Species of Contagion Animal To Human Transplantation in The Age of Emerging Infectious Disease Ray Carr All Chapter

Species of Contagion:
Animal-to-Human Transplantation in
the Age of Emerging Infectious Disease
Ray Carr
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HEALTH, TECHNOLOGY AND SOCIETY
Species of Contagion
Animal-to-Human Transplantation in the
Age of Emerging Infectious Disease
Ray Carr
Health, Technology and Society
Series Editors
Rebecca Lynch
Life Sciences and Medicine
King’s College London
London, UK
Martyn Pickersgill
Usher Institute
University of Edinburgh
Edinburgh, UK
Medicine, health care, and the wider social meaning and management of
health are undergoing major changes. In part this reflects developments
in science and technology, which enable new forms of diagnosis, treat-
ment and delivery of health care. It also reflects changes in the locus of
care and the social management of health. Locating technical develop-
ments in wider socio-economic and political processes, each book in the
series discusses and critiques recent developments in health technologies
in specific areas, drawing on a range of analyses provided by the social
sciences. Some have a more theoretical focus, some a more applied focus
but all draw on recent research by the authors. The series also looks
toward the medium term in anticipating the likely configurations of
health in advanced industrial society and does so comparatively, through
exploring the globalization and internationalization of health.
More information about this series at

http://link.springer.com/series/14875
Ray Carr
Species of Contagion
Animal-to-Human Transplantation
in the Age of Emerging Infectious
Disease
Ray Carr
Independent Scholar
Corrimal, NSW, Australia
Health, Technology and Society

ISBN 978-981-16-8288-9 ISBN 978-981-16-8289-6 (eBook)
https://doi.org/10.1007/978-981-16-8289-6
© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Singapore
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For Maisie
Series Editors’ Preface
Medicine, health care, and the wider social meanings and management of
health are continually in the process of change. While the “birth of the
clinic” heralded the process through which health and illness became
increasingly subject to the surveillance of medicine, for example, surveil-
lance has become more complex, sophisticated, and targeted—as seen in
the search for “precision medicine” and now “precision public health”.
Both surveillance and health itself emerge as more provisional, uncertain,
and risk-laden as a consequence, and we might also ask what now consti-
tutes “the clinic”, how meaningful a concept of a clinic ultimately is, and
where else might we now find (or not find) health care spaces and
interventions.
Ongoing developments in science and technology are helping to
enable and propel new forms of diagnosis, treatment, and the delivery of
health care. In many contexts, these innovations both reflect and further
contribute to changes in the locus of care and burden of responsibility for
health. Genetics, informatics, imaging—to name but a few—are redefin-
ing collective and individual understandings of the body, health, and dis-
ease. At the same time, long established and even ostensibly mundane
technologies and techniques can generate ripples in local discourse and
practices as ideas about the nature and focus of health care shift in
response to global debates about, for instance, One Health and
Planetary Health.
vii
viii Series Editors’ Preface
The very technologies that (re)define health are also the means through
which the individualisation of health care can occur—through, for
instance, digital health, diagnostic tests, and the commodification of
restorative tissue. This individualisation of health is both culturally
derived and state-sponsored, as exemplified by the promotion of “self-
care”. These shifts are simultaneously welcomed and contested by profes-
sionals, patients, and wider publics. Hence they at once signal and
instantiate wider societal ambivalences and divisions.
This Series explores these processes within and beyond the conven-
tional domain of “the clinic”, and asks whether they amount to a qualita-
tive shift in the social ordering and value of medicine and health. Locating
technical use and developments in wider socio-economic and political
processes, each book discusses and critiques the dynamics between health,
technology, and society through a variety of specific cases, and drawing
on a range of analyses provided by the social sciences.
The Series has already published more than 20 books that have explored
many of these issues, drawing on novel, critical, and deeply informed
research undertaken by their authors. In doing so, the books have shown
how the boundaries between the three core dimensions that underpin the
whole Series—health, technology, and society—are changing in funda-
mental ways.
In Species of Contagion, Ray Carr focuses on an area that has galvanised
debate and analysis within biomedicine, the social sciences, and popular
culture: animal-to-human transplantation. This exciting monograph
considers compelling questions around what and who counts as “self ”
and “other”, and the technoscientific production and negotiation of “nat-
uralness” and “purity”. Through Species of Contagion, Carr illustrates the
complexities of understandings of hybridity and contagion within bio-
medical regulation and industry activities, and the transformations that
can happen both because of and to contemporary practices of xenotrans-
plantation. Accordingly, this monograph provides a bold and vital analy-
sis of the reconfiguring of (the relations between) forms of capital, logics
of power, and somas across diverse biological entities.
London, UK Rebecca Lynch

Edinburgh, UK Martyn Pickersgill
Acknowledgements
I would like to express my sincere gratitude to my PhD supervisors,

Melinda Cooper, Catherine Waldby, and Dinesh Wadiwel, who were
extremely generous, nurturing, and intellectually inspiring. Without
their presence and support this book would never have happened. A spe-
cial thanks also to the many people who read parts of this book and
provided invaluable feedback and editorial advice, including Sue
Cochrane, Rebecca Pietsch, Linda Steele, Nicky Evans, Brian McLoughlin,
Sonja van Wichelen, Jane Durie, and Elizabeth Durie. My thanks to
Thom van Dooren for inspiring me to undertake this research, to Sarah
Franklin, Anna Tsing, and Donna Haraway, who I have never met but
whose works have provided a continuous source from which to rejuve-
nate my curiosity. I am grateful for the insights of anonymous reviewers
on the manuscript of this book and the article published in Animal Studies
Journal. Thank you to the editors at Palgrave in giving me this opportu-
nity, and particularly Joshua Pitt who has been incredibly patient and
positive throughout. Lastly, for their endless patience and support I want
to acknowledge my mother, Jan, co-parent Alasdair, and, most impor-
tantly, my amazing daughter Maisie.
Part of Chap. 2 of this book was previously published as: Carr,
R. (2016). “100% Pure Pigs: New Zealand and the Cultivation of Pure
ix
x Acknowledgements
Auckland Island Pigs for Xenotransplantation”. Animal Studies Journal,

5(2), 78–100.
The views expressed in this book are those of the author and are not
representative of any university or other organisation with whom the
author is, or has been, employed.
Contents
1 Introduction: Forms of Contagion 1
2 100% Pure Pigs: New Zealand and the Cultivation of Pure

Auckland Island Pigs for Xenotransplantation 39
3 Hierarchies of Valuable Life: Positioning Pigs and Primates

in UK Bioethics 79
4 Circulating Non-human Tissues: Xenotransplantation and

Security in the United States117
5 Ecological and Organismic Body Politics: The Moratorium

on Xenotransplantation in Australia159
6 Conclusion205
Index217
xi
1
Introduction: Forms of Contagion
The surgeon completes the transplant of the pig heart into the baboon …
The pig heart initially becomes a healthy pink color as the recipient’s blood
flows through it. It begins to beat. But, after as little as two minutes, the
surgeon watches as it becomes a mottled, dusky blue color, and the con-
tractions become weak and irregular. Blood ceases to flow through the
organ as the small capillaries in the heart muscle become occluded by clots.
The blood vessels rupture, and the heart rapidly swells due to the leakage of
blood and fluid into the muscle wall. The heart stops beating. It is now an
ugly black mass. (D. K. C. Cooper and Lanza 2000, 55)
Within understandings of biomedicine, the immune system manifests

