| This dissertation examines the circumstances of scientists working at the periphery of a globalized research community in order to illuminate links between place, power, and knowledge-making. Contemporary medical research---like contemporary "big science" more generally---is a widely dispersed endeavor; however, the lower status data generation work and higher status knowledge production work that make up this research are often unequally distributed. I examine the situated, emplaced practice of science as performed at THAIDS, an HIV clinical research center in Bangkok, Thailand over its history from 1996 to 2007. Scientific actors with global aspirations---like the clinic at the center of this dissertation---aim to transform the structure of local and global research fields in order to create a protected and powerful niche. I argue that for clinics sited in resource limited settings, one useful strategy for climbing the global clinical trials hierarchy is to move from a position of power based on access to valuable patients to one based on scientific clout.;As a local clinic engaged in international research, THAIDS navigated between what it saw as a need to conduct "locally relevant research" while still performing as a "world class research center", which impacted the content and conduct of THAIDS's research portfolio. THAIDS's primary strategy for navigating between local and global rested upon the belief that Thais made up a class of particular patients, and therefore deserved tailored care based on a body of evidence generated from---and for---Thais. THAIDS's participation in clinical research affected the conduct of HIV care in Thailand, both directly (at the clinic) and indirectly (though the tailoring of treatment guidelines and other shaping of national care). THAIDS's ability to navigate the local and the global, and conduct care, depended upon the availability of resources including scientific clout, economic capital and materials, the goodwill of outside actors, and access to research subjects. This analysis contributes to the growing body of sociological work on clinical trials as knowledge production schemes by a global scientific community, and more broadly to the scholarship examining the international contours of scientific participation. |
