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Long abstract:

Long Covid has been identified by global health authorities as a medical, scientific, and economic problem affecting all countries. As Tedros Adhanom Ghebreyesus, the Secretary-General of the WHO declared, “It is critical for governments to invest long-term in their health system and workers and make a plan now for dealing with long Covid”. But what’s in a name? The WHO’s “view from the center” assumes that there is a single illness, representing a common challenge across the globe. The view from the center dials forward to a future when the WHO will count Long Covid as a uniform and standardized disease category, just as it now counts Malaria or Tubercolosis cases globally. However, in our study of Long Covid and Covid-19 recovery in the United States (survey n=334, interviews n=92), Brazil (survey n=144, interviews n=32), and China (interviews n=44), we find a wide range of patient identities around post-Covid symptoms. In this article, we ask: (1) What explains differences in naming and identification among patients in the three countries; and (2) What do these differences tell us about the global politics of expertise more generally? Patient identity, we find, is determined by a different constellation of the politics of expertise in each country, along three axes of comparison: (1) the symbolic politics of disease classification and representation; (2) institutionalized channels of healthcare and welfare state provision; and (3) position in the global geopolitical and knowledge production system.

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Short abstract:

This paper examines the role of entrepreneurial scientists and investors in shaping the priorities and goals of longevity and anti-aging biotechnology. Aiming to bring forward a revolution in medicine, the involvement of private actors is posed to reconfigure between science, society and healthcare.

Long abstract:

Scientists and biotechnology investors have been making headlines in recent years, for the desire to “live forever” and defeating death. Recently, XPRIZE launched a $101 million competition for innovations that combat aging and restore a decade of life. Efforts are being made by private actors for longevity biotechnology to be taken seriously, as they claim that aging is a biological mechanism that can be manipulated with molecular and cellular tools. Novel biomarkers, genomic profiles, and approaches to clinical experimentation are being developed. Backed by some of the wealthiest persons in the world, some institutions have signed declarations and are advocating for more funding for this field. While much of the hype is associated with investors from Silicon Valley, in this paper I examine the ways in which private actors aim to shape research priorities and goals of longevity biotechnology, making promises of living longer and promoting a “revolution” in medicine. This presents profound implications for the meaning of disease, the boundary between individualized (or personalized) medicine and public health, and between treatment versus enhancement. I examine whether there is a role for a revolution in healthcare that makes room for social policy and non-medicalized approaches, accounting for social determinants of health and exacerbation of inequalities. This research is based on participant observation in longevity conferences, and analysis of secondary sources like articles, videoclips and podcasts. This work reflects shifts in society’s relationship with time, aging, the self, and the limits of the body.

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Short abstract:

With a global history approach, I analyze the construction of different sociotechnical worlds against diarrheal diseases in the South and the North. I argue that domination in the laboratory affected the design of infrastructural technologies for the North and small-scale fixes for the South.

Long abstract:

While diarrheal diseases have always been a truly global affliction, different sociotechnical worlds have been constructed to keep them at bay. Infrastructure technologies – such as water and sanitation infrastructure – have significantly reduced mortality rates in the North. In contrast, small-scale technologies such as oral rehydration salts have been designed for the South, where diarrheal diseases continue to be the main cause of childhood death. This project explores how political conditions in laboratories of technology design underlie such technological bifurcation. I build on subaltern studies’ conceptualization of domination without and with hegemony as a key characteristic of metropolitan and peripheral rule. Going back to the late 19th century, four historical case studies explore how far such political differences co-produced the construction of infrastructural and small-scale technologies. Infrastructural technologies such as water filtration or hospital-based intravenous rehydration therapy have depended on support from domination with hegemony to extend far-reaching, at the same time promising to support the hegemonic stance of medical and public health establishments. In contrast, small-scale interventions such as oral rehydration salts or disinfection techniques of colonial empires were developed in contexts of domination without hegemony, promising to demand neither the legitimized backing of affected populations nor extended financial support. The project charts novel theoretical ground for STS scholarship in exploring how domination in the laboratory interacts with technology design; exploring the interplay of global political and technological inequities.

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Short abstract:

This paper examines a new strategy by HIV-negative gay/bisexual men not on PrEP, engaging in condomless sex with partners with undetectable viral loads or on PrEP as an indirect protection measure aimed at balancing pleasure and risk - i.e., prevention by proxy.

Long abstract:

The increasing availability of antiretroviral drugs in certain regions of the world for HIV treatment and prevention has led many gay, bisexual, and other men who have sex with men (GBM) to “make transformations” in their sexual practices. A new phenomenon is taking place whereby some HIV-negative GBM not on pre-exposure prophylaxis (PrEP) engage in condomless sexual activities with partners with undetectable viral loads or partners using PrEP. This indirect protection measure is a strategy to balance pleasure and risk reduction in the context of HIV prevention during sex. In other words, these GBM are using antiretrovirals for HIV prevention without directly consuming antiretrovirals themselves, which represents a form of “prevention by proxy.”

This presentation explores this emerging sexual trend, highlighting how GBM are incorporating knowledge of scientific advancements into their sexual practices, despite diverging from conventional public health recommendations. The presentation will discuss how this innovative approach to HIV prevention challenges long-standing public health messages that have historically emphasized “direct self-protection” for HIV-negative GBM by advocating for consistent condom use and, more recently, the adoption of PrEP.

Moreover, the presentation will discuss the global health implications of this new trend. The uneven global access to antiretroviral drugs for both treatment and PrEP highlights a significant justice issue. The “prevention by proxy” phenomenon is continuation of this justice issue by showing that not everyone has the same opportunity to adopt this strategy due to varying antiretroviral access across different regions.

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Short abstract:

This proposal focuses on some implications around HPV diagnosis for Mexican cisgender women in Mexico City. It is highlighted how gynecological consultation represents a violent space for women where heteropatriarchal understandings of bodies and disease are relevant.

Long abstract:

In the early 1980s, biomedical research linked the transmission of Human Papillomavirus (HPV) to anal, oral and vaginal sex and genital-to-genital contact. The term HPV describes a cluster of viruses causing various types of cancer, including cervical cancer, one of the leading causes of death among cisgender women in their 20s and 30s in the global South. Through screening, HPV can be readily identified and treated to prevent the progression of disease to cancer. In countries from the global South, such as Mexico, cervical cancer represents the first cause of death among the ones between their 20-40’s. Therefore, technoscientific advances to both prevent and treat the human papillomavirus (HPV).

Biomedical interventions in Mexico (such as vaccines and Papanicolaou) are available only for cisgender women, which reifies understandings of heteronormativity, unequal development and implementation. These reifying processes are influenced by the complex neocolonial narratives embedded in how biomedical interventions travel (Echeverría 2008), where the gynecological consultation space emerge as a setting that enables inequalities for cisgender women. From an intersectional perspective that takes into account the ways gender, sexual orientation, age and social class interact, I highlight in this proposal how biomedical knowledge is translated into power relationships forces for women that are not related to biological information about viruses, cancer and biomedical interventions. This proposal also queries how feminist activism represents a way to face biomedical power by constructing phenomenological alternatives to understand an experience HPV diagnosis.