Issues and Practices of transnational medical research in Africa. Anthropological analysis of a clinical research center on HIV in Dakar (Senegal)
The feasibility of clinical researches conducted in Africa (standard of care, information and participants' understanding, benefits for the population, and so on...) has been debated but narrowed to medical or ethical aspects until now. My work gives another point of view to this debate, showing clinical trials as complex social objects, medium of socio-cultural representations, norms and stakes (both local and international). Based on a 20 months ethnographic study in Dakar (Senegal), my work documents the conditions in which clinical experimentation is being conducted and more specifically HIV research. To achieve this, this work describes the establishment of a center dedicated to the reception and the realization of clinical research on HIV (CRCF) and analyzes the " organizational cultures " of five clinical studies spreaded in three different health care or research facilities. This study allows on the one hand, to understand the logic of the actors involved in HIV clinical research in Senegal and on the other hand, to account for the "practice framework" of research projects (North-South scientific cooperation, professionalization of local health actors towards "professions of clinical research", the application of international standard procedures, the set up of an ethical environment, the role of PLWHA in clinical research process, etc..). Finally, my work shows the construction of a public and transnational medical research concerning HIV in Senegal both with its specificities.