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Politics and trust in Ebola vaccine trials

The case of Ghana

Published online by Cambridge University Press:  16 April 2020

John K. Aggrey  and
Wesley Shrum
John K. Aggrey
Affiliation:
Louisiana State University
Wesley Shrum*
Affiliation:
Louisiana State University
*
Corresponding author: Wesley Shrum, Department of Sociology, Louisiana State University, 126 Stubbs Hall, Baton Rouge, LA, USA. Email: [email protected]
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Abstract

Vaccine trials for infectious diseases take place in a milieu of trust in which scientists, regulatory institutions, and volunteers trust each other to play traditional roles. This milieu of trust emerges from a combination of preexisting linkages embedded in the local and national political context. Using the case of failed vaccine trials in Hohoe, Ghana, we explore this milieu of trust by employing the concept of tandems of trust and control, with a particular focus on the perceived characteristics of the disease and the linkages formed. An analysis of qualitative interviews collected in Hohoe following the West Africa Ebola outbreak of 2014–2016 shows that the trust/control nexus in vaccine trials precedes the implementation of those trials, while both the characteristics of Ebola and the political context shaped the formation and breakdown of relationships in the trial network.

Keywords

EbolatrustvaccineGhanainfectious diseasepolitics
Type
Article
Information
Politics and the Life Sciences , Volume 39 , Issue 1 , Spring 2020 , pp. 38 - 55
Copyright
© Association for Politics and the Life Sciences 2020

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References

Abadie, R. (2010). The professional guinea pig: Big pharma and the risky world of human subjects. Duke University Press.CrossRefGoogle Scholar
Appiah, E. (2015, June 11). Rejection of Ebola vaccine trial a sad day for science—Prof. Dodoo. Joy FM Online. https://www.myjoyonline.com/news/2015/June-11th/rejection-of-ebola-vaccine-trial-a-sad-day-for-science-prof-dodoo.phpGoogle Scholar
Asiedu, A. A. (2015, June 11). Mahama should take Ebola vaccine trials to Bole—V/R NPP Chairman. Joy FM Online. https://www.myjoyonline.com/politics/2015/June-11th/mahama-should-take-ebola-vaccine-trials-to-bole-vr-npp-chairman.phpGoogle Scholar
Babbs, C. F. (2014). Choosing inclusion criteria that minimize the time and cost of clinical Trials. World Journal of Methodology, 4(2), 109–122.CrossRefGoogle ScholarPubMed
Babbie, E. (2010). The practice of social research. Wadsworth Cengage.Google Scholar
Bester, J. C. (2015). Vaccine refusal and trust: The trouble with coercion and education and suggestions for a cure. Bioethical Inquiry, 12(4), 555–559.CrossRefGoogle ScholarPubMed
Bijlsma-Frankema, K. M. (2004). Dilemmas of control in managerial perspectives on success and failure of acquisition processes. Journal of Managerial Psychology, 19(3), 204–218.CrossRefGoogle Scholar
Bijlsma-Frankema, K. M., & Costa, A. C. (2005). Understanding the trust-control nexus. International Sociology, 20(3), 259–282.CrossRefGoogle Scholar
Bijker, E. M., Sauerwein, R. W., & Bijker, W. E. (2016). Controlled human malaria infection Science, 46(1), 56–86.Google ScholarPubMed
Boadu, K. A. (2014, October 29). Mahama—Africa’s lone voice on Ebola. Graphic Online. https://www.graphic.com.gh/features/features/mahama-africa-s-lone-voice-on-ebola.htmlGoogle Scholar
Bokor, M. J. K. (2015, June 9). No Ghanaian should be a guinea pig for Ebola experiments. Modern Ghana. https://www.modernghana.com/news/622266/no-ghanaian-should-be-a-guinea-pig-for-ebola-experiments.htmlGoogle Scholar