the bodily response to hybridity and contagion. In the above quote,
researchers describe the immunological rejection of a pig organ trans-
planted across species into a baboon. Organs transplanted across species
quickly turn black and die as the immune system responds to the newly
introduced tissues.1 In Frank Macfarlane Burnet’s paradigmatic work on
immunology, the self/non-self distinction explains this reaction: the body
rejects the organ because it is “not self ”.2 In this perspective, the body
responds to “otherness” by attacking or rejecting it, whereas “self ” is
allowed to live, is “tolerated”. The biomedical representation of the
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022 1
R. Carr, Species of Contagion, Health, Technology and Society,
https://doi.org/10.1007/978-981-16-8289-6_1
2 R. Carr
immune system as a mechanism that divides self from non-self recalls the
sovereign division between friend and enemy (Schmitt 2007). However,
contemporary immunology offers more than one understanding of
immune function, and accordingly different accounts of how the body
treats the presence of other species, whether in the form of microbes or
transplants. Immunological theories sometimes render immune system
activities as maintaining balance within cellular networks or as adaptive
systems. Even Burnet’s paradigmatic explanation of the immunological-
self had ecological aspects (Anderson and Mackay 2014).3 More strik-
ingly, in the 1970s, Niels Jerne’s “idiotypic network theory” proposed
that a destructive immune reaction is prompted by a disturbance in the
interactions within a network of immune cells, rather than being caused
by a transgression of the self/other boundary. Immunologist Klaus
Rajewsky explains that for Jerne “the antibody response is just an adapta-
tion to a new equilibrium” (Eichmann 2008, 162). Polly Matzinger’s
(2001) “danger theory” goes further in postulating that the immune sys-
tem responds to cellular signals of stress and injury, as “a flexible system
that adapts to a changing self ” (8). While these theories remain at the
fringes of immunology, medical historian Alfred Tauber (2000) argues
that most contemporary immunologists understand destructive immune
system responses as occurring within a network of cellular and molecular
interactions, dependent on context.4 Nevertheless, many theorists remain
attached to the concept of the immunological self (Tauber 2000).
Xenotransplantation can be thought of as a hybrid technology. It aims
to take live tissues from other animals and incorporate them into the
human body, co-opting the biological functions of other animals to sup-
plement human biology. Transplants can involve non-human animal
cells, tissues, or organs.5 Human clinical trials of cellular transplants have
been performed in several countries, using pig cells, in an attempt to treat
diabetes and Parkinson’s disease (LCT n.d.; Valdes-Gonzalez et al. 2005).
One company in New Zealand, Living Cell Technologies (LCT)/Diatranz
Otsuka, already secured government approval to commercialise its cellu-
lar xenotransplantation product for diabetes in Russia (LCT 2010).6
Other companies are attempting to develop technologies for transplant-
ing pig organs into humans; however, this is far more difficult because of
the radical immunological rejection of non-human organs, and these
experimental pig transplants are yet to succeed for any length of time in
non-human experimental subjects (usually baboons). To reduce the risk
of immune system rejection, some researchers are genetically altering pig
source animals to make them “more human”. In more than one way,
then, xenotransplantation technologies blur the biological boundaries
between humans and other animals (Brown 1999; P. S. Cook and
Osbaldiston 2010; Marie Fox 2005; Sharp 2013).7
Concern over the interplay between the self and other manifests in an
intriguing problematic in xenotransplantation. On the one hand, the
radical immunological rejection of tissues from other species presents an
obstacle to transplantation. And on the other hand, from a regulatory
point of view, the possibility that infectious disease might be spread by
the practice of xenotransplantation poses significant problems. The
extraordinarily intimate contact between live human and non-human
animal flesh opens the individual, and potentially, entire human popula-
tions, to novel viruses and other microbes lying latent in transplant tis-
sues. It is possible that a virus or other microbe might be transferred,
along with the transplant, into the human recipient, and onward from
there into the human population. (This kind of transmission of an animal
virus into the human population is called zoonosis, while the term xenozo-
onosis denotes this same process happening through xenotransplanta-
tion.) Infectious disease experts have warned that the technologies used
to overcome immune rejection, such as genetic engineering and immu-
nosuppression, could even facilitate a microbe adapting to better infect
the human population. Diminishing the boundaries between self and
other is thus posed as a public health risk as well as a potentially lifesaving
technology.
How is the immune system response to non-human tissues under-
stood in the xenotransplantation industry?8 Above I quoted xenotrans-
plantation researchers David Cooper and Robert Paul Lanza (2000),
describing the rejection of a xenograft. They continue by explaining the
baboon’s extraordinary immune response to transplanted pig tissues as
follows:
The surgeon has witnessed the most powerful immunological reaction that
the human body can mount, a response initially developed millions of
4 R. Carr
years ago in primitive animal species as a defense against invading micro-

organisms, largely bacteria and viruses. This innate response has become
the reflex reaction to the foreign threat. (p. 55)
Similarly, Bob Elliot, at the time CEO of Living Cell Technologies

(LCT), and immunologist Christopher Thanos describe immune rejec-
tion of xenografts as a “coordinated attack on the foreign tissue marked by
cell-mediated pathways” (Thanos and Elliott 2009, 31). Within the
xenotransplantation research community, then, the metaphor of self and
other maintains its central position, at least on the surface. However, the
practical approaches being adopted to regulate or avoid immune reaction
reveal more complex understandings of the immune system. Here I
briefly outline two different approaches being taken by researchers in the
field, which illustrate two different forms of power, articulated at the cel-
lular scale.
The transplantation medical field has succeeded in working around
rejection in human-to-human transplantation with the aid of immuno-
suppressant drugs, and by finding a suitably matched donor. However,
immunosuppression alone is not enough to inhibit the rejection in pig-
to-human (or pig-to-non-human-primate) transplants, and many
researchers have assumed that genetic engineering will play a role in
enabling xenotransplantation. However, the New Zealand company
Living Cell Technologies has adopted an alternative approach to the
problem that does not involve either of these techniques, instead using
seaweed to create a barrier that prevents contact between the “donor” pig
cells and the human immune cells. Before being implanted in the human
body, LCT’s technicians coat the cells in an alginate substance derived
from seaweed. The alginate surface is structured with small holes that,
once the pig cells are transplanted, allow oxygen and nutrients from the
recipient blood to sustain the cells and enable the cells to perform their
therapeutic function (such as releasing insulin). However, the openings
in this porous surface are not large enough for human antibodies (immune
cells) to penetrate and interact with the pig cells. The seaweed forms a
“biocompatible barrier”: unlike pig cells, the human immune system
only mounts a mild rejection response to the alginate (Living Cells
Technologies 2007, 25). In keeping with the theme of purity employed
by LCT to market their xenotransplantation products (see Chap. 2), the

alginate is “ultrapure” (Elliot 2009). LCT nevertheless expects the algi-
nate encapsulation to break down over time, and that the human immune
system, which remains fully active, will subsequently destroy the pig cells.
When this occurs, the patient will simply receive another transplant
of cells.
While the seaweed membrane surrounding the transplanted pig cells
does not quite constitute a hermetically sealed enclosure, as far as the
immune system is concerned, it is a complete barrier between self and
other. The encapsulation creates a tiny, enclosed sanctuary (an island)
inside the human body so that the pig cells can augment human biologi-
cal functioning and yet remain isolated. With this method, there is no
need for the bodily response to “otherness” to be altered or suppressed;
the “other” is merely contained, temporarily, within the sanctuary. As I
discuss in Chap. 4, experts anticipate that suppressing the recipient’s
immune system, or otherwise altering the immune response may in fact
exacerbate risks of new disease emerging through xenotransplantation.
Accordingly, LCT sells “[t]he maintenance of an intact immune system”
as “an important safety factor” (Thanos and Elliott 2009, 398), because
“[a] suppressed immune system, with lower surveillance of foreign anti-
gens, can provide an opportunity for infection” (Thanos and Elliott 2009,
399). From the perspective of the immunological self, this approach
maintains the integrity of the self/non-self distinction.
The US-based biotechnology company United Therapeutics, with a
proposed high-tech breeding facility for producing “XenoLung” pig
transplants, takes a more liberal approach to the immunological self.
CEO Martine Rothblatt wishes to develop technologies in two direc-
tions: “[t]aking full advantage of the wonderful new tools of transgenetic
modifications and cloning”; and “[e]mbracing, not fearing, some level of
biochemical incompatibility via using pre-treatment regimens to engen-
der immunological chimerism” (Rothblatt 2012, 387). In her recom-
mendation that we should embrace “incompatibility”, Rothblatt
advocates adopting hybridity as a modus operandi. In particular, she
planned to use biomedical techniques to adapt the human immune sys-
tem so that it becomes a hybrid human-pig system, producing “immuno-
logical chimerism”. The aim here is to reprogram the immune system so
6 R. Carr
that it does not “attack” transplanted tissues, also called “inducing toler-
ance”. The term “tolerance” usually refers to the immune system’s lack of
reactivity to the organism’s own cells; techniques for inducing tolerance
aim to transfer the immunity from one’s immune system onto donor tis-
sues as well.
A team of researchers based at Harvard Medical School, led by immu-
nologist David Sachs, has been exploring methods of inducing tolerance
in both human-to-human transplantation and animal-to-human trans-
plantation. Sachs (2011) defines tolerance as “the specific absence of a
destructive immune response to a transplanted tissue in the absence of
immunosuppression” (p. 501). The lack of a damaging reaction does not
mean that the immune system does not respond at all, as is often pre-
sumed under the self/non-self model. The immune system does respond
to “tolerated” tissues, but it is not strictly destructive; from this perspec-
tive, the immune system is capable of positive reactions as well as damag-
ing ones:
Until recently, immunologic tolerance was thought to imply the specific

