Yoshioka AY (1998). Streptomycin, 1946: British central administration of supplies of a new drug of American origin with special reference to clinical trials in tuberculosis. Philosophy Thesis, University of London.
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© Alan Y Yoshioka, Email: ay1@aysedit.com


Cite as: Yoshioka AY (1998). Streptomycin, 1946: British central administration of supplies of a new drug of American origin with special reference to clinical trials in tuberculosis. Philosophy Thesis, University of London. JLL Bulletin: Commentaries on the history of treatment evaluation (https://www.jameslindlibrary.org/articles/streptomycin-1946-british-central-administration-of-supplies-of-a-new-drug-of-american-origin-with-special-reference-to-clinical-trials-in-tuberculosis-philosophy-thesis-university-of-london/)


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Abstract

This thesis is the first detailed and integrated account of the introduction of the antibiotic drug streptomycin to Britain shortly after the Second World War. Based largely on archives of the Medical Research Council (MRC) and other Departments, it describes how the central government handled imports, production, distribution and clinical research. It provides an alternative to a literature focusing narrowly on the research methods used in the MRC’s clinical trials.

Streptomycin, isolated in the USA in 1943, was developed commercially under government control, following the model of penicillin. Laboratory results suggested that streptomycin was potentially useful in treatment of several diseases, including tuberculosis, which was then a major public health problem in many countries. The Ministry of Health anticipated a surge of public demand for this drug, that was then extremely expensive in its country of origin and not yet available in the UK, while there was still little sound evidence of its effect in human disease. The Ministry of Supply agreed to allow industrial firms to develop facilities to produce enough streptomycin for the MRC to ascertain its clinical value; however, domestic production was continually delayed. Following months of frustration of British attempts to procure even small quantities of streptomycin from the USA, finally, in November 1946, American export control authorities released a huge quota of the drug at a cost of £80,000. The Treasury approved the purchase, which was earmarked for research.

Drawing attention to the management of material resources through selective framing of knowledge, this thesis provides a portrait of the work of technical experts within a bureaucratic system, and [in an argument refined subsequently¹] it reveals how the shortage of streptomycin shaped the existence and form of an important research programme.

¹. Yoshioka A, Use of randomisation in the Medical Research Council’s clinical trial of streptomycin in pulmonary tuberculosis in the 1940s. BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7167.1220