Boon, S., & Holmes, J. (1991). The dynamics of interpersonal trust: Resolving uncertainty in the face of risk. In Hinde, R. & Gorebel, J. (Eds.), Cooperation and prosocial behaviour (pp. 190–211). Cambridge University Press.Google Scholar
Bouder, F. (2015). Risk communication of vaccines: Challenges in the post-trust environment. Current Drug Safety, 10(1), 9–15.CrossRefGoogle ScholarPubMed
Brownlie, J., & Howson, A. (2005). “Leaps of faith” and MMR: An empirical study of trust. Sociology, 39(2), 221–239.CrossRefGoogle Scholar
Campbell, M. K., Snowdon, C., Francis, D., Elbourne, D., McDonald, A. M., Knight, R., & Grant, A. (2007). Recruitment to randomised trials: Strategies for trial enrollment and participation study: The STEPS study. Health Technology Assessment, 11(48). https://doi.org/10.3310/hta11480CrossRefGoogle ScholarPubMed
Cardinal, L. B., Sitkin, S. B., & Long, C. P. (2004). Balancing and rebalancing in the creation and evolution of organizational control. Organization Science, 15(4), 411–431.CrossRefGoogle Scholar
ClinicalTrials.gov. (2017). Effectiveness of intermittent preventive treatment for malaria in children. Identifier No. NCT00119132. Retrieved February 11, 2019 from https://clinicaltrials.gov/ct2/show/NCT00119132?cond=Malaria&cntry=GH&city=Hohoe&rank=1Google Scholar
ClinicalTrials.gov. (2019). Efficacy of ivermectin and albendazole against onchocerciasis in the Volta Region, Ghana. Identifier No. NCT02078024. Retrieved February 11, 2019 from https://clinicaltrials.gov/ct2/show/NCT02078024?cond=Onchocerciasis&cntry=GH&city=Hohoe&rank=1Google Scholar
Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications.Google Scholar
Conteh, L., Patouillard, E., Kweku, M., Legood, R., Greenwood, B., & Chandramohan, D. (2010). Cost effectiveness of seasonal intermittent preventive treatment using amodiaquine and artesunate or sulphadoxine-pyrimethamine in Ghanaian children. PLOS ONE, 5(8), e12223. https://doi.org/10.1371/journal.pone.0012223CrossRefGoogle ScholarPubMed
Das, T. K., & Teng, B. S. (2001). Trust, control and risk in strategic alliances: An integrated framework. Organization Studies, 22(2), 251–283.CrossRefGoogle Scholar
De Vries, R., & Lemmens, T. (2006). The social and cultural shaping of medical evidence: Case studies from pharmaceutical research and obstetric science. Social Science & Medicine, 62(11), 2694–2706.CrossRefGoogle ScholarPubMed
Dixion-Woods, M., & Tarrant, C. (2009). Why do people cooperate with medical research? Findings from three studies. Social Science & Medicine, 68(12), 2215–2222.CrossRefGoogle Scholar
Ear, S. (2011). Avian influenza: The political economy of disease control in Cambodia. Politics and the Life Sciences, 30(1), 2–19.CrossRefGoogle ScholarPubMed
Ear, S. (2012). Swine flu: Mexico’s handling of A/H1N1 in comparative perspective. Politics and the Life Sciences, 31(1–2), 52–66.CrossRefGoogle ScholarPubMed
Ear, S. (2014). Emerging infectious disease surveillance in Southeast Asia: Cambodia, Indonesia, and the US Naval Area Medical Research Unit 2. Asian Security, 8(2), 164–187.CrossRefGoogle Scholar
Enria, L., Lees, S., Smout, E., Mooney, T., Tengbeh, A. T., Leigh, B., Greenwood, B., Watson-Jones, D., & Larson, H. (2016). Power, fairness and trust: Understanding and engaging with vaccine trial participants and communities in the setting up the EBOVAC-Salone vaccine trial in Sierra Leone. BMC Public Health, 16, 1140. https://doi.org/10.1186/s12889-016-3799-xCrossRefGoogle ScholarPubMed
