Community engagement in neo-liberal biopolitics: health care and clinical research in Kenya
Salla Sariola (University of Helsinki)
Paper short abstract:
Community Engagement is an increasingly common requirement in international medical research. It builds direct relationships between research institutions and patients, by-passing the state. This paper explores such relationships and the role of community engagement in health research in Kenya.
Paper long abstract:
Community Engagement, also known as 'public engagement', 'patient and public involvement', and 'public participation', is an increasingly common requirement in 'ethical and socially relevant' international medical research. In practice, public participation has meant including lay members in policy making boards and other committees, hearing social movements in health-related knowledge production, and involving communities in the management of Global Health research. This normative demand by many medical charities and international research funding bodies to involve of publics in design, knowledge production, and science policy is believed to democratise these processes by pushing for accountability, and redefine expertise and ownership. Meanwhile, when operating in resource and research poor contexts, community engagement facilitates neo-liberal biopolitics by building direct relationships between research collaborations including international and Kenyan medical research institutions, and patients and communities. Community engagement acts as a contract that legitimates clinical research while individual patients and communities use clinical trials as ways of accessing health care. Hence, community engagement contributes to the ways in which research works to compensate ill-resourced state health care systems, but also replaces the role of the state as the main health care provider. Based on three months of ethnographic field work in Kenya, this paper explores and analyses the relationships between medical organisations and communities, and how terms 'community' and 'engagement' are understood and employed. What do these relationships tell us about the role of community engagement in health research?
Commercialization, experimentation and health in low-resource countries: pharmaceuticals, collaborations and global philanthropy