Doctoral Dissertation Research: Ethics, Experiment, Aid: China's Efforts to Eradicate Malaria in the Union of the Comoros

这篇博士论文研究由美国国家科学基金会的科学、技术和社会项目支持，研究了中国在非洲健康和发展中日益重要的作用。通过民族志实地调查，该项目将跟踪中国与疟疾有关的援助，从其在北京的科学和政策起源，到在非洲的实施，再到日内瓦的全球卫生行动者如何看待这种援助。本项目采用多地点人种学，以增进对全球卫生实践和政策的了解，并研究疾病控制和预防措施。与传统的流行病学方法或卫生政策结果的经济分析相比，这种方法可以更深入地研究这一援助和实验混合项目。中国对非洲疟疾相关援助的一个基石是提供中国制造的以青蒿素为基础的联合疗法（ACT，一种强大的抗疟疾药物），用于非洲国家的大规模药物管理（MDA）。中国援助的第一个例子是2007年至2008年中国研究人员在科摩罗联盟进行的一项有争议的疟疾根除实验。本研究将特别关注科摩罗的MDA，将其作为援助与实验相结合的先例，为中国在其他非洲国家提出类似的MDA铺平了道路。这项研究是在全球疟疾控制努力的关键时刻进行的，因为国际卫生界的成员目前正在讨论根除和消除疟疾以及如何实现这两项目标。世界卫生组织正在起草关于在大规模管理中接受使用抗疟疾药物的新准则，与此同时，中国正在将其在非洲的新兴卫生发展努力集中于通过提供中国制造的以青蒿素为基础的联合治疗药物来控制疟疾。通过努力了解中国在非洲卫生和发展中的新兴作用，该研究将为疟疾控制和卫生治理的政策制定者以及对中国在非洲的作用以及实验和国际援助中日益增加的杂交趋势感兴趣的学者提供见解。

This doctoral dissertation research, supported by the Science, Technology & Society program at NSF, examines China's growing role in African health and development. Through ethnographic fieldwork, the project will follow China's malaria-related aid from its scientific and policy origins in Beijing, through its implementation at sites in Africa, to an examination of how such aid is viewed by global health actors in Geneva. The multi-sited ethnography in this project is employed to advance understanding of global health practice and policy, and research on disease control and prevention initiatives. This approach permits a more in-depth look at this hybrid aid and experiment project than more traditional epidemiological methods or economic analyses of health policy outcomes. A cornerstone of China's malaria-related aid to Africa is the provision of Chinese-made artemisinin-based combination therapies (ACT, a powerful anti-malarial) for use in mass drug administration (MDA) in African nations. The first instance of such Chinese aid came in the form of a controversial malaria-eradication experiment carried out in 2007-08 by Chinese researchers in the Union of the Comoros. This study will pay particular attention to the Comoros MDA as a precedent-setting hybrid of aid and experiment that has paved the way for China to propose similar MDAs in other African nations. This research comes at a pivotal moment in the trajectory of global malaria control efforts, as eradication and elimination, and how each might be achieved, are now under discussion by members of the international health communities. The World Heath Organization is in the process of drafting new guidelines on the accepted use of anti-malarial pharmaceuticals in mass administration just as China is focusing its emerging health development efforts in Africa on the control of malaria through the provision of Chinese-made ACTs. By striving to understand China's emerging role in African health and development, the research stands to provide insight for policy-makers in malaria control and health governance, as well as for scholars interested in China's role in Africa and the increasing trend towards hybridity in experiment and international aid.