Feller, S. (2015, December 30). One in four cancer trials fails to enroll enough participants. UPI. https://www.upi.com/Health_News/2015/12/30/One-in-four-cancer-trials-failsto-enroll-enough-participants/2611451485504/Google Scholar
Fisher, J. A. (2008). Institutional mistrust in the organization of pharmaceutical clinical trials. Medicine, Health Care and Philosophy, 11(4), 403–413.CrossRefGoogle ScholarPubMed
Fisher, J. A. (2015). Feeding and bleeding: The institutional banalization of risk to healthy volunteers in phase I pharmaceutical clinical trials. Science, Technology & Human Values, 40(2), 199–226.CrossRefGoogle ScholarPubMed
Getz, K. A. (2015). Characterizing the real cost of site regulatory compliance. Applied Clinical Trials, 24(6), 18–20.Google Scholar
Getz, K. A., Zuckerman, R., Cropp, A. B., Hindle, A. L., Krauss, R., & Kaitlin, K. I. (2011). Measuring the incidence, causes, and repercussions of protocol amendments. Drug Information Journal, 45(3), 265–275.CrossRefGoogle Scholar
GhanaWeb. (2015a, June 8). NDC says no to “needless” Ebola vaccines trial in V/R. https://www.ghanaweb.com/GhanaHomePage/NewsArchive/NDC-says-no-to-needless-Ebola-vaccines-trial-in-V-R-361405Google Scholar
GhanaWeb. (2015c, June 23). Allowing Ebola Vaccine trial shows NDC insensitivity—Wontumi. https://www.ghanaweb.com/GhanaHomePage/NewsArchive/Allowing-Ebola-Vaccine-trial-shows-NDC-insensitivity-Wontumi-364057Google Scholar
GhanaWeb. (2015d, June 23). Ebola vaccines trial: Lead scientist offers to be used for test. https://www.ghanaweb.com/GhanaHomePage/health/Ebola-vaccines-trial-Lead-scientist-offers-to-be-used-for-test-364062Google Scholar
Graphic Online. (2015a, March 16). UN commends President Mahama; For hosting UNMEER. https://www.graphic.com.gh/news/general-news/un-commends-president-mahama-for-hosting-unmeer.htmlGoogle Scholar
Graphic Online (2015b, June 8). Ebola vaccine trial won’t harm Ghanaians—FDA. https://www.graphic.com.gh/news/general-news/ebola-vaccine-trial-won-t-harm-ghanaians-fda.htmlGoogle Scholar
Graphic Online. (2015c, June 10). Health minister suspends Ebola vaccine trial. https://www.graphic.com.gh/news/general-news/health-minister-suspends-ebola-vaccine-trial.htmlGoogle Scholar
Graphic Online. (2015d, June 11). Take “cruel” Ebola trial to Bole—NPP chair tells Prez Mahama. https://www.graphic.com.gh/news/politics/take-cruel-ebola-trial-to-bole-npp-chair-tells-prez-mahama.htmlGoogle Scholar
Graphic Online. (2015e, June 14). Noguchi boss criticises suspension of Ebola vaccine trials. https://www.graphic.com.gh/news/politics/noguchi-boss-criticises-suspension-of-ebola-vaccine-trials.htmlGoogle Scholar
Graphic Online. (2015f, June 22). Ebola vaccine trial: Lead scientist offers to be used for test. https://www.ghanaweb.com/GhanaHomePage/NewsArchive/Ebola-vaccines-trial-Lead-scientist-offers-to-be-used-for-test-364062Google Scholar
Hammersley, M. (1997). Qualitative data archiving: Some reflections on its prospects and problems. Sociology, 31(1), 131–142.CrossRefGoogle Scholar
Hedgecoe, A. M. (2014). A deviation from standard design? Clinical trials, research ethics committees, and the regulatory co-construction of organizational deviance. Social Studies of Science, 44(1), 59–81.CrossRefGoogle ScholarPubMed
Heneghan, C., Goldacre, B., & Mahtani, K. R. (2017). Why clinical trial outcomes fail to translate into benefits for patients. Trials, 18, 122. https://doi.org/10.1186/s13063-017-1870-2CrossRefGoogle ScholarPubMed
Hill, N. S., Preston, I. R., & Roberts, K. E. (2008). Patients with pulmonary arterial hypertension in clinical trials: Who are they? Proceedings of the American Thoracic Society, 5(5), 603–609.CrossRefGoogle Scholar
