Mapping and analysing the TB vaccine research field through an economic sociology lens: how can R&D for neglected diseases be better supported?

© 2014 Dr. Peta FreestoneThe re-emergence of tuberculosis (TB) as a major global health challenge is linked to poverty, social stratification, and the inadequacy of existing biomedical tools. A new, efficacious vaccine is one of the integral components in the long-term strategy to eliminate the disease. Yet the R&D pipeline for TB vaccines is modest, primarily because of the lack of a lucrative market for this innovation. Beyond exploring why this is the case, this study evaluates how TB vaccine research can be better supported. It is particularly concerned with a relatively new method of organising R&D for international development—Product Development Partnerships (PDPs). Utilising a theoretical framework drawn from economic sociology, this thesis first uses bibliometric data to systematically map the key organisational actors and relationships in TB vaccine research, an exercise that has not been previously attempted in the literature. Social Network Analysis (SNA) of this dataset also informs the choice of four organisations for in-depth case studies: Aeras, the University of Oxford, the South African Tuberculosis Vaccine Initiative and McMaster University. These case studies use interviews and workplace observation to illustrate how actors create and negotiate the social structures of networks, cultures and institutions in this research field. The findings of this study reveal that the central PDP has been instrumental in the recent progression of the TB vaccine pipeline. However, this thesis argues that there are opportunities to improve this model in order to a) realise partnerships that are transformative for less empowered participants, b) build sustainable research capacity in developing contexts, and c) make more efficient use of resources in a field in which funds and clinical trial sites are severely limited