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Kirsten Moore-Sheeley is Assistant Professor in the Program in the History of Medicine at Cedars-Sinai Medical Center. She is a 2023–24 Consortium Research Fellow.
During the last third of the twentieth century, new breakthroughs in biotechnology transformed vaccine research and development. Advances in genetic engineering and the production of monoclonal antibodies allowed researchers to create and test more precise vaccine targets, including for pathogens such as malaria parasites, which had been—and still are—challenging to neutralize through vaccination. Despite this scientific and technological progress, effective vaccines for malaria, schistosomiasis, HIV/AIDS, and tuberculosis (a new one) did not materialize immediately. Indeed, many searches for these vaccines are ongoing. Why has it been so challenging to develop these vaccines, and why do funding agencies continue to pour substantial amounts of money into their development? What have the consequences been of the efforts to create these vaccines, not only for scientific knowledge, but also for scientists and research institutions; disease control efforts and funding; and the populations intended to benefit from these biomedical promises? And what does this history of perpetual cycles of hope and disappointment tell us about what gets valued, and what does not, in the making of biomedicine?
My new book project, Chasing the Magic Bullet: The History and Consequences of Vaccine Research, examines these and related questions, using the malaria vaccine as a central case study. Like vaccines for schistosomiasis, HIV/AIDS, and tuberculosis, malaria vaccines are intended largely to benefit populations in the global South. Thus, the pursuit of this technology has come to represent a kind of biomedical humanitarian effort on the part of wealthy counties with the resources to develop sophisticated, synthetic vaccines. At the same time, this pursuit has enrolled numerous residents of endemic countries in clinical trials, bolstered medical research institutions in these countries, and led to the creation of new, technology focused public-private partnerships. Examining the history of malaria vaccine research and its myriad effects will help elucidate the various costs and benefits of the search for vaccines. Exploring this history alongside the history of vaccines for HIV/AIDS, tuberculosis, and schistosomiasis will offer new insights into global health priorities and developments in vaccinology since the 1970s.
Funding from the Consortium for the History of Science, Technology, and Medicine has been instrumental in helping me flesh out this book project. As a research fellow, I was able to visit the National Library of Medicine (NLM), where I learned a lot about the United States’ motivation to get involved in malaria vaccine research. The papers of Franklin Neva, Director of the National Institutes of Health’s (NIH) Laboratory of Parasitic Diseases from 1969-2004, were particularly useful in this regard. They described how the US became newly interested in parasitic diseases such as malaria during the Vietnam War, and how this interest evolved into one of using America’s scientific and technological prowess to intervene in international health and development. In contrast to the immediate post-WWII decades, the US sought to illustrate this prowess by developing products that scientists and health officials in endemic countries could use to mitigate their countries’ own disease burdens—as opposed to imposing interventions overseas in a top-down manner. The NLM also holds international reports on malaria and tuberculosis vaccine development, which provided me with a broader perspective on how scientists and health officials sought to develop, test, and eventually implement these vaccines in endemic countries. Finally, I was able to consult a number of audio-visual materials at the NLM, including many news and informational programs about malaria from the 1980s, 1990s, and 2000s, that gave me new insights into how the search for a malaria vaccine was being presented to the public in the US, Canada, and Australia. These were incredibly interesting and allowed me to see a piece of this history that would have been difficult to see otherwise.
My trip to the Clendening Library at the University of Kansas Medical Center was also tremendously useful in helping me understand the motivations for research into vaccines for malaria, tuberculosis, and HIV/AIDS over the last third of the twentieth century. I consulted a 1971 conference report on tuberculosis immunization, for instance, which illustrated how the clustering of TB cases in the US among Native Americans, immigrants, and Black urban populations stimulated interest in finding a new TB vaccine when overall cases in the country had declined. As with malaria vaccines, American medical and governmental authorities had to think about domestic interests in vaccines that would largely benefit populations overseas. The Clendening also holds writings about the ethical dilemmas of testing an HIV/AIDS vaccine in the 1990s, which illustrated the urgency for creating this technology and the ways stakeholders weighed its potential costs and benefits. This gets to the heart of one of my project’s central questions.
I was also incredibly fortunate to visit the Wellcome Collection through my Consortium fellowship, where I was able to get a much better view of the British and Australian side of malaria vaccine development. Robert Freeman’s papers offered insights into how malaria vaccine scientists tapped into global research networks to access parasite material for study and circulate new scientific knowledge. I was especially surprised to learn from his papers about the ways malaria vaccine research was instrumental to the expansion of medical research in Papua New Guinea—eventually leading to the testing of insecticide-treated nets, the subject of my first book. I was also able to look at Wellcome Trust reports describing the organization’s interest and investment in malaria vaccine research, which helped fill in the gaps left by American funding in the 1990s. Like the NLM, the Wellcome also holds a number of audio-visual materials that gave me a sense of how malaria and malaria vaccines were presented to the British public. Together, the materials from the Wellcome broadened the geography of my study and shined new light on how networks underpinning malaria vaccine research operated in practice.
I am tremendously grateful to the Consortium for giving me the opportunity to travel to these libraries and archives. I now have new materials and new enthusiasm for writing up this project.
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