Multipolar technoscience: clinical science collaborations in a changing world system

This dissertation focuses on the formation and governance of international clinical research collaborations in the field of regenerative stem cell medicine, and analyzes these processes against the background of the current transition to a multipolarizing scientific world system. The empirical point of departure of this study is an ethnographic analysis of the establishment of a trans-continental academia-centered clinical trials infrastructure, between researchers based in China, Hong Kong and the USA. Field research was carried out in mainland China and Hong Kong amongst scientists, clinical researchers, medical entrepreneurs, government regulators and patients, between April 2010 and May 2011. The dissertation contributes to debates on the processes and challenges that surround the global distribution of evidence-based medicine clinical research standards, and the study of science and globalization in the context of the emergence of new scientific, economic and geopolitical center regions in the world, with a particular focus on literature that comments on the scientific ascent of the People’s Republic of China. The dissertation reveals that the global diffusion of evidence-based clinical research standards, in regenerative stem cell medicine, is accompanied by the surfacing of vital forms of resistance and the creation of novel transnational spaces of alter-standardization, in which less rigorous, physician-based forms of experimental clinical practice are endorsed, publicized and tried to be legitimized. The dissertation uncovers, furthermore, that the creation of internationally standardized research zones, in the clinical stem cell field, is not necessarily a stable or constant process. The implementation of internationally recognized standards can be highly temporary and depends upon activation in specific situational contexts. Multiple modalities of experimental clinical practices continue to exist side by side to each other. Another line of theorization in this study focuses on the contemporary dynamics of global scientific multipolarization, and explores the empirical and theoretical implications of this trend for international clinical research collaborations. The dissertation argues that a new mode of clinical research partnerships may gradually be emerging. Processes of collective financiering and joint-innovation are giving rise to changing patterns of labour division, decision-making, benefit sharing, profit sharing and revised forms of ownership regarding inventions and research data. Based on a reflective engagement with postcolonial approaches to the study of science and technology, the dissertation concludes that new analytical perspectives are required, through which the empirical transformations and impact associated with the move toward a multipolarizing science system, can be captured in a more nuanced, and comprehensive manner.