Exploring the Political Dynamics of Knowledge Integration

Introduction Scientific breakthroughs, the most publicized in recent years being the sequencing of the human genome, have spawned the development of numerous 'new' developing fields of science within the broad domain of genetics in areas such as bioinformatics, genomics, pharmacogenetics etc. In order for the results of the genome project to be translated into biomedical innovation however, demands a high degree of interactivity among the various institutional actors involved (e.g. academics, clinicians, policy makers, industrialists). In practice, this high level of interactivity is typically not occurring and the development of biomedical innovations is being hindered 1. This is evidenced in the pharmaceutical industry by the fact that, after five successive years of decline, 2003 saw just 26 New Molecular Entities (NMEs) launched on the world market. This is fewer than any time in the last 20 years. NMEs are novel, often radical medicines not previously available for therapeutic use (e.g. cancer vaccines) and as such, the number of NMEs brought to market is a key indicator of pharmaceutical industry innovation. In addition, drug development time has also increased to an all time high of 12 years and costs increased to $50.3 billion in 2003 representing a 5.3% increase over the last 5 years 2. It has already been recognized that failures to develop biomedical innovation often occur because breakthroughs are potentially 'competency destroying' 3 and therefore highly disruptive 4. New developments made possible by breakthroughs in science do not tend to align well, with existing powerful professional communities 4 5. It is, therefore, not simply the scientific breakthrough – the creation of new knowledge-that generate biomedical innovation but, rather, the ability to successfully integrate knowledge arising from new fields of science associated with that breakthrough-with existing knowledge across a network of powerful professional communities and organizations 6. In this paper, a UK policy initiative explicitly designed and implemented in order to facilitate the translation of scientific breakthroughs in genetics into new medical treatments is examined in order to analyze the degree of interactivity and political dynamics occurring across the various institutions and actors involved. In the next section the dynamics of knowledge integration and the nature of scientific collaboration are considered. An overview of some of the literature, on power and politics that is used to frame the analysis follows, drawing primarily on the 3 work of Hickson et al 7 and Hardy 8. The initiative is then presented chronologically …