absence of an immune response. However, it has now become clear that, at
least in the field of transplantation, tolerance can also be brought about by
a positive immunologic response of a regulatory nature. (Sachs 2011, 501)
Sachs suggests that healthy bodies require an ongoing positive action

from the immune system. Although most components of an individual’s
immune system that respond negatively to “self ” are eliminated in the
thymus (as Burnet’s clonal selection theory suggests), all bodies typically
still retain some self-destructive cells. As these self-destructive antibodies
circulate, they sometimes react negatively to the organism’s own cells.
However, this response is “downregulated” by other components of the
immune system. If a self-antibody begins to aggressively respond to the
body’s own cells, other immune cells come into action, responding “posi-
tively” with a protective function and calming the destructive instinct. In
short, the immune system, in this understanding, can modulate its own
interactions, within the community of cells, and according to the context.
The team at Harvard have been exploring two ways to induce tolerance
in transplant recipients (Sachs et al. 2009). One is to transplant
hematopoietic stem cells (HSCs), usually using bone marrow or periph-

eral blood progenitor cells (PBPCs), from the donor into the recipient.
Stem cells produce the cells of the body, including immune cells, and,
after being transplanted into the recipient, they continue to produce
immune system cells of the donor species, creating a mixed donor-recipi-
ent immune system.9 The second method deploys the skills of the thymus
to eliminate (most) self-reacting immune system cells. In this approach
donor thymus tissue is transplanted into the recipient, and in theory it
will drain out those immune system cells that are reactive to pigs tissues,
coaxing the body to “regard porcine antigens displayed in the donor thy-
mus as self ” (Griesemer et al. 2014, 9). Put very simply, in the first pro-
cess the human recipient body would be populated with immune cells
from the source pig, producing a hybrid repertoire of immune cells. In
this second procedure, the pig-reactive components would be removed
from the human immune system so that it treats pig tissues as “self ”. To
achieve a viable pig-to-human organ transplantation, both strategies are
likely to be used together.10
The team at Harvard University has had some success in these tech-
niques with human-human transplants using donors with a mismatched
HLA (human leukocyte antigen) (Kawai et al. 2008); the recipient would
usually reject these mismatched transplants. Sachs’ team have achieved
tolerance by transplanting donor bone marrow along with a kidney trans-
plant, with the result that the recipient body did not destroy the allograft
even without immunosuppression. Interestingly, however, while the
recipient initially showed signs of mixed donor-recipient immune cells,
this disappeared over time, and the body achieved tolerance by another
mechanism. That is, in experiments to date, the donor immune system
cells, transplanted only to induce tolerance, did not survive very long in
the recipient body, but seem to have catalysed other forms of tolerance in
the recipient—these remain “mystifying” (Wilkinson 2009). What is
clear is that when these techniques were deployed, the recipient immune
system adapted its responses so that it no longer rejected donor tissues,
even after chimerism disappeared and without immunosuppression. In
the language of immunological selfhood, the recipient immune system
altered its categorisation of self to include the donor.
8 R. Carr
The Harvard University researchers have been able to persuade a mouse

body to become tolerant to a pig transplant, so that it no longer reacted
destructively to it (Sachs et al. 2009). This success is yet to be replicated
with cross-species transplants into non-human primates. The experiments
with small animals, however, have convinced the scientists involved that
the technology could theoretically work with cross-species transplants in
humans. With pig-to-baboon transplants, the team have only been able
to produce a chimeric immune system very temporarily in the recipient
baboon, and this has not supported the acceptance of a pig tissue trans-
plant. Not yet at least. Sachs’ team, like United Therapeutics, expect that
a number of genetic-engineering techniques, combined with these
tolerance-inducing mechanisms, will be required to enable pig-to-non-
human-primate, and subsequently pig-to-human, organ xenotransplan-
tation.11 If successful, this approach would entail modifying the human
immunological system to incorporate pig tissues as “self ”. Indeed, the
immunological tolerance achieved by human recipients of mismatched
HLA transplants seems to point to a capacity for the immune system to
re-adjust its own sense of “self ”, or its own reactivity.12 Sachs’ hypothesis
is that this involves the “peripheral” regulatory elements of the immune
system, which “downgrade”, or counter, its own reactions.
Two imperatives reveal themselves in these two examples: one is to
represent the body as a unitary entity with integrity (a biological self ) and
one is to imagine the body as adaptive or self-adjusting. Donna Haraway
(1991) proposes that in biomedicine “the immune system is a plan for
meaningful action to construct and maintain the boundaries for what
may count as self and other in the crucial realms of the normal and the
pathological” (p. 204). In the two approaches to xenotransplantation I
have discussed, who and what counts as self and other?
LCT’s approach operates within form of power that Foucault identi-
fies as sovereignty. It tries to prevent dangerous interactions and asserts
the importance of an immunological division between self and other. As
I discuss in Chap. 2, LCT markets its products along with a narrative
that affirms distinct boundaries between the categories of human and
animal, representing their source pigs as natural and microbiologically
pristine because they have been historically isolated from
contaminations. Within this context, LCT’s marketing materials also

express an imperative to affirm and maintain a sense of biological sover-
eignty, the boundaries of the self. The encapsulation technology resonates
with LCT’s marketing strategy, leveraging off NZ tourism’s 100% Pure
narrative, at the biological level as neither humans nor pigs have their
biological integrity compromised. In keeping with the narrative, pig
source animals remain “natural” and non-genetically modified. And,
immunologically, human identity is kept intact. Despite the fact that the
human body sustains the pig cells, the components of each species also
appear to be separated and maintain their distinct difference. In short,
these mechanisms seem to re-impose a duality over and against the
hybridity of xenotransplantation.
Whereas LCT’s researchers intimated that it is dangerous to under-
mine the bodily capacity to destroy that which is “foreign”, tolerance
induction deliberately reprograms the body’s destructive responses to
new components. Even though Sachs and his team use the terms “self ”
and “foreign”, it is clear that, for them, immunological response is con-
textual and adaptable; the immune system can counter its own reactivity
and regulate its treatment of antigens. Practically, these technologies treat
the immune system as a contingent process of managing dangers to the
body through regulation; this renders the immune system as a form of
biological governmentality. The body is being secured, with a system that
regulates the presence of cells in the body depending on the circum-
stances, rather than protecting itself at the border from that which is
definitively non-self.13
LCT’s technologies seek to ensure that the self remains pure, natural,
and human. United Therapeutics’ strategy embraces difference, and the
immune system is modified to incorporate the donor pig as self. In order
to strive for a more livable world for humans and other animals we need
to understand how these differing mechanisms of power meld, antago-
nise, and interact with each other, and how these interconnections shape
our relationships with others.
In this book, I examine regulatory and industry understandings of
hybridity and contagion in the xenotransplantation field to demonstrate
that both sovereignty and security operate dynamically in regulating the
10 R. Carr
transplantation of non-human animal tissues into humans. I use xeno-

transplantation as a lens to explore power mechanisms as they address
borders and interconnections between bodies, species, and nations, and
to demonstrate the entwined histories of infectious disease management,
immigration, and economies.
As experimental xenotransplantation research progresses into human
clinical trials in research-intensive countries, governments have moved to
regulate these technologies. Current government regulation responds to
the public health issue, highlighted by infectious disease specialists, of a
novel human disease emerging via xenotransplantation recipients. In
responding to the potential contagious effects of xenotransplantation,
government bodies and industry practices position humans and non-
human animals in relation to one another. Their responses speak to the
meaning of hybridity in the social and political contexts in which research
and regulation take place.
Yet, in the field of xenotransplantation, contagion and cross-species
exchanges have been dealt with in surprisingly different ways in various
contexts (Beynon-Jones and Brown 2011; Cheng 2015a; Rémy 2009;
Tallacchini 2011). While fear of a new disease emerging through xeno-
transplantation practices is widespread, how this threat is understood and
managed has varied depending on the country and the species in ques-
tion. As I will show, apes, baboons, and other monkeys, and pigs, have
been treated very differently, and there are divergences between the forms
of regulation and practice adopted in New Zealand, the United States,
the UK, and Australia (the countries I have chosen to examine in
this book).
Xenotransplantation emerged as a public health issue during the
1990s. Prior to this period, surgeons had long experimented with trans-
plants from various kinds of non-human animals, beginning as early as
the sixteenth century and spanning Europe, the Middle East, Asia, South
Africa, and the United States (Deschamps et al. 2005). In the early twen-
tieth century such experiments became almost “common place”, particu-
larly in France where the much-ridiculed Serge Voronoff transplanted
thousands of patients with testicular tissue from baboons and chimpan-
zees (Rémy 2009). Modern xenotransplantation developed during the
1960s (Boneva et al. 2001), in the United States and Europe, with the
advent of immunosuppressant drugs designed for human-to-human

