry into US biopolitics more broadly. Close attention to the conditional release and its context demands a broader frame than traditional bioethics and helps to push science and technology studies (STS) analysis of race past its conventional focus on genetics. This article draws on the Scott Sisters’ case as a site for interrogating the US context of racialized mass incarceration and kin-oriented and consumerist valorization of organ donation. Tensions between racialized exclusions, the promise of consumerist freedom, and the lack of expectations of the state are foundational to a distinctly American biological citizenship. By putting the Scott Sisters’ case into conversation with broader arguments about incarceration as a site of racialization and STS literatures of organ transplantation and of biological citizenship in diverse geographical sites, this article seeks to articulate some of the racialized contours of biopolitics in the United States.

Coronary artery disease and the contours of pharmaceuticalization

Coronary artery disease (CAD) has dominated mortality for most of the past century, not just in Europe and North America but worldwide. Treatments for CAD, both pharmaceutical and surgical, have become leading sectors of the healthcare economy. This paper focuses on the therapeutic landscape for CAD in the United States. We hope to add texture to the broader conversation of pharmaceuticalization explored in this issue by situating pharmaceutical therapies as just one element in the broader therapeutic terrain, alongside cardiac surgery and interventional cardiology. Patients with CAD must navigate a therapeutic landscape with three intersecting paths: lifestyle change, pharmaceuticals, and surgery. While pharmaceuticals are often seen as a quick fix, a way of avoiding more difficult lifestyle changes, it is surgery and angioplasty that promise patients the quickest fix of all. There also is another option, often overlooked by analysts but popular among physicians and patients: inaction. The U.S. context is often critiqued as a site of excessive treatment with respect to both drugs and procedures, and yet there is deep stratification within it--over-treatment in many populations and under-treatment in others. People who experience the serious risks of CAD do so in a racialized terrain of durable preoccupations with difference and unequal access to care. While the pharmaceuticalization literature disproportionately attends to lifestyle drugs, which some observers consider to be medically inappropriate or unnecessary, CAD does remain the leading cause of death. Thus, the stakes are high. Examination of the pharmaceuticalization of CAD in light of surgical treatments and racial disparities offers a window into the pervasiveness and persuasiveness of pharmaceuticals in an increasingly consumer-driven medicine, as well as the limits of their appeal and their reach.

Reading Friedan: Toward a Feminist Articulation of Heart Disease

This article uses Betty Friedan’s idiosyncratic invocations of heart disease in her work from the 1960s through the 1990s, as well as her autobiographical comments about it and her theory of the feminine mystique, to grapple with a feminist articulation of heart disease. Although this leading cause of death for women in industrialized countries has been peripheral to feminist health discourse and most women’s preoccupations, heart disease played an interesting narrative role in Friedan’s work and life. Drawing on Friedan’s unconventional philosophy of health provides an opportunity to problematize health awareness and reconsider the role of disease and health in feminist critique more generally. As we try to understand gendered stories of disease that are emerging at the dawn of the 21st century, rereading Friedan can help illuminate the limits, possibilities and dangers of framing heart disease as a ‘women’s health issue’.