María Jesús Santesmases

History Teaches Us That Confronting Antibiotic Resistance Requires Stronger Global Collective Action

Antibiotic development and usage, and antibiotic resistance in particular, are today considered global concerns, simultaneously mandating local and global perspectives and actions. Yet such global considerations have not always been part of antibiotic policy formation, and those who attempt to formulate a globally coordinated response to antibiotic resistance will need to confront a history of heterogeneous, often uncoordinated, and at times conflicting reform efforts, whose legacies remain apparent today. Historical analysis permits us to highlight such entrenched trends and processes, helping to frame contemporary efforts to improve access, conservation and innovation.

Scientific Organizations in Spain (1950-1970): Social Isolation and International Legitimation of Biochemists and Molecular Biologists on the Periphery

Through a study of Spanish scientific organizations and the involvement of Spanish scientists in international ones, the beginnings of biochemistry and molecular biology in Spain are explored. The centre-periphery dichotomy is useful in explaining the progress of the establishment of these disciplines, together with the political context, both national and international, in which such establishment took place. It is suggested that international ties and national support are both necessary, but not sufficient conditions to overcome the distance between the Spanish scientific community and the centres of development and productivity in biochemistry and molecular biology. The interplay between both national and international factors has proved to be crucial. As a tool to study the whole scientific community of biochemists and molecular biologists, scientific societies allow us to analyze the role of that interplay in Spanish scientific development.

Circulation of antibiotics: an introduction

The history of twentieth-century medical drugs is a research subject to which many contributions are currently being made from history of science, medicine and from history of industry 1. The historiography of antibiotics has in good part underlined the role of penicillin as the pioneer miracle since its creation in the 1940s. Penicillin became the emblematic wonder-drug of the post-WWII years and its discovery, production and distribution have been celebrated for half a century as a compelling and relevant historical subject. It also seems to indicate a shift in the history of pharmaceutical industries, in that this history was presumably dominated by Germany until World War II, when the United States took over. The U.S. also stood out among the nations whose use and production of penicillin has been comprehensively studied 2.

The human autonomous karyotype and the origins of prenatal testing: Children, pregnant women and early Down's syndrome cytogenetics, Madrid 1962–1975

Through their ability to reveal and record abnormal chromosomes, whether inherited or accidentally altered, chromosomal studies, known as karyotyping, became the basis upon which medical genetics was constructed. The techniques involved became the visual evidence that confirmed a medical examination and were configured as a material culture for redefining health and disease, or the normal and the abnormal, in cytological terms. I will show that the study of foetal cells obtained by amniocentesis led to the stabilisation of karyotyping in its own right, while also keeping pregnant women under the vigilant medical eye. In the absence of any other examination, prenatal diagnosis by foetal karyotyping became autonomous from the foetal body. Although medical cytogenetics was practiced on an individual basis, data collected about patients over time contributed to the construction of population figures regarding birth defects. I study this complex trajectory by focussing on a Unit for Cytogenetics created in 1962 at the Clínica de la Concepción in Madrid. I incorporate the work and training of the clinicians who created the unit, and worked there as well as at other units in the large new hospitals of the national health care system built in Madrid during the mid-1960s and early 1970s.

National politics and international trends: EMBO and the making of molecular biology in Spain (1960–1975)

Abstract From the mid-1960s onwards, a set of Spanish molecular biology research groups emerged in Spain. The factors contributing to this included: the return of a group of molecular biologists from their postdoctoral period abroad, the negotiations for the return of Spanish-born Nobel prize winner Severo Ochoa from New York, the negotiations for Spanish membership in the European Conference of Molecular Biology, and national policy towards university reform. As a result, the early molecular biologists’ research groups began to be recognised as research schools by Spanish authorities and postgraduate courses and new research centres for molecular biology were set up. Foreign influence in the whole process was crucial.

