(Re)configuring research value: international commercial clinical trials in the Russian Federation

Abstract

Clinical trials of new drugs are generally understood in terms of contribution to the future well-being of patients and society at large, while studies of the political economy of trials reveal that global health inequalities have come to sustain the continuous and lucrative operation of this enterprise. The divide between profit generation and improvements in local well-being could be especially vivid when international commercial clinical trials are conducted in new, non-traditional locations outside of North America and Western Europe. This article focuses on how this divide is managed in the everyday work of conducting trials in a research centre in Russia. It explores how investigators and research participants engage in the work of translating trials into academic capacity-building, development of local medical expertise and provision of public health benefits. That is, research value is being multiply configured in clinical, scientific and economic domains. We view the conduct of clinical trials as a boundary process which, through enabling multiplication of value, bridges the realms of health and wealth. This reading of the process of conducting trials opens up opportunities to think about ways to maximise the value of medical experimentation and to (re)link clinical research and public good.