Paper short abstract:

This paper explores the production, transformation and movement of evidence collected for a clinical trial. This movement exposes how evidence is differently understood in a variety of settings and the complex relationships forged between northern and southern global health institutions.

Paper long abstract:

Global health is reliant on the collection and analysis of evidence to support interventions. One way that evidence is produced in global health is through clinical trials, whereby rigorous science is deployed in the production of experimental data. Drawing on ethnographic research in northeastern Tanzania, this paper explores the collection, transformation and movement of evidence in a clinical trial for a malaria vaccine. I focus on the procedure of how blood, a main source of evidence in many clinical trials, moves across space and is transformed into information that is trusted and meaningful. Blood is laden with evidence and the transitional meaning of blood, from biological factor, to object of inquiry, to a matter of clinical proof, reveal its differential understandings in the clinic, laboratory and business sphere. For this clinical trial, blood samples were collected from trial participants, transported to a Tanzanian research centre and fragmented into smaller units for analysis, resulting in information about the health of participants. The blood and information gathered were then transported to laboratories and computers outside of Tanzania for further analysis. In addition to tracing shifts in meaning from one setting to another, this paper looks at how the collected blood and information also built credibility through its movement from a research site in the south to reputable centres of science and technology in the north. Through an examination of the flow of blood and data in this clinical trial, I uncover complex, historically-rooted relationships between northern and southern global health institutions.