transplantation (allotransplantation), and along with significant successes
in allotransplantation. In the 1960s Keith Reemsta, for example, trans-
planted kidneys from chimpanzees to human recipients in the United
States. During the 1980s, a failed experimental attempt to transplant a
heart from a baboon into a baby (“Baby Fae”), in the United States, was
highly publicised, and briefly derailed research. The public, researchers,
and animal activists criticised the researchers for their treatment of non-
human animals and the lack of appropriate ethical processes regarding
recipient risk and consent (Rémy 2009). Following this failure, during
1980s, the research community restricted itself temporarily from further
experiments (Deschamps et al. 2005; Rémy 2009; Sharp 2013).14 The
UK government had also initiated a moratorium during the 1980s, until
1992, following the Baby Fae case (Haddow et al. 2010) catalysed by
ethical concerns rather than infectious disease issues.
The 1990s saw research reinvigorated, however, as the development of
genetic engineering techniques promised a new solution to immunologi-
cal obstacles and opened further avenues of research. The 1990s also
introduced new foci in xenotransplantation research—pigs as a tissue
source, cellular technologies, and the problem of xenozoonosis. Longer-
standing concerns for human recipient and non-human animal welfare
have also remained, feeding into the contemporary regulatory landscape,
particularly in the UK, as I discuss in Chap. 3. It is significant that during
the more recent phase of regulatory development, non-human primates
have been almost entirely excluded from research, as tissue sources, on
the basis of ethical and infectious disease issues (see Chaps. 3 and 4). The
1990s ushered in a new period of government regulation of xenotrans-
plantation framed dominantly around biological security concerns. As I
discuss at length in Chap. 5, recent experiences with HIV and new per-
spectives on emerging infectious disease facilitated a reframing of xeno-
transplantation technologies as a risk to the human population at large
(Weiss 1999).15
Framing xenotransplantation as a public health issue shaped the regu-
latory landscape as it shifted concern from individual welfare (non-
human source animals and human experimental subjects for instance) to
population health and security.16 This new stance on xenotransplantation
12 R. Carr
connected the regulation of xenotransplantation to questions of global

and interspecies interconnectedness; the science of viral emergence and
environmental change; and strategies of emergency preparedness and
pre-emption. It enabled a discursive (including administrative) co-
production of bodily, species, and national boundaries.
Regulating bodies in Europe, the UK, New Zealand, and Australia have
now set guidelines for those applying to perform clinical trials in xeno-
transplantation, which closely follow the models set by the US FDA and
European Union. In these countries, applications for clinical trials are
expected to be reviewed by both local research ethics committees and a
national body for medicines regulation, such as the FDA.17 These agency
guidelines typically approach the risk to population health by focusing on
researcher requirements to: (i) raise microbiologically protected source
animals; (ii) conduct ongoing biological monitoring and surveillance of
recipients and source animals; (iii) advise recipients on behaviour manage-
ment. As I discuss in Chap. 5 the regulation of xenotransplantation here
draws from the public health approach to HIV/AIDS with a particular
focus on possible spread of disease via blood or sexual fluids.
Social and legal scholars have analysed the regulatory development on
xenotransplantation research in several countries, and compared jurisdic-
tions.18 Globally, the trend in xenotransplantation government regula-
tion from the late 1990s has been for governments to move from stringent
requirements and monitoring to more flexible regulation.19 In the UK
and the United States, for example, national regulatory oversight has sub-
sequently given way to local management. However, the timing and
meaning of this trajectory are not the same across countries. Tallacchini
(2011) for example, has argued that the relaxation of oversight in Canada
corresponds to a normalisation of xenotransplantation technologies,
compelled partly by the transition of research to transplanting cells
instead of organs. In contrast, Beynon-Jones and Brown (2011) argue
that in the UK government oversight diminished as the industry failed to
progress towards the clinical trials they had promised.
Several countries (including the UK, New Zealand, Sweden, Germany,
and Australia), and global organisations such as the Council of Europe,
initiated a temporary moratorium on xenotransplantation in response to
disease concerns. The moratorium in Australia was later and longer than
some others, beginning in 2003 and stretching to 2009;20 in contrast, by

2003 the Council of Europe had lifted their moratorium and published
guidelines for research. The US FDA, alternatively, only placed xeno-
transplantation clinical trials on hold, without a moratorium, and specifi-
cally for the purpose of developing guidelines which would enable
research to continue (Schuurman 2015).21 I read these differences in
regulatory experiences across countries as expressions of two different
forms of power and corresponding understandings of contagion; follow-
ing Foucault, I refer to these as sovereignty and security.
Sovereignty operates in a fundamentally negative way, through legal-
juridical mechanisms. Legal mechanisms divide the prohibited from the
permitted and punish transgressions (Foucault 2007, 46). In sovereign
regimes of power, political control works by organising the world into
clean categories and policing the boundaries between them. In the lecture
series Abnormal (2003), Foucault provides a telling example of how sov-
ereign regimes of power understand and relate to contagion. When con-
fronted with the problem of leprosy during the Middle Ages, the sovereign
responded by separating out those who were infected and preventing all
contact with the community. People with leprosy were cast out of the
town walls, often along with a funeral rite, and designated as dead to the
community. Here Foucault (2003) highlights the way in which conta-
gion is dealt with through a negative and prohibitive process of spatial
separation, remarking that “the individual [is] driven out in order to
purify the community” (p. 44).22
Mary Douglas famously proposed that fears of pollution only arise in
societies that have a strong social order and structures of symbolic catego-
rization; pollution is associated with that which resists categorisation
within the dominant social order, that which strays beyond the divides
structuring society. Whether such fears of pollution are informed by
understandings of pathogens and microbes, as in contemporary society,
or by social taboos or religious edicts, an underlying social system must
be in place. As Catherine Waldby (1996, 68) argues, “the biomedical
concept of infectious contagion is in a sense a subset of this abjected con-
tagion”. The occurrence of infectious disease, within a particular sover-
eigntist understanding of bodies and social systems, is frequently
identified with boundary crossing, transgression, and fear of loss of
14 R. Carr
identity (Shildrick 2000). While disease itself is often experienced as

abject, vulnerable social identities or perceived invasive threats can serve
to exacerbate fears of medical infection.23 For instance, the source of
infectious disease is often attributed to marginalised or abject social iden-
tities (such as immigrants, sex workers, people who are homeless, and
homosexual men) who are targeted for intervention (Craddock 2000;
Shildrick 2000; Wald 2008; Waldby 1996).24
Animal studies scholars and philosophers have argued that the con-
struction of “the human” is dependent on the othering or suppression of
“the animal” (Agamben 2004; Derrida and Wills 2002; Oliver 2010;
Wolfe 2003).25 In particular, the juridical-legal concept of human rights
implicitly relies on the human/animal binary and the exclusion of non-
humans from the community of equals.26 Derrida diagnoses this rights
discourse as the “philosophical and juridical machine thanks to which the
exploitation of animal material for food, work, experimentation, etc., has
been practiced” (Derrida and Roudinesco 2004, 65).27 And indeed,
scholars have argued that the same mechanism also structures violence
perpetrated against humans who are often represented as “animal”
(Agamben 2004; Wolfe 2003). Undoubtedly, a range of other social-
political discourses construct the animal as constitutive other to the
human; “the animal”, Cary Wolfe suggests, lies at the “very heart of the
constitutive disavowals and self-constructing narratives enacted by that
fantasy figure called ‘the human’ ” (p. 6).
The foundational role of the human/animal binary in human society
and politics prompts Mary Murray to suggest that concerns about xeno-
zoonosis indicate the precariousness of this critical distinction in xeno-
transplantation technologies:
The perceived transgression of boundaries implied in animal to human

organ transplantation and attendant fears of zoonosis can activate anxieties
that we may be making animals of ourselves and creating beastly species of
Frankenstein-type monsters … these kinds of questions … connect to our
sense of ontological security, a security partly founded upon the assump-
tion that there is a fundamental difference between humans and other ani-
mals. (Murray 2006, 51)
As Brown (1999) states, xenotransplantation technologies “merge and