Holt, D., Bouder, F., Elemuwa, C., Gaedicke, G., Khamesipour, A., Kisler, B., Kochhar, S., Kutalek, R., Maurer, W., Obermeier, P., Seeber, L., Trusko, B., Gould, S., & Rath, B. (2016). The importance of the patient voice in vaccination and vaccine safety—Are we listening? Clinical Microbiology and Infection, 22, S146–S153.CrossRefGoogle ScholarPubMed
Hwang, T. J., Carpenter, D., Lauffenburger, J. C., Wang, B., Franklin, J. M., & Kesselheim, A. S. (2016). Failure of investigational drugs in late-stage clinical development and publication of trial results. JAMA Internal Medicine, 176(12), 1826–1833.CrossRefGoogle ScholarPubMed
Jonvallen, P., Berg, E., & Barry, J. (2011). The development of contract research organisations in Sweden: Health care, privatisation and neo-liberalism. New Technology, Work and Employment, 26(3), 196–209.CrossRefGoogle Scholar
Joy FM Online. (2015, June 3). FDA holds meeting on Ebola vaccination trials. https://www.myjoyonline.com/news/2015/june-3rd/fda-holds-meeting-on-ebola-vaccination-trials.phpGoogle Scholar
Keiser, P. B., Reynolds, S. M., Awadzi, K., Ottesen, E. A, Taylor, M. J., & Nutman, T. B. (2002). Bacterial endosymbionts of Onchocerca volvulus in the pathogenesis of posttreatment reactions. Journal of Infectious Diseases, 185(6), 805–811. https://doi.org/10.1086/339344CrossRefGoogle ScholarPubMed
Kerkhof, P., Vahstal-Lapaix, N., & Caljé, H. (2005). Store and advertiser reputation effects on consumer trust in an internet store: Results of an experimental study. In Bijlsma-Frankema, K. M. & Woolthuis, R. J. A. Klein (Eds.), Trust under pressure: Empirical investigations of the functioning of trust and trust building in uncertain circumstances (pp. 170–186). Edward Elgar.Google Scholar
Kummervold, P. E., Schulz, W. S., Smout, E., Fernandez-Luque, L., and Larson, H. J. (2017). Controversial Ebola vaccine trials in Ghana: A thematic analysis of critiques and rebuttals in digital news. BMC Public Health, 17, 642.CrossRefGoogle ScholarPubMed
Kweku, M., Liu, D., Adjuik, M., Binka, F., Seidu, M., Greenwood, B., & Chandramohan, D. (2008). Seasonal intermittent preventive treatment for the prevention of anaemia andmalaria in Ghanaian children: A randomized, placebo controlled trial. PLOS ONE, 3(12), e4000. https://doi.org/10.1371/journal.pone.0004000CrossRefGoogle ScholarPubMed
Lofstedt, R. (2005). Risk management in post-trust societies. Palgrave Macmillan.CrossRefGoogle Scholar
Lösch, C., & Neuhäuser, M. (2008). The statistical analysis of a clinical trial when a protocol amendment changed the inclusion criteria. BMC Medical Research Methodology, 8, 16. https://doi.org/10.1186/1471-2288-8-16CrossRefGoogle ScholarPubMed
Luhmann, N. (1988). Familiarity, confidence, trust: Problems and alternatives. In Gambetta, D. (Ed.), Trust: Making and breaking co-operative relations (pp. 94–107). Basil Blackwell.Google Scholar
Maïga, O., Djimdé, A. A., Hubert, V., Renard, E., Aubouy, A., Kironde, F., Nsimba, B., Koram, K., Doumbo, O. K., Le Bras, J., & Clain, J. (2007). A shared Asian origin of the triple-mutant dhfr allele in Plasmodium falciparum from sites across Africa. Journal of Infectious Diseases, 196(1), 165–172. https://doi.org/10.1086/518512CrossRefGoogle ScholarPubMed
Mayer, R. C., Davis, J. H., & Schoorman, F. D. (1995). An integrative model of organizational trust. Academy of Management Review, 20(3), 709–734.CrossRefGoogle Scholar
McEvily, B., Perrone, V., & Zaheer, A. (2003). Trust as an organizing principle. Organization Science, 14(1), 91–103.CrossRefGoogle Scholar
