An Ungovernable Foe: Science and Policy Innovation in the U.S. National Cancer Institute

by Natalie B. Aviles

Overview

Winner, 2024 Choice Outstanding Academic Title

In American politics, medical innovation is often considered the domain of the private sector. Yet some of the most significant scientific and health breakthroughs of the past century have emerged from government research institutes. The U.S. National Cancer Institute (NCI) is tasked with both understanding and eradicating cancer—and its researchers have developed a surprising expertise in virus research and vaccine development.

An Ungovernable Foe examines seventy years of federally funded scientific breakthroughs in the laboratories of the NCI to shed new light on how bureaucratic organizations nurture innovation. Natalie B. Aviles analyzes research and policy efforts around the search for a viral cause of leukemia in the 1960s, the discovery of HIV and the development of AIDS drugs in the 1980s, and the invention of the HPV vaccine in the 1990s. She argues that the NCI transformed generations of researchers into innovative public servants who have learned to balance their scientific and bureaucratic missions. These “scientist-bureaucrats” are simultaneously committed to conducting cutting-edge research and stewarding the nation’s investment in cancer research, and as a result they have developed an unparalleled expertise. Aviles demonstrates how the interplay of science, politics, and administration shaped the NCI into a mission-oriented agency that enabled significant breakthroughs in cancer research—and in the process, she shows how organizational cultures indelibly stamp scientific work.

Product Details

ISBN-13:	9780231196697
Publisher:	Columbia University Press
Publication date:	01/23/2024
Pages:	360
Product dimensions:	6.12(w) x 9.25(h) x (d)

About the Author

Natalie B. Aviles is an assistant professor of sociology at the University of Virginia.

Table of Contents

Acknowledgments
Introduction
1. Medicine, Meliorism, and the Making of a Modern NCI
2. Cancer Viruses and the Promise of a Vaccine, 1958–1968
3. Moving Targets in the War on Cancer, 1969–1979
4. Back to Basics: Human Cancer Retrovirus Research, 1980–1984
5. HIV Research and Drug Development, 1985–1989
6. Lost in Translation, 1990–2001
7. From Roadmap to Moonshot, 2002–2016
Conclusion
Methodological Appendix
Notes
Bibliography
Index

Editorial Reviews

An important addition to understanding the complex history of the U.S. National Cancer Institute...Highly recommended.

Choice

How can we inspire innovation in the public interest? An Ungovernable Foe offers a thorough history of the NCI’s virus program, which played a crucial history in shaping HIV treatment and developing the HPV vaccine. At a moment of growing concern about the social impacts of the biomedical research enterprise as it is currently constituted, this book is both timely and important.

Shobita Parthasarathy

A textured, lucid, and cogent study of how the single largest biomedical research organization of the twentieth century adapted to the intellectual and political challenges of translational research.

H-Sci-Med-Tech

In this comprehensive book, Natalie Aviles takes us deep inside the National Cancer Institute, tracing how a federal agency has orchestrated the evolving mission to treat a much-feared disease over seven decades. Sure to become a classic in the study of government-sponsored science, An Ungovernable Foe tells the surprising story of how scientific innovation as well as failure emerge from the inner workings of the federal bureaucratic machine.--Steven Epstein, author of The Quest for Sexual Health: How an Elusive Ideal Has Transformed Science, Politics, and Everyday Life

An Ungovernable Foe is essential reading for scholars studying translational research and public-private partnerships. Aviles makes a compelling case that we should not be too quick to label these organizational forms as neoliberal or to dismiss government scientists as unimaginative. Through her meticulous study of the National Cancer Institute, she shows that federal agencies are an underappreciated site of both scientific and bureaucratic innovation.--Nicole C. Nelson, coeditor of Social Studies of Science and author of Model Behavior: Animal Experiments, Complexity, and the Genetics of Psychiatric Disorders

The U.S. government's long-term investment in cancer research and treatment has had profound effects on cancer, but also on the relationships among health, science, industry, and democracy. Spanning an extraordinary seventy-year period, An Ungovernable Foe traces the ways the National Cancer Institute's dual missions, scientific developments, and organizational imperatives have shaped both politics and health. If you want to understand the ways science and democracy shape one another, you can't afford to miss this book.--Andrew J. Perrin, SNF-Agora Professor of Sociology, Johns Hopkins University

How can we inspire innovation in the public interest? An Ungovernable Foe offers a thorough history of the NCI's virus program, which played a crucial history in shaping HIV treatment and developing the HPV vaccine. At a moment of growing concern about the social impacts of the biomedical research enterprise as it is currently constituted, this book is both timely and important.--Shobita Parthasarathy, author of Patent Politics: Life Forms, Markets, and the Public Interest in the United States and Europe

From the Publisher

Breaks new ground in the sociological understanding of how scientists working in the public interest, manage, shape, and govern the complexities of the social, political, and economic environments, to meet their mandate to improve the nation’s health and well-being.

Social Forces

An Ungovernable Foe is essential reading for scholars studying translational research and public-private partnerships. Aviles makes a compelling case that we should not be too quick to label these organizational forms as neoliberal or to dismiss government scientists as unimaginative. Through her meticulous study of the National Cancer Institute, she shows that federal agencies are an underappreciated site of both scientific and bureaucratic innovation.

Nicole C. Nelson

The U.S. government's long-term investment in cancer research and treatment has had profound effects on cancer, but also on the relationships among health, science, industry, and democracy. Spanning an extraordinary seventy-year period, An Ungovernable Foe traces the ways the National Cancer Institute's dual missions, scientific developments, and organizational imperatives have shaped both politics and health. If you want to understand the ways science and democracy shape one another, you can't afford to miss this book.

Andrew J. Perrin

A valuable contribution to the sociology of Big Science in medicine, a revision to the standard stories of the institutions and limitations of government science, and a fresh approach to the study of innovation and biomedical discovery.

Contemporary Sociology

In this comprehensive book, Natalie Aviles takes us deep inside the National Cancer Institute, tracing how a federal agency has orchestrated the evolving mission to treat a much-feared disease over seven decades. Sure to become a classic in the study of government-sponsored science, An Ungovernable Foe tells the surprising story of how scientific innovation as well as failure emerge from the inner workings of the federal bureaucratic machine.

Steven Epstein