confuse” (p. 327) the distinctions between human and animal and also
between science and culture.28 Should we, then, read discourses on xeno-
zoonosis as a pollution ritual that affirms a social order in which humans
and other animals are properly differentiated?
From the perspective of sovereign power, discourses in which xeno-
transplants, or hypothetical xenotransplant recipients, are figured as con-
tagious can present boundary-making activities, potentially reaffirming
ontological boundaries between animals and humans, or nature and cul-
ture. I will explore several examples of the (re)assertion of boundaries in
response to xenotransplantation technologies in the chapters that follow,
including the xenotransplantation moratorium in Australia, which sup-
port such a reading. However, this is not the only understanding of con-
tagion at work in xenotransplantation research and regulation.
Xenotransplantation biomedical technologies, which aim to mobilise
biological functioning across species, entail a completely different opera-
tion of power; they involve what Foucault (2007) calls “security mecha-
nisms” or “governmentality”. This form of power does not function by
enforcing boundaries, and binary divisions. Instead, it requires circula-
tion for its operation, and targets the states of equilibrium and disequilib-
rium—and later on crisis and reorganisation—that characterise aggregate
systems. Mechanisms within this form of power attempt to modulate
natural systemic processes, such as those relating to economies, popula-
tions, ecosystems, or the biosphere.
Security techniques correspond to what Foucault originally calls bio-
politics, the second pole of biopower that focuses on the biological popu-
lation, also called the “species body”.29 Informed in part by concepts from
physics and biology, and later evolving in concert with systems theory,
these mechanisms of power function with an understanding of aggregate
phenomena that can self-adjust: that can spontaneously find an equilib-
rium, or evolve and adapt in response to environmental changes. Foucault
argues that governmentality, a self-limiting form of power, emerged as
classical political economy: a new form of economic governing which was
not concerned with simply increasing sovereign wealth and military
power but rather finding the ideal relationship between the elements of
the economy for population wealth and wellbeing, such as production,
16 R. Carr
consumption, import, and export. This form of power takes collectives

(rather than binaries) as its objects, for example, the population under-
stood as a collective body with its own specific biological dynamics that
can be indirectly influenced. We are no longer dealing here with static
formations to be protected or maintained, like territories, but dynamic
collective processes for which freedom and circulation are critical to func-
tioning: a security mechanism “cannot operate well except on condition
that it is given freedom … the possibility of movement, change of place,
and processes of circulation of both people and things” (p. 49).30
Accordingly, regimes of power based on the imperative of security
understand contagion as neither inherently good nor bad. Infection is a
phenomenon that cannot be eliminated, but may be limited, counter-
acted, or made to function in the interests of the population and its
health. For example, vaccination techniques actively induce a low level of
infection in order to limit more severe disease outbreaks by creating
immunity (Foucault 2007, 58). Rather than fearing or avoiding all forms
of disease transmission, this strategy responds to infectious disease by
utilising the very process itself, encouraging one form of infection to
counteract a less desirable form. Vaccination provokes infection in order
to secure populations against its dangerous effects (see Chap. 4).
Foucault’s analysis of classical political economy focused on systems
that return to equilibrium. However, security scholars have argued that
adverse events are no longer only represented as calculable risks within
equilibrium systems, they are frequently rendered uncertain and cata-
strophic, engendering novel forms of preparedness, pre-emption, systems
security, and resilience in the face of unknown, but imminent, emergen-
cies (Aradau 2014; M. Cooper 2006; Evans and Reid 2014; Lakoff and
Collier 2008; Walker and Cooper 2011). Melinda Cooper argues that
new forms of governing economic and other insecurity are tightly inter-
woven with the emergence of post-Fordist production and financialisa-
tion in the life sciences in particular (M. Cooper 2008). Production in
the contemporary post-Fordist life sciences, Cooper (2008) argues, is
concerned with recreating life “beyond the limits”. Contemporary secu-
rity apparatuses invest in a continual reinvention of life; “it is all about
thriving in complex systems which promote radical connectivity and
accept radical uncertainty” (Evans and Reid 2014, 62).
Biocapital and Trans-species Adaptation

Contemporary biomedicine has progressively opened up possibilities for
circulation and interconnection of biological fragments as “moleculariza-
tion” (Rose 2009) and understandings of genetics have refigured biology
(cells, embryos and so on) as re-engineerable and re-combinable in a mul-
titude of ways. Anthropologist Sarah Franklin (2006) calls this a shift to
“trans-biology”, locating its origins in embryology. Certainly, intercon-
nections and circulations of biological fragments among humans and
non-human animals are increasing (and increasingly relevant to gover-
nance), because of biotechnological advances and globalisation, among
other factors (as I discuss in Chap. 4). Blue and Rock (2011), accord-
ingly, call for analyses of “trans-biopolitics” which explore the apparatuses
governing connections and circulations, and power relationships, between
(as well as within) multiple species populations.31
As I suggested above, xenotransplantation can be understood as a secu-
rity apparatus that increases the movement of biological functioning
across species for the benefit of human populations. Proponents of xeno-
transplantation argue that a key advantage of xenotransplantation tech-
nologies is in “circumventing the shortage of human allographs for
transplantation” (US Food and Drug Administration 2003, p. 2), reduc-
ing the burden of chronic disease in society (see also Boneva et al. 2001;
Fishman 1998).
The history of human-to-human transplantation (allotransplantation),
already a recombinatory technology that circulates body fragments across
individual bodies, shapes this argument about the need for xenotrans-
plantation technologies. In the 1980s and 1990s, the allotransplantation
field boomed with the development of surgical technologies and the use
of cyclosporine as an immunosuppressant, which widened the scope of
transplantation between different human bodies (Cohen 2001, 7;
R. C. Fox and Swazey 2013). These technological developments in allo-
transplantation since the mid-twentieth century have produced global
movements of live body parts, within licit and illicit markets (see Scheper-
Hughes 2002; Cohen 2001), amidst an ostensible scarcity of human
organs. However, the widely publicised organ “scarcity” has been
18 R. Carr
critiqued by social studies scholars who argue that it is produced by the

very technologies and social policies that make transplantation possible
and acceptable for a large range of recipients (Cohen 2001; Lock 2002;
Scheper-Hughes 2002). As Rémy (2009) argues, success with allografts
generated “a demand for grafts that was impossible to satisfy which, in
turn, created an incentive to revive experiments in xenografts” (412).
In the context of the supposed need for human tissues, and as a tool
for decreasing the burden of some chronic conditions, xenotransplanta-
tion practices take a liberal approach to species differences. Species do not
have definitive “boundaries”; rather, cross-species biological connectivi-
ties are elements to inhibit or facilitate towards population-level health
outcomes. Rothblatt and United Therapeutics, for example, aim to
genetically engineer pigs for XenoLungs, fostering genetic and tissue
exchange across species. In this instance, hybridity (or trans-species
recombination) and contagion across species in xenotransplantation are
not inherently troubling to the operation of power, indeed contagion—
melding, recombining—are its modus operandi.
Overstated expectations are typical within the life science industries,
however. Sunder Rajan, in his seminal account of political economy and
the life sciences, points to the speculative nature of capitalism, “biocapi-
tal”, evident in contemporary US biotechnology industries. “Exuberant”
discourses of hype, he argues, intersect with more traditional modes of
scientific fact production, so that the production of biotech and life sci-
ences (in the United States) is inseparable from the hyped up and imag-
ined future on which it depends for venture funding and thus survival
(Sunder Rajan 2006, 111). Melinda Cooper adds that “what is new in the
contemporary biosciences is not so much the commodification of bio-
logical life—this is a foregone conclusion—but rather its transmutation
into speculative surplus value” (148). Biocapital, in other words, makes it
possible to secure value now from life imagined in the future via a whole
set of legislative or regulatory mechanisms as well as strategically captur-
ing the emergent potential of life itself.
Processes of infection and exchange are central to the modes within
which contemporary security mechanisms and biotechnology operate to
(speculatively) extend beyond existing forms of life. In contrast with the
moratorium that attempts to prevent contact between humans and
animals, the approach that flows from the imperative of security employs
infectious processes and adapt life and pre-empt the possibility of disease
outbreaks. As hinted already, biotechnology’s promissory discourses are
not the only future-oriented narratives shaping the xenotransplantation
field, as alongside these is the future painted of potential catastrophic
zoonotic outbreaks. I address the intersection of these speculative logics
in Chap. 4.
The imperative of security structures the relationship between humans
and animals along quite different lines to the dualistic friend/enemy
structure of sovereign power. It provides an alternative to the inside/out-
side division that theorists often identify as the guiding premise of human
exploitation of non-human animals. Nevertheless, security mechanisms
are also methods of control and coercion, and their operation is not gen-
erally concerned with the wellbeing of individuals, since they focus on
collectivities, or existing livelihoods, as are oriented to the future. As
Evans and Reid’s (2014) critique of contemporary political economy
argues, security apparatuses may exacerbate the vulnerabilities of those
already most exposed, as the expectation placed on individuals and com-
munities to become resilient to future catastrophes supersedes protective
strategies from government. Moreover, as I will explore throughout this
book, while security, as a mode of power, is essentially liberal, in some
cases it can nonetheless effectively incorporate sovereigntist binaries
within its operations to support the continuation of human domination
of non-human animals. Speculative life sciences rely on non-human bod-
ies—their lives and deaths—for the development of biocapital. And
xenotransplantation procedures—even while they may undermine
human/animal binaries—relentlessly circulate value from other animals
to (some) humans.
Structure of the Book