Michael, M. (2017). Actor-network theory. Trials, trails and translation. Sage Publications.CrossRefGoogle Scholar
Mirowski, P., & Van Horn, R. (2005). The contract research organization and the commercialization of scientific research. Social Studies of Science, 35(4), 503–548.CrossRefGoogle ScholarPubMed
Ghana, Modern. (2014, September 22). NPP is praying for Ebola to hit Ghana—Yamin. Retrived from https://www.modernghana.com/news/570459/npp-is-praying-for-ebola-to-hit-ghanayamin.htmlGoogle Scholar
Ghana, Modern. (2015a, June 8) NDC says no to “needless” Ebola vaccines trial in Volta region. https://www.modernghana.com/news/621918/1/ndc-says-no-to-needless-ebola-vaccines-trial-in-vr.htmlGoogle Scholar
Ghana, Modern. (2015b, June 10). Ebola Vaccine trial in VR suspended. https://www.modernghana.com/news/622538/ebola-vaccine-trial-in-vr-suspended.htmlGoogle Scholar
Ghana, Modern. (2015c, June 10). FDA gives approval for Ebola vaccine clinical trials. https://www.modernghana.com/news/622582/1/fda-gives-approval-for-ebola-vaccine-clinical-tria.htmlGoogle Scholar
Ghana, Modern. (2015d, June 11). MPs angry over Ebola for phone trial. https://www.modernghana.com/news/622700/mps-angry-over-ebola-for-phone-trial.htmlGoogle Scholar
Ghana, Modern. (2015e, June 11). Parliament calls for suspension, stoppage of Ebola vaccine trial. https://www.modernghana.com/news/622719/parliament-calls-for-suspension-stoppage-of-ebola.htmlGoogle Scholar
Ghana, Modern. (2015f, June 11). Rejection of Ebola Vaccine trial a sad day for science—Prof. Dodoo. https://www.modernghana.com/news/622775/rejection-of-ebola-vaccine-trial-a-sad-day-for-science-pro.htmlGoogle Scholar
Ghana, Modern. (2015g, June 15). We are not guinea pigs! https://www.modernghana.com/news/623582/we-are-not-guinea-pigs-.htmlGoogle Scholar
Ghana, Modern. (2015h, July 17). FDA gives evidence in Parliament. https://www.modernghana.com/news/630446/fda-gives-evidence-in-parliament.htmlGoogle Scholar
Mol, A. (2010). Actor-network theory: Sensitive terms and enduring tensions. Kölner Zeitschrift für Soziologie und Sozialpsychologie Sonderheft, 50(1), 253–269.Google Scholar
Möllering, G. (2001). The nature of trust: From Georg Simmel to a theory of expectation, interpretation and suspension. Sociology, 35(2), 403–420.CrossRefGoogle Scholar
Möllering, G. (2005). The trust/control duality: An integrative perspective on positive expectations of others. International Sociology, 20(3), 283–305.CrossRefGoogle Scholar
Monahan, T., & Fisher, J. A. (2015). “I’m still a hustler”: Entrepreneurial responses to precarity by participants in phase I clinical trials. Economy and Society, 44(4), 545–566.CrossRefGoogle Scholar
Morris, N., & Bàlmer, B. (2006). Volunteer human subjects’ understandings of their participation in a biomedical research experiment. Social Science & Medicine, 62(4), 998– 1008.CrossRefGoogle Scholar
Okyere, T. (2015, November 14). Parliament approves Ebola vaccine trials in the country. Graphic Online. https://web.archive.org/web/20170728092805/ http://www.graphic.com.gh/news/general-news/parliament-approves-ebola-vaccine-trials-in-the-country.htmlGoogle Scholar
Prescott, H. M. (2002). Using the student body: College and university students as research 1subjects in the United States during the twentieth century. Journal of the History of Medicine and Allied Sciences, 57(1), 3–38.CrossRefGoogle Scholar
Quaicoe-Duho, Rebecca. (2015a, June 10). FDA okays Ebola vaccine trial. Graphic Online. https://www.graphic.com.gh/news/general-news/fda-okays-ebola-vaccine-trial.htmlGoogle Scholar
