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CODESRIA has just published its Bulletin on RCTs.
This is the beginning of pan-African and South-South conversations on the role of RCTs in the South. Whether we critique or defend, this is our conversation, on our own terms. A short thread. https://twitter.com/CODESRIA/status/1293226095626596358
This is the beginning of pan-African and South-South conversations on the role of RCTs in the South. Whether we critique or defend, this is our conversation, on our own terms. A short thread. https://twitter.com/CODESRIA/status/1293226095626596358
1. These conversations were already happening in social media and small workshops. But to the best of my knowledge, not a single major journal has devoted space to southern dialogue on the issue. The Bulletin is the first space to do so. Thank you @CODESRIA 
2. In my experience, when southern intellectuals critique the randomistas' intellectual project, we are accused of being uncivil, disinvited from events and blocked online. Legitimate critique is either ignored or vilified as uncouth.This is why fora for South-South debate is NB.
3. What is the content of our critiques thus far? I think it's still developing, but this issue of the Bulletin sets our four important areas of enquiry:
4. First, RCTs are part of an intellectual history - both of development, but also of policymaking. As I read it, @gchelwa's elegant essay sets us this challenge: how do we understand this intellectual history and how do we position ourselves in this history going forward?
5. Second, there are serious problems with the epistemic character of RCTs - not only in terms of external validity but also in terms of the undue role that RCTs play in policy. @peripheralecon has worked for years documenting the inconsistencies and pitfalls of such arrogance.
(One of the things I particularly appreciate about this thoughtful and nuanced essay is that it discusses the damage done by experiments conducted in South Africa - usually Kenya and India are seen as the epicentre of RCTs, so this discussion broadens the debate)
6. Third, there are serious ethical-political issues with RCTs. The evidence leads me to believe that the design of many RCTs make informed consent unlikely. This is not just an ethical problem, it's a political problem because it violates the tenets of democratic social policy.
7. Fourth, in virtue of the apparent nonconsensual nature of many RCTs, it is important to understand resistance to RCTs. This is exactly the task that @MarionOuma takes up, when she examines people's resistance to random cash transfers as part of the GiveDirectly experiment
8. This piece is exceptionally important for what it tells us about local resistance to an RCT that is touted by US economists as revolutionary. It speaks to the ways in which it may have undermined rather than strengthened social policy,& the social compact upon which it relies
9. Rosaine Yegbemey offers the perspective of an RCT practitioner (a climate info RCT in Benin).What stands out for me is the humility with which he writes & the ways in which the humanity of participants is foregrounded. It's an example of doing research with others, not on them
10. For an extended and very thoughtful discussion of how the contributions fit together, the introduction by @GodwinMurunga is a must read. This is one of my favourite parts of the introduction - it's a really rich and generative insight.
11. Taken together, I think the Bulletin raises three new and important areas of enquiry into RCTs: their intellectual history vis-a-vis development, the research-policy nexus in terms of its epistemic and its political dimensions, and people's resistance to RCTs.
12. I think we in the South also have a responsibility to resist unethical experimentation on our peoples. And this means we need to find out more about how to ensure more effective governance, which means that we need to learn from the experiences of public health scholars.
13. This is just the beginning of the conversation. A subsequent issue of the Bulletin will publish further essays on RCTs, including some from African public health scholars on medical experimentation, which I'm especially excited to read.