The following chapters trace the interplay of security and sovereignty in
four case studies of xenotransplantation regulation and industry in New
Zealand, the UK, the United States, and Australia. Despite globally cir-
culating narratives of emerging infectious disease, the meaning of
20 R. Carr
infectious disease risks in xenotransplantation is inflected by local regula-

tory and industry practice. I start from the assumption that, as a number
of scholars suggest, we need to understand the politics and progress of
science, technology, and medicine as informed by a range of cultural nar-
ratives (Franklin 2007; Squier 2004; Waldby 1996), and explore in depth
the imaginaries that inform these varying regulatory responses. In par-
ticular, as Shiela Jasanoff and Sang-Hyun Kim (2009, 120) observe, gov-
ernment regulation, and investment in science and technology projects,
often reflect “collectively imagined forms of social life and social order”
(120) (see also Jasanoff 2005, 2015).
Benedict Anderson’s (2006) pioneering work on national “imaginar-
ies” offered an understanding of nation as a collectively imagined entity.
Anderson’s work is useful for thinking about how understandings of the
social body are linked to national media and other widely circulating
discourses. More recently, Jasanoff and Kim’s (2009) work on socio-
technical imaginaries has emphasised the centrality of science and tech-
nology in collective imaginaries of social bodies. For instance, the
discourses, scientific developments, and regulation of new technologies
often reflect on and generate an imagined ideal future community and its
social order. Jasanoff and Kim (Jasanoff and Kim 2009, 6) define socio-
technical imaginaries as “collectively held, institutionally stabilized and
publicly performed visions of desirable futures, animated by shared
understandings of forms of social life and social order, attainable through,
and supportive of advances in science and technology”.
This book is not about the history of xenotransplantation or the tech-
nology, per se, but about the political, social, and scientific regulation of
the hybridity it involves. In each chapter, I analyse different sets of knowl-
edges, imaginaries, and narratives that cut across philosophy, epidemiol-
ogy, tourism, conservation, and primatology, to illustrate how
interconnections, borders, or boundaries are treated in the xenotrans-
plantation field. Throughout the book, I employ both genealogy and dis-
course analysis. Along with analysing narratives in the xenotransplantation
field, in the following chapters, I also trace the emergence and transfor-
mations of discourses and practices (for instance, the concept of “emer-
gence” that animates contemporary US biosecurity practices regarding
infectious disease). Most chapters draw out a theoretical framework

before entering into the case study.
During my research, I conducted eight face-to-face interviews and
three phone interviews with pig farmers and experts in the areas of xeno-
transplantation research, public health, epidemiology, and transplanta-
tion. Several of the experts played key roles in the debate and development
of xenotransplantation regulation in Australia. These interviews informed
my research and have been included in the discourse analysis in Chap. 5.
All but one participant consented to being identified.
Chapters 2 and 3 examine two cases in which the response to xeno-
transplantation and cultural narratives expresses a sovereign form of
power by reaffirming the boundaries and categories that xenotransplanta-
tion appears to threaten.
One of the central mechanisms of sovereignty is purification, the pro-
cess of separating out elements into clean categories. Purification is often
clearly visible in the making of territory and nations, especially in the
antipodes. During the colonial period, both New Zealand and Australia
were consumed by the task of maintaining British identity in a totally
foreign environment, and relentlessly pursued a pure identity in a hybrid-
izing context. In New Zealand, the pursuit of purity has tended to express
itself via the mobilisation of romantic narratives of a pristine environ-
ment (Belich 1997; Bell 1996).
In Chap. 2, I explore the connections between national narratives of
purity in New Zealand and a xenotransplantation company that strives to
promote the safety of its xenotransplantation products amidst fears of
contagion. I argue that the company Living Cell Technologies leverages
off broader national imaginaries to position the pigs as the “cleanest pigs
on earth” (PharmaVentures 2010) and ease some of the anxieties about
xenozoonosis. By mimicking elements of the 100% Pure New Zealand
campaign, LCT stages a myth of original purity figured geographically
and temporally. Here we are reminded that boundary-making in bio-
medicine can draw on broader social imaginaries to figure the naturalness
of categories, including narratives of nationhood, tourism, and
environmentalism.
Rather than preventing the hybrid human-animal embodiment gener-
ated in xenotransplantation, the New Zealand government has allowed
22 R. Carr
LCT to conduct clinical trials because of the company’s special source

pigs originating on the isolated Auckland Islands. In this context, the
problem of contagion is figured as a problem of boundaries, where trans-
gression calls for a simultaneous reassertion of absolute difference.
As governments began to regulate burgeoning xenotransplantation
clinical trials during the 1990s, they also turned to the question of which
non-human animal would be suitable to use as a source for tissues. Up
until the 1990s, scientists in the field predominantly targeted non-human
primates for xenotransplant tissues, as they are the closest, biologically, to
humans. However, during the 1990s, alongside disease concerns, ethics
committees also began to argue that developing non-human primates as
a source of xenotransplantation tissues was ethically problematic.32
Bioethics committees in the UK, in particular, set out clearly that it
would be ethically acceptable to cultivate pigs for human tissues, but not
non-human primates (Department of Health 1997; Nuffield Council on
Bioethics 1996). These discourses established divisions among species
according to their greater or lesser suitability for use in xenotransplanta-
tion; based on their assumed level of personhood and capacity to suffer.
In Chap. 3, I analyse the bioethical discourses that determine which
species are acceptable as xenotransplantation sources in the UK. My
investigation in this chapter involves a close reading of Peter Singer’s
Practical Ethics (Singer 1993), and research on pig minds, to illustrate the
connections between knowledge practices and ethics discourses in repro-
ducing a human centric hierarchy. I argue that, in the xenotransplanta-
tion field, the elevation of non-human primates to the status of (near)
persons has a deleterious effect on pigs, who are now being developed as
tissue sources in research. I argue that personhood, in this context, oper-
ates as a sovereign and biopolitical mechanism that hierarchises non-
human animals, making some, but not others, available as transplant
sources within a utilitarian calculus of suffering.
In Chap. 4, I move to exploring security mechanisms which make our
interconnections with other species and with environments explicit in
the operation of power.
During the 1980s and 1990s, a new discourse and set of practices
relating to infectious disease emerged, one that has been identified as the
“emerging infectious disease” paradigm (Institute of Medicine 1992;
Morse 1993). Around the same time public health and infectious disease
experts raised concerns that the community might be infected with a new
animal disease via xenotransplantation technologies. These fears for the
public health were formulated with reference to the new paradigm of
emerging infectious disease. In Chap. 4, I trace the development of these
discourses and how they informed conceptualisations of xenozoonosis.
The term “emerging” here signals a change in scientific understanding of
microbes and infectious disease. Scientists and public health experts
increasingly began to comprehend microbes, especially viruses, as highly
adaptable and able to infect humans in new ways (Domingo and Perales
2001). Furthermore, in this perspective, humans, non-human animals,
and microbes were increasingly understood as interconnected in continu-
ally emergent relationships.
In this chapter I propose that both the construction of xenozoonosis
and the US regulatory approach to infectious disease risk in xenotrans-
plantation are best understood as security apparatuses. I give a longer
exegesis of Foucault’s account of governmentality in Security, Territory,
Population, and extend his analysis to the contemporary context of emerg-
ing infectious disease and xenotransplantation, drawing on the work of
Walker and Cooper (2011).
Of the countries I study in this book, the response to xenozoonosis in
the United States most clearly exemplifies the workings of liberal security
apparatuses. In keeping with the way that xenozoonosis has been concep-
tualised by infectious disease experts in the liberal US context, govern-
ment regulation stimulates a range of pre-emptive and preparedness
measures, including biotechnological innovations, which further mobil-
ise movements and interconnection between humans, pigs, and microbes.
While in the United States the conceptualisation of xenozoonosis has
provoked a deployment of security mechanisms, in Australia the concep-
tualisation has resulted in a moratorium on xenotransplantation, a deci-
sion that has involved the deployment of an older method of ensuring
public health: prevention of contact and exclusion. Why is Australia’s
response so out of keeping with the paradigm of emerging infectious
disease, with its emphasis on the interconnection and adaptation? In
Chap. 5, I seek to resolve this puzzle of Australia’s distinctly local response,
24 R. Carr
by looking to the formative moments of an imagined community at