Quaicoe-Duho, Rebecca. (2015b, June 10). Ministry suspends Ebola vaccine trial. Graphic Online. https://www.graphic.com.gh/news/general-news/ministry-suspends-ebola-vaccine-trial.htmlGoogle Scholar
Quaicoe-Duho, Rebecca. (2015c, June 12). MPs must apologize for Ebola comments—Prof. Alex Dodoo. Graphic Online. https://www.graphic.com.gh/news/general-news/mps-must-apologise-for-ebola-comments-prof-alex-dodoo.htmlGoogle Scholar
Quaicoe-Duho, Rebecca. (2015d, July 19). Citizens kick against Ebola vaccine trial. Graphic Online. https://www.graphic.com.gh/news/health/citizens-kick-against-ebola-vaccine-trial.htmlGoogle Scholar
Reed, M. I. (2001). Organization, trust and control: A realist analysis. Organization Studies, 22(2), 201–28.CrossRefGoogle Scholar
Rogers, W. O., Atuguba, F., Oduro, A. R., Hodgson, A., & Koram, K. A. (2006). Clinical case definitions and malaria vaccine efficacy. Journal of Infectious Diseases, 193(3), 467–473. https://doi.org/10.1086/499314CrossRefGoogle ScholarPubMed
Ryan, M. J., Giles-Vernick, T., & Graham, J. E. 2019. Technologies of trust in epidemic response: Openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa. BMJ Global Health, 4, e001272. https://doi.org/10.1136/bmjgh-2018-001272CrossRefGoogle ScholarPubMed
Scott, C., Walker, J., White, P., & Lewith, G. (2011). Forging convictions: The effects of active participation in a clinical trial. Social Science & Medicine, 72(12), 2041–2048.CrossRefGoogle ScholarPubMed
Sismondo, S. (2008). How pharmaceutical industry funding affects trial outcomes: Causal structures and responses. Social Science & Medicine, 66(9), 1909–1914.CrossRefGoogle ScholarPubMed
Sismondo, S. (2009). Ghosts in the machine: Publication planning in the medical sciences. Social Studies of Science, 39(2), 171–198.CrossRefGoogle ScholarPubMed
Smith-Asante, E. (2014, October 8). Ministers to appear before Parliament on Ebola response centre. Graphic Online. https://www.graphic.com.gh/news/general-news/ministers-to-appear-before-parliament-on-ebola-response-centre.htmlGoogle Scholar
Smith-Asante, E. (2015, June 16). It is unsafe to undertake Ebola vaccine trial. Graphic Online. http://www.graphic.com.gh/news/general-news/it-is-unsafe-to-undertake-ebola-vaccine-trial.html.Google Scholar
Starr FM Online. (2015a, June 8). “Ebola vaccine trial won’t harm Ghanaians”—FDA. http://web.archive.org/web/20150730025947/http://www.starrfmonline.com/1.4322726Google Scholar
Starr FM Online. (2015b, June 8). NDC says no to “needless” Ebola vaccines trial in Volta region. http://web.archive.org/web/20150611033541/http://www.starrfmonline.com:80/1.4294638Google Scholar
Sydow, J., & Windeler, A. (2003). Knowledge, trust and control: Managing tensions and contradictions in a regional network of service firms. International Studies of Management and Organization, 33(2), 69–99.CrossRefGoogle Scholar
Tyler, T. R. (2003). Trust within organisations. Personnel Review, 32(5), 556–68.CrossRefGoogle Scholar
Vanderstoep, S. W., & Johnston, D. D. (2008). Research methods for everyday life: Blending qualitative and quantitative approaches. John Wiley & Sons.Google Scholar
Wadmann, S. (2014). Physician–industry collaboration: Conflicts of interest and the imputation of motive. Social Studies of Science, 44(4), 531–554.CrossRefGoogle ScholarPubMed
Wynia, M., & Boren, D. (2009). Better regulation of industry-sponsored clinical trials is long overdue. Journal of Law, Medicine & Ethics, 37(3), 410–419.CrossRefGoogle ScholarPubMed
Youde, J. (2013). Cattle scourge no more: The eradication of rinderpest and its lessons for global health campaigns. Politics and the Life Sciences, 32(1), 43–57.CrossRefGoogle ScholarPubMed