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Primary source knowledge and technical decision-making: Mbeki and the AZT debate

机译：主要来源知识和技术决策：姆贝基和AZT辩论

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Demands for public participation in technical decision-making are currently high on the agenda of Science & Technology Studies. It is assumed that the democratisation of technical decision-making processes generally leads to more socially desirable and acceptable outcomes. While this may be true in certain cases, this assumption cannot be generalised. I will discuss the case of the so-called 'South African AZT debate'. The controversy started when President Thabo Mbeki, after reading some scientific papers on the toxicity of AZT, decided to bar the use of the drug in the public health sector as a means to reduce the transmission of HIV from mothers to children. While the scientific mainstream accepts the effectiveness of AZT in reducing the risk of vertical HIV transmission, a few maverick scientists reject the clinical evidence and argue that the risks of using AZT by far outweigh its benefits. Based on various textual sources and using the 'Periodic Table of Expertises' developed by Collins and Evans, Mbeki's expertise at the time of his intervention into the technical question whether AZT is a medicine or a poison can be classified as primary source knowledge. It is shown that this type of expertise is insufficient for technical decision-making. Mbeki's primary source knowledge legitimated his presentation of the claims of maverick scientists as a serious contribution to the debate—with tragic consequences for tens of thousands of babies.
机译：目前，公众参与技术决策的需求已列在科学与技术研究的议程上。假定技术决策过程的民主化通常会导致社会上更令人满意和更可接受的结果。尽管在某些情况下这可能是正确的，但该假设不能一概而论。我将讨论所谓的“南非AZT辩论”。争议始于萨博·姆贝基（Thabo Mbeki）总统在阅读了一些有关AZT毒性的科学论文后，决定禁止在公共卫生部门使用这种药物，以减少艾滋病毒从母亲向儿童的传播。尽管科学主流接受AZT在降低垂直HIV传播风险方面的有效性，但一些特立独行的科学家拒绝了临床证据，并认为使用AZT的风险远大于其益处。基于多种文字资料，并使用Collins和Evans开发的“定期专业知识表”，姆贝基在介入AZT是药物还是毒药这一技术问题时的专长可以归为主要资料来源。结果表明，这种专业知识不足以进行技术决策。姆贝基（Mbeki）的主要来源知识使他对特立独行的科学家的主张的陈述合法化，这是对辩论的严重贡献-对成千上万的婴儿造成了悲剧性后果。

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