Australian Federation.
The public health response to xenotransplantation in Australia inter-
prets species barriers within the framework of an organismic body poli-
tics and tries to reinstate a firm boundary between humans and animals
in the face of these technologies. I read the sovereign response to xeno-
transplantation in Australia as indicative of a recurring organismic body
politics in Australian public health, tracing this politics to immigration
and quarantine practices around Federation.
This book situates understandings of borders and systems of infection
within contextual knowledge practices and cultural imaginaries. The
mechanisms of security and sovereignty together dynamically regulate
certain forms of human-animal relationships in the field of xenotrans-
plantation, securing human exceptionalism and non-human animal
exploitation, although not always in a model of enmity.
Notes
1. On the other hand, people who have received extracorporeal blood per-
fusion treatments using pig tissues have been found to have pig cells
remaining in their bodies nine years later (Collignon and Purdy 2001;
Paradis et al. 1999), which indicates the human immune system may not
always respond quite so radically or effectively to all “otherness”.
2. Burnet’s clonal selection theory proposed that the immune self emerges
during the prenatal period, at which point the body produces a vast
number of immune cells through mutation, each reactive to different
molecules. The immune system becomes tolerant, or non-reactive, to
“self ” by deleting all immune system cells or molecules that react to
existing cells in the body leaving only those that would target something
from outside (Burnet 1959).
3. Burnet’s (2015) explanation of the immune self is ecological, invoking
notions from evolution, in that he understands the “self ” to emerge from
mutation, or variation, and selection of appropriate immune cells rela-
tive to the bodily environment.
4. For this reason several theorists suggest that the “self ” concept is now
redundant (Pradeu 2012; Tauber 2000).
5. The US Food and Drug Administration (US Food and Drug

Administration 2003) defines xenotransplantation “any procedure that
involves the transplantation, implantation or infusion into a human
recipient of either (a) live cells, tissues, or organs from a nonhuman ani-
mal source, or (b) human body fluids, cells, tissues or organs that have
had ex vivo contact with live nonhuman animal cells, tissues or organs”
(p. 1). This definition does not include the use of non-human heart
valves in human patients because these are not live tissues.
6. Although the company and product have now been bought out by its
Japanese-owned partner company, Diatranz Otsuka Limited.
7. There is a much longer history of experimentally transplanting animal
tissues and organs into humans For this history see Deschamps
et al. (2005).
8. This question deserves further research, and a more detailed analysis
than I can provide here.
9. The recipient’s own immune cells are first depleted so that they do not
destroy the stem cells (Griesemer et al. 2014).
10. Sachs is inspired and intrigued by Jerne’s network theory, even if he does
not adopt it directly in this work (Eichmann 2008, 167–70).
11. New CRISPR techniques developed by another biotech firm, eGenesis,
allow multiple genetic changes to pigs that could speed up the process of
producing pigs whose tissues can survive in a non-human primate body
(Reardon 2015) (see Chap. 4).
12. While the scientists provoked the immune system tolerance with the
pre-clinical treatment, in the end, the body, through rather mysterious
mechanisms, adapted to, and included, the transplant.
13. Haraway (1991) traces the understanding of the immune system as a
networked communications system to post-war cybernetic science,
which is undoubtedly a formative field of knowledge/practice in these
accounts of the immune system. As I explore at length in Chap. 4,
Foucault (2007) traces the power mechanism associated with the kind of
conceptual apparatus that is evident in network immunology further
back to the e mergence of political economy (not with reference to the
immune system explicitly).
14. As Sharp (2013, 70) details, an experimental transplant of a baboon
heart into a 12-day-old baby, “Baby Fae”, which was highly unsuccessful,
“led to a decade long, self-imposed moratorium on human xenografting
26 R. Carr
by xeno experts”. Research was again started in 1992 by high-profile

transplantation expert Robert Starlz (Deschamps et al. 2005).
15. The problem of xenozoonosis or “xenosis” (Fishman 1994) initially
emerged in US and UK discourses, and subsequently a wave of regula-
tory activity spread across the globe. Several transplant and infectious
disease experts raised the potential for disease transfer into and among
the human population; including, Jay Fishman (1994), expert in infec-
tious disease in transplantation; Douglas Smith (1993), pathologist; and
HIV researcher Jonathan S. Allan (Allan 1994). These experts drew on
the examples of HIV as well as other recently emerging zoonoses, and
new insights into viruses to argue that xenotransplantation was perfectly
positioned to facilitate new disease in human populations. The intimate
connection of non-human flesh and human flesh, most likely under con-
ditions compromising the recipient’s immune response, they argued,
created the perfect opportunities for pathogens to adapt to and spread
among humans (addressed in Chap. 4).
16. While informed consent continued to be a model for understanding or
managing ethics (consistent with the tradition of health bioethics/
research ethics), xenotransplantation pushed these concepts to the limit.
For example, for some it raised the question: if xenotransplantation
poses risks for the whole population, should consent be sought from the
whole population, not just the recipient (Daar 1997)?
17. In Australia, the Therapeutic Goods Association (TGA), and in the UK
the Medicines and Healthcare Products Regulatory Agency.
18. In particular they have described the roles of public and industry in
policy development (Beynon-Jones and Brown 2011; Brown and
Beynon-Jones 2012; Cheng 2015b; P. Cook 2008; E. F. Einsiedel 2002;
Einsiedel et al. 2011; P. E. F. Einsiedel and Ross 2002; Jones and Einsiedel
2011; Tallacchini 2011; Kögel and Marckmann 2020), regulatory insti-
tutional boundaries and cultural narratives (Brown et al. 2006; Brown
and Michael 2001a; Haddow et al. 2010), and legal and ethical aspects
of regulation (Fovargue 2005, 2011; M Fox and McHale 1998; Marie
Fox 2005; Freeman et al. 2014; S. A. M. McLean and Williamson 2004;
S. McLean and Williamson 2005, 2007; Mortensen 2005; Samanta
2015; Williamson et al. 2007; Van Rongen 1998).
19. In at least cellular xenotransplantation, if not whole organ xenografts.
20. By contrast the UK moratorium was initiated in 1997 and ended in

1998. Sweden and Germany had instigated a moratorium by 1998 (M
Fox and McHale 1998). New Zealand lifted their moratorium in 2006.
21. In contrast a long-term moratorium on the use of non-human primates
as source animals persists in most countries (discussed further in Chaps.
4 and 5).
22. Foucault (2003) expands “Generally, we describe the effects and mecha-
nisms of the power exercised over these categories as mechanisms and
effects of exclusion, disqualification, exile, rejection, deprivation, refusal,
and incomprehension; that is to say, an entire arsenal of negative con-
cepts or mechanisms of exclusion” (44).
23. However, infectious disease itself is also threatening to the internal struc-
ture of a very rigidly organised social system, especially where bodies are
understood as firmly bounded and highly differentiated. A contagious
disease spreads inconspicuously and uncontrollably from one body to
another without respect for those supposedly fundamental borders
between bodies, classes, or other social divisions.
24. In other words, the causal explanation and treatment of infectious dis-
ease can get hooked in complicated ways into processes of abjecting cer-
tain identities, where abjection is a “device of discriminations, of
differences” (Kristeva 1982, 69).
25. Derrida has argued that the term “the animal” is already a violent cate-
gorisation that suppresses the individual differences among species
(Derrida and Wills 2002).
26. For a sophisticated examination of the relationship between animals and
human sovereignty see Wadiwel (2015).
27. The exclusion of animals from rights and care hinges on a philosophical
canon that represents animals as lacking subjectivity, thought, speech,
and the capacity to respond, including in work of Heidegger, Descartes,
Kant, Freud, and Lacan (Calarco 2008; Derrida and Wills 2002;
D. Haraway 2008). Dinesh Wadiwel (2015) argues that “[o]ur self-
declared sovereignty is not gained through our rationality; nor through
our cleverness; nor through our extraordinary moral worth. On the con-
trary, … our capability results from our use of violence to appropriate
other animals, a process by which we come, after the fact, to claim a
supposed “superiority” over other living beings” (223). In short, the sov-
ereign mechanism mobilises the human/animal duality in support of its
workings.
28 R. Carr
28. Regulation of xenotransplantation also challenges the distinctions

