Springer Science and Business Media LLC

This article examines ‘the NIDA paradigm’, the theory that addiction is a chronic, relapsing brain disease characterized by loss of control over drug taking. I critically review the official history of the National Institute on Drug Abuse (NIDA) paradigm and analyze the sources of resistance to it. I argue that, even though the theory remains contested, it has yielded important insights in other fields, including my own discipline of history.

This paper traces the history of the concept of metabolic disorder in global health and its application to the collection of health metrics relating to the ‘epidemic’ of non-communicable diseases in Southern Africa, with a focus on Malawi. Although the contemporary science of metabolism points to complexity and contingency, the application of a simplified version of ‘metabolic disorder’ or ‘metabolic syndrome’ as the supposed central driver of non-communicable disease in low- and middle-income countries runs the risk of obscuring the ways in which local circumstances and histories interact with global forces to produce epidemiological change. The paper discusses health data collection and its interpretation in Malawi to demonstrate how the use of this concept has led to a narrowing of the category of non-communicable disease and a neglect of the role of infectious disease in producing chronic conditions. Finally, the paper points to alternative approaches which might yield a better understanding of pressing health problems.

The accidental discovery of smallpox vials at the National Institutes of Health earlier this year quickly attracted the attention of the health and security communities. Smallpox was officially eradicated decades ago, and is only supposed to exist in two carefully guarded labs – and the National Institutes of Health isn’t one of them! This interview focuses on a biotech company that has spent the last 10 years developing a vaccine against what has so far been a non-existent disease. It discusses possible avenues for the re-emergence of smallpox, including the impact of developments in synthetic biology, and it gives an inside view on the biodefence industry and its unusual business model.