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       THE EXPERIMENT MUST CONTINUE

       PERSPECTIVES ON GLOBAL HEALTH

      Series editor: James L. A. Webb, Jr.

      The History of Blood Transfusion in Sub-Saharan Africa, by William H. Schneider

      Global Health in Africa: Historical Perspectives on Disease Control, edited by Tamara Giles-Vernick and James L. A. Webb, Jr.

      Preaching Prevention: Born-Again Christianity and the Moral Politics of AIDS in Uganda, by Lydia Boyd

      The Experiment Must Continue: Medical Research and Ethics in East Africa, 1940–2014, by Melissa Graboyes

       THE EXPERIMENT MUST CONTINUE

      Medical Research and Ethics in East Africa, 1940–2014

      Melissa Graboyes

      Ohio University Press

      Athens

      Ohio University Press, Athens, Ohio 45701

       ohioswallow.com

      © 2015 by Ohio University Press

      All rights reserved

      To obtain permission to quote, reprint, or otherwise reproduce or distribute material from Ohio University Press publications, please contact our rights and permissions department at (740) 593–1154 or (740) 593–4536 (fax).

      Cover image: Uncataloged archival materials at Amani Medical Research Station, Amani, Tanzania, 2008. Photo by author.

      Cover design by Beth Pratt.

      Printed in the United States of America

      Ohio University Press books are printed on acid-free paper

      225 24 23 22 21 20 19 18 17 16 15 5 4 3 2 1

       Library of Congress Cataloging-in-Publication Data

      Graboyes, Melissa, author.

      The experiment must continue : medical research and ethics in East Africa, 1940/2014 / Melissa Graboyes.

      p. ; cm. — (Perspectives on global health)

      Includes bibliographical references and index.

      ISBN 978-0-8214-2172-7 (hc : alk. paper) — ISBN 978-0-8214-2173-4 (pb : alk. paper) — ISBN 978-0-8214-4534-1 (pdf)

      I. Title. II. Series: Perspectives on global health.

      [DNLM: 1. Biomedical Research—history—Africa, Eastern. 2. Anthropology, Cultural—history—Africa, Eastern. 3. Biomedical Research—ethics—Africa, Eastern. 4. History, 20th Century—Africa, Eastern. 5. History, 21st Century—Africa, Eastern. 6. Human Experimentation—history—Africa, Eastern. W 20.5]

      R850

      610.72'4—dc23

      2015034120

      Dedicated to each of my families.

      My parents and sister, who model and respect hard work

      My large Italian family, acquired by luck of marriage

      My own piccola famiglia, Alfredo, Silvia, and Giovanna.

      CONTENTS

       List of Illustrations

       Preface

       Acknowledgments

       Abbreviations

       THE EXPERIMENT BEGINS

       ONE. Medical Research Past and Present

       PERCEPTIONS

       TWO. East African Perceptions of Medical Research

       RESEARCHERS ARRIVE

       HISTORICAL NARRATIVE: “Inspeakable Entomologists”

       H. H. Goiny and a Failed Attempt to Eliminate Lymphatic Filariasis, Pate Island, Kenya, 1956

       MODERN NARRATIVE: A “Remarkable Achievement”?

       Lymphatic Filariasis Elimination, Zanzibar, 2001

       THREE. First Encounters, First Impressions

       CONSENT OR COERCION?

       HISTORICAL NARRATIVE: “Forced to Accept Trial Treatment”?

       A Tuberculosis Drug Trial, Nairobi, Kenya, 1961

       MODERN NARRATIVE: Focusing on Fieldworkers in Kilifi, Kenya

       FOUR. Ethical Recruitment and Gathering Human Subjects

       BALANCING RISKS AND BENEFITS

       HISTORICAL NARRATIVE: Hope Trant and a Compound on Fire in Tanganyika, 1954

       MODERN NARRATIVE: A Male Circumcision Trial Canceled in Rakai, Uganda, 2005

       FIVE. Finding an Ethical Balance

       EXITS AND LONGER-TERM OBLIGATIONS

       HISTORICAL NARRATIVE: “Almost Completely Eradicated”

       The Pare-Taveta Malaria Scheme, 1955

       MODERN NARRATIVE: A New Malaria Vaccine?

       Testing the RTS,S Vaccine across Africa, 2010

       SIX.

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