between experts and public (Brown 1999; Brown and Michael 2001b).
Brown (1999), for example, proposes that all these transgressions pro-
voke a sense of disgust at xenotransplantation.
29. Foucault (2008) describes the two poles of biopower as follows:
One of these poles—the first to be formed, it seems—centered on the
body as a machine: its disciplining, the optimization of its capabili-
ties, the extortion of its forces, … All this was ensured by the proce-
dures of power that characterized the disciplines: an anatomo-politics
of the human body. The second, formed somewhat later, focused on
the species body, the body imbued with the mechanics of life and
serving as the basis of biological processes: propagation, births and
mortality, the level of health, life-expectancy and longevity, with all
the conditions that can cause these to vary. Their supervision was
effected through an entire series of interventions and regulatory con-
trols: a biopolitics of the population. (p. 139)
30. For example, Foucault (2007) remarks that classical political economy
seeks to allow and guide, rather than prohibit, desire: “if one gives it free
play, and on condition that it is given free play, all things considered,
within a certain limit and thanks to a number of relationships and con-
nections, it will produce the general interest of the population” (p. 73).
Within this framework, facilitating individual to act economically in
accordance with their own interests is thought to benefit the economy as
a whole.
31. Blue and Rock (2011) examine, as an instance of trans-biopolitics, gov-
ernment regulation of food consumption and health of human and non-
human populations (cats and cows) in the public health response to
Bovine Spongiform Encephalopathy (BSE) and Creutzfeld Jakob Disease
(CJD). They stress that biopolitical analyses should not be limited to
singular species as though they were distinct entities. Svendsen (2017)
explores the connections between human-pig interactions and pub-
lic health.
32. Non-human primates have been increasingly rendered as human-like
persons over the past century, particularly since the 1950s. It is not sur-
prising that they are considered the most contagious, and at the same
time excluded because the ethics of primate research has become
fraught—both of these tendencies reflect the degree to which non-
human primates are encroaching on the territory of the human.
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THE MARRIAGE CHAIR.
In which a bride of the upper classes is carried to her husband’s

home. It is often a very beautiful thing, gorgeous with its embroidery
in silk and colours. People who are not rich enough to have one of
their own can hire them for the occasion. In China large families are
the rule. If a mother dies, the women of the village suckle and bring
up the child between them, and children are not weaned until they
are from three to five years of age. Chinese women are very modest
and kind-hearted, are faithful wives, and, according to their own
notions, good mothers. In Sze Chuan there is no trace of infanticide,
but it is practised in many parts of the Empire.
THE MARRIAGE CHAIR
MODE OF CARRYING
CASH AND BABIES.
In travelling, the carriage of money is a great annoyance, owing to

the smallness of its value and the large number of coins or “cash”
necessary to make up an amount of any size. Exchanging eighteen
shillings English for brass cash, the weight of them amounted to
seventy-two pounds, which had to be carried by the coolies. These
cash have a square hole in the middle, and are strung together upon
a piece of straw twist. Should the straw break, the loss of time in
getting up the pieces is much more than the loss of the money. The
Chinese are honest, very keen at a bargain, but when the bargain is
made the Chinaman may be depended on to keep it.
MODE OF CARRYING
CASH AND BABIES
A PAI-FANG,
OR WIDOW’S ARCH.
These are often very fine structures in stone, wonderfully carved, or

in wood highly decorated. It is not uncommon to enter a town under
quite a succession of them. Very fine ones are often found at the
entrance of very squalid villages. They are erections put up to
honour widows who, faithful to the memory of their husbands, have
remained widows, devoting themselves to good works and to the
service of their parents-in-law, which is the great duty of every good
wife. Permission of the Emperor has to be obtained for their erection.
The various towns and villages take pride in their “widows’ arches.” It
is not uncommon to find a shrine for the burning of incense beside
the arch.
A PAI-FANG,
OR WIDOW’S ARCH
TWO SOLDIERS OF
SZE CHUAN.
The military are usually dressed in picturesque but unserviceable,

not to say grotesque costumes, the carnation red, beloved of the
Chinese, and blue being the prevailing colours. They carry fans, and
often paper umbrellas. They are ill-trained and indolent, lounging
about the gates of the cities or the streets gambling and smoking.
Their curse is that they have nothing to do.
TWO SOLDIERS OF
SZE CHUAN
OPIUM CULTURE
ENCROACHING
ON THE RICE LANDS,
SZE CHUAN.
The great system of irrigation at Sze Chuan was intended for the
cultivation of rice only; but the great and terrible growth in the
demand for opium has caused the cultivation of the poppy so to
increase that it is encroaching on the rice lands.
This may be regarded as the saddest and most terrible fact as
regards the future of China.
The use of opium is of comparatively recent date, but the growth and
spreading of the habit has been most rapid.
At the first, both local and government officials did their best to stop it
and to stamp out the culture of the poppy; but although laws were
passed making death the penalty for its cultivation they became a
dead letter, until to-day it is estimated that eighty per cent. of the
men and fifty per cent. of the women, in one or two populous
provinces, are opium smokers. They do not all smoke to excess.
There are moderate smokers as we have our moderate drinkers; but
all through the province of Sze Chuan the opium shops are as thick
as the gin shops in the lower parts of London.
It is not necessary to dilate on the effects of opium when freely
indulged in. They are too well known. China’s only hope is to
emancipate herself from the vice that is eating away her manhood.
But will she be able to do it?
OPIUM CULTURE
ENCROACHING
ON THE RICE LANDS,
SZE CHUAN

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Health, Technology and Society

Cover illustration: © SEAN GLADWELL

London, UK Rebecca Lynch

I would like to express my sincere gratitude to my PhD supervisors,

Auckland Island Pigs for Xenotransplantation”. Animal Studies Journal,

1 Introduction: Forms of Contagion 1

2 100% Pure Pigs: New Zealand and the Cultivation of Pure

3 Hierarchies of Valuable Life: Positioning Pigs and Primates

4 Circulating Non-human Tissues: Xenotransplantation and

5 Ecological and Organismic Body Politics: The Moratorium

Within understandings of biomedicine, the immune system manifests

years ago in primitive animal species as a defense against invading micro-­

Similarly, Bob Elliot, at the time CEO of Living Cell Technologies

by LCT to market their xenotransplantation products (see Chap. 2), the

Until recently, immunologic tolerance was thought to imply the specific

Sachs suggests that healthy bodies require an ongoing positive action

hematopoietic stem cells (HSCs), usually using bone marrow or periph-

The Harvard University researchers have been able to persuade a mouse

contaminations. Within this context, LCT’s marketing materials also

transplantation of non-human animal tissues into humans. I use xeno-

advent of immunosuppressant drugs designed for human-to-human

connected the regulation of xenotransplantation to questions of global

some others, beginning in 2003 and stretching to 2009;20 in contrast, by

identity (Shildrick 2000). While disease itself is often experienced as

The perceived transgression of boundaries implied in animal to human

As Brown (1999) states, xenotransplantation technologies “merge and

consumption, import, and export. This form of power takes collectives

Biocapital and Trans-species Adaptation

critiqued by social studies scholars who argue that it is produced by the

Structure of the Book

infectious disease risks in xenotransplantation is inflected by local regula-

infectious disease). Most chapters draw out a theoretical framework

LCT to conduct clinical trials because of the company’s special source

by looking to the formative moments of an imagined community at

5. The US Food and Drug Administration (US Food and Drug

by xeno experts”. Research was again started in 1992 by high-profile

20. By contrast the UK moratorium was initiated in 1997 and ended in

28. Regulation of xenotransplantation also challenges the distinctions

Transpecies Transplantation. Social Theory & Health 4 (1): 1–24. https://doi.

Department of Health. 1997. Animal Tissue into Humans: A Report by the

Matzinger, P. 2001. Essay 1: The Danger Model in Its Historical Context.

In which a bride of the upper classes is carried to her husband’s

In travelling, the carriage of money is a great annoyance, owing to

These are often very fine structures in stone, wonderfully carved, or

The military are usually dressed in picturesque but unserviceable,

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London, UK Rebecca Lynch

1 Introduction: Forms of Contagion 1

2 100% Pure Pigs: New Zealand and the Cultivation of Pure

3 Hierarchies of Valuable Life: Positioning Pigs and Primates

4 Circulating Non-human Tissues: Xenotransplantation and

5 Ecological and Organismic Body Politics: The Moratorium

years ago in primitive animal species as a defense against invading micro-

Biocapital and Trans-species Adaptation

Structure of the Book