War and Disease: Biomedical Research on Malaria in the Twentieth Century

Chapter 6: Trust and Transition

132 The war began to turn dramatically in favor of the Allies during 1943. The surrender of the German army at Stalingrad in February and the Allied invasion of Sicily in July were two indicators of this shift. With the postwar world clearly in their sights and the growing complexity of wartime research demanding more administration, government functionaries looked to new bureaucratic structures for the management and control of projects like the antimalarial program. They worked changes not just in scale, organization, and methods of drug development but in the values of science and the scope of government involvement in biomedicine. What did it mean for prewar values that the government became deeply involved in the management of biomedical research? Growing government bureaucracy impinged on the promises of confidentiality that NRC had made to commercial firms. It also created a drive for centralization. Personalities, egos, and values had to accommodate themselves to changing organizational parameters and new power structures. The transition from the professional ethos of NRC to the bureaucratic realm of wartime government work was not an easy one for the antimalarial program or its main NRC protagonist, William Mansfield Clark. Some of this difficulty was even visible in the official, triumphalist history of OSRD published after the war. Stewart Irvin, deputy director of OSRD, wrote, There were disadvantages to this relationship between CMR and NRC, stemming from the dual functions which the NRC committee members were required to exercise. They had been appointed by the NRC to NRC committees. Insofar as they sat around a table and formulated Trust and Transition Chapter 6 Trust and Transition 133 advice for the Surgeons General they were functioning in their capacity as members of the NRC committees. When, sitting around the same table, they recommended proposals for research to CMR, they were functioning as advisors or consultants of CMR. When they advised the Surgeons General on the basis of CMR research it would be difficult to define their capacity. This situation led to some confusion; several members of NRC committees went through the war only vaguely familiar with CMR, unaware that it paid the expenses of their meetings and incompletely aware that the ultimate responsibility and entire expense of the research program was its province. It is fair to say that this confusion was an annoyance rather than a hindrance to the success of the program and that it was minimized by general confidence in the integrity of the principals.1 Words such as “disadvantages” and “confusion” suggest that the melding of the NRC advisory committees with the CMR bureaucracy created a disjuncture between the academics and professionals (employed primarily in academic and industrial settings) on the one hand and the bureaucrats and soldiers (employed by the government) on the other. The NRC was originally founded to address the demands of the nation during a period of national crisis, emerging as it did from technological boom years of World War I.2 Yet, as Irvin suggested, NRC’s members were not accustomed to the government structures they encountered during World War II. Things only held together because of the “integrity of the principals.” Emblematic of the culture clash was a conflict between William Mans- field Clark and A. N. Richards, chairman of CMR. Although they were both academics engaged in extracurricular service, Clark’s and Richards’s contrasting roles in the antimalarial program brought Clark to a crisis of conscience over the sharing of proprietary information. This “Feud,” as Clark termed it, directly illustrates a major shift in research culture in the United States. The professional, individual—even gentlemanly—ethos of Clark and NRC offered a stark contrast to the regimented, legalistic networks of Richards and OSRD. The ascendancy of government bureaucracy was a major example of the shifting culture of R&D at large scale. Both sides of the feud bear detailed attention: though the bureaucracy largely prevailed, essential elements of Clark’s ethos survived the war. The tension remained even as the balance of power shifted. Understanding the postwar organization and funding of biomedicine requires an appreciation of this balance and how it is maintained. At stake, in a time of national emergency, were issues of 134 War and Disease centralization, growing government bureaucracy, and potential conflicts of interest between private entities and the government.3 For the antimalarial program, Clark stood firmly on the side of professional ethos over government...