Screening antibiotics: industrial research by CEPA and Merck in the 1950s

This article is an account of a screening programme in search of new antibiotics established by CEPA (Compania Espanola de Penicilinas y Antibioticos) and Merck in Madrid in 1954. An exploration of the genealogy for such a programme, its narratives and practices, shows that the main inspiration for this programme was the factory system of production, on the one hand, and Selman Waksman’s research agenda on microorganisms of the soil, on the other. In this article, the relationship between industrial production of antibiotics and the research program aimed at identifying new candidate drugs is examined. I suggest that this screening program in search of new antibiotics was organised like industrial manufacturing. The research objects and tools came, both materially and conceptually, from industrial production: a line of artisanship put together in order to obtain a product with the collaboration of every member of the production line. Following the style developed by Selman Waksman in Rutgers, the screening program evaluated samples manually, and the microbiological skills were enhanced with every test. The Madrid team’s practice of applying instructions for use led to circulation of knowledge and practices, including research material and microbiological methods.

From prophylaxis to atomic cocktail: circulation of radioiodine

This paper is a history of iodine. To trace the trajectory of this element, goiter is used as a guideline for the articulation of a historical account, as a representation of thyroid disorders and of the spaces of knowledge and practices related to iodine. Iodines journey from goiter treatment and prophylaxis in the late interwar period took on a new course after WWII by including the elements radioactive isotopes. I intend to show how the introduction of radioiodine contributed to stabilize the epistemic role of iodine, in both its non-radioactive and radioactive form, in thyroid gland studies and in the treatment of its disorders.

The Bacterial Cell Wall in the Antibiotic Era: An Ontology in Transit Between Morphology and Metabolism, 1940s-1960s.

This essay details a historical crossroad in biochemistry and microbiology in which penicillin was a co-agent. I narrate the trajectory of the bacterial cell wall as the precise target for antibiotic action. As a strategic object of research, the bacterial cell wall remained at the core of experimental practices, scientific narratives and research funding appeals throughout the antibiotic era. The research laboratory was dedicated to the search for new antibiotics while remaining the site at which the mode of action of this new substance was investigated. This combination of circumstances made the bacterial wall an ontology in transit. As invisible as the bacterial wall was for clinical purposes, in the biological laboratory, cellular meaning in regard to the action of penicillin made the bacterial wall visible within both microbiology and biochemistry. As a border to be crossed, some components of the bacterial cell wall and the biochemical destruction produced by penicillin became known during the 1950s and 1960s. The cell wall was constructed piece by piece in a transatlantic circulation of methods, names, and images of the shape of the wall itself. From 1955 onwards, microbiologists and biochemists mobilized new names and associated conceptual meanings. The composition of this thin and rigid layer would account for its shape, growth and destruction. This paper presents a history of biochemical morphology: a chemistry of shape – the shape of bacteria, as provided by its wall – that accounted for biology, for life itself. While penicillin was being established as an industrially-manufactured object, it remained a scientific tool within the research laboratory, contributing to the circulation of further scientific objects.

Modern Times: Screening Antibiotics and the Factory Line

This chapter is an account of the screening programme in search of new antibiotics established by CEPA (Compania Espanola de Penicilinas y Antibioticos) and Merck in Madrid in 1954. An exploration of the genealogy for such a programme, its narratives and practices, shows that the main inspirations were the factory system of production, and Selman Waksman’s research agenda on microorganisms of the soil. The relationship between industrial production of antibiotics and the research programme intended to identify new candidate drugs is examined, and I suggest there were organisational similarities. Moreover, the research objects and tools originated—both materially and conceptually—from industrial production: a line of artisanship constructed to obtain a product through the combined effort of the production line workers. Following the style developed by Selman Waksman at Rutgers University, the screening programme evaluated samples manually, and microbiological skills were enhanced with every test. The Madrid team’s practice of using instructions from Merck led to the circulation of knowledge and practices, including research material and microbiological methods.

Smuggling: The Management of Scarcity and Trade of Penicillin as a Post-War Commodity

Reflecting on archival material relating to smuggling—documented in personal memoirs for the 1940s and in public archives for the early 1950s—alongside the relevant historiography, enables an analysis of the cultures and social life of penicillin, and its relation to other scarce commodities of the time, such as tobacco and nylons. The practices which surrounded obtaining the drug demonstrate the relationship between official secrecy and public knowledge, and its embeddedness in the political strategies of Franco’s dictatorship. Penicillin will also be discussed in this chapter as both a border-crossing material and symbolic object, representing the on-going therapeutic revolution. The historiography on corruption suggests the illegal trade in penicillin might also be linked to the “business of power”, when, for example, gasoline supplied for official use was being sold on the black market.