Ethnography of a Socialist Innovation: Sociological Collaboration and Power Relations in Cuban Biomedicine

The Cuban biotechnology industry is considered by the government as a ‘socialist enterprise of high technology’. This sector is guided by a double state mandate: improving the national health system and contributing to the country’s economic development. Drawing on my Ph.D. fieldwork in Cuba between 2014 and 2017 about a clinical trial aiming to integrate locally developed cancer immunotherapies within primary care, I discuss three moments in accessing my fieldwork. (1) Biomedical diplomacy, or the need to commit to the revolutionary project of making health and medicine sources of political legitimacy in Cuba and abroad. (2) Sociological collaboration, which corresponds to a joint epistemic work with local biomedical researchers. (3) Studying socialism up and down, which means the need to understand the power relations between institutions, professions, and people including grasping the contrasting experiences of less visible and recognized people involved in cancer biomedicine. These three forms of engagement with Cuban socialist biomedicine do not correspond to specific moments, but are actually three intertwined dimensions. Overall, I argue that my own evolving positionality is reflecting the dominant power of the domestic biotechnology industry to regulate innovation in oncology, while also highlighting pervasive professional jurisdictions and informal practices blurring the difference between the personal and the institutional.