The Political and Social Lives of New Cancer Technologies in the Global South

Introduction :

This workshop will bring together historians, social scientists and epidemiologists, to explore the political, economic and social dimensions of the deployment of new biological and digital technologies in the fight against cancer in the global South. Over the last decades, experts have been warning that the global south is facing a fast-growing cancer epidemic (Reubi et al. 2016; Caduff et al. 2019). Indeed, most cancer cases (57%) and deaths (65%) are now occurring in the global South (Torre et al. 2012). This has led to increased action internationally, with efforts such as the WHO’s Cervical Cancer Elimination Initiative, as well as on a national level, with ever more low- and middle-income countries adopting cancer control programmes.
At the same time, the last decades have seen increasing biomedical innovations in the field of oncology in the global North, from new testing devices and cancer vaccines to cutting-edge immunotherapies and digital surveillance techniques. The place of these new biomedical and digital technologies in efforts to tackle the cancer epidemic in the global South is under-researched and not well understood. Some experts have argued that cancer prevention, care and surveillance in the global South is characterised by lack and improvisation, from a dearth of specialists and infrastructures to older-generation medicines and broken-down machines (e.g. Livingston 2012; Mulemi 2017; Banerjee 2020). While these tropes of lack and improvisation remain valid to a certain extent, recent developments on the ground seem to point in a different direction. Expensive radiotherapy machines are being set up in a growing number of hospitals. Pharmaceutical companies are partnering with states to offer HPV and Hepatitis vaccines or expensive immunotherapies to populations. Coalitions of philanthropies, government agencies and NGOs are conducting large testing drives. And surveillance experts are helping countries to digitalise patient records and cancer registration procedures.
The aim of this workshop is to explore these recent developments, understand what makes them possible and evaluate what impact they are having on cancer care and the wider society. Specifically, the workshop will explore three types of technologies – preventive technologies such as vaccines and testing; therapeutic technologies such as radiotherapy and immunotherapies; and surveillance technologies such as digital patient records – along the following three themes:

1. Socio-technical infrastructures: Many of the new technologies are expensive, complex and often produced abroad. To make them available in economically disadvantaged contexts, they need new financial partnerships between governments, the pharmaceutical industry and philanthropies. They also rely on expanded universal health coverage and private insurance schemes, require the training of new specialists (oncologists, radiotherapists, technicians), and necessitate distribution networks, storage facilities and repair infrastructures. The workshop will study what the socio-technical infrastructures that make new technologies possible and how they are (or are not) put in place. It will be particularly attentive to south-south partnerships between India and Africa in the building of these infrastructures.

2. Political Imaginaries: These new technologies and the infrastructures that make them possible are driven and shaped by political promises, hopes and fears. These can be promises of being a modern nation that cares for its own population, or promises of new therapeutic markets. However, there can also be fears about the possible harms of and hesitancy towards vaccines, pharmaceuticals and other novel therapeutics. Similarly, there can be serious concerns about how these technologies may exacerbate already existing inequalities or about their long-term financial sustainability.

3. Patient lives and mobilities: New technologies are also shifting how care is done and how patients experience disease. Malignancies that were previously considered incurable are reimagined as treatable. Patients learn and sometimes resist new ways to care for themselves and their families, from vaccination to testing regimens. The availability of advanced treatments at home (rather than abroad) is reconfiguring patients’ therapeutic landscapes, geographies and mobilities. Health activists will start campaigning for wider and more equal access to the new technologies.

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