Tessa Quayle, the young wife of a British civil servant in Kenya, is mysteriously murdered. Tessa, a lawyer, had been an outspoken human rights activist, and something of an embarrassment to her husband. But shaken from his marital and political complacency by her death and the rumors that quickly surround it, Justin Quayle sets out to solve the mystery and in doing so inherits her cause.

Tessa had discovered, as Justin now learns, that a new tuberculosis drug was being prematurely tested on Kenyan patients: clinical trials were effectively being carried out on the African population by the drug's giant pharmaceutical producer without the patients' knowledge or consent, but with the support and cover of a global corporation with African interests and of the British High Commission in Kenya. Lethal side effects and deaths were being concealed, the drug retitrated and retested in preparation for its safer and more lucrative release in the west in time for a predicted rise in incidence of multi-resistant strains of TB.

Justin, now a kind of rogue agent, uncovers the layers of sinister plotting to be expected in one of Le Carré's intelligence thrillers, but in the process we are led to consider, vividly, the interlocking roles of international biomedical research, postcolonial political interests, and global capital in determining the fates of impoverished, uneducated, and deeply vulnerable patients in developing countries--as well as the fates of those who try, often against all odds, to offer them the best available care. The novel also gives us, in Justin Quayle's odyssey, a moving study of desire, loss, regret, and, finally, outraged action.


This novel, as Le Carré himself avows, is fictional, its primary purpose that of any intelligently-written mystery thriller. It nonetheless explores some topical and contentious issues in the financing of biomedical research and the global distribution of health care. It engages in current debates about provision of HIV-AIDS medication to developing countries, the production of cheaper generic versions of such drugs, and the sociopolitical and economic infrastructure factors that complicate the provision of health care to these populations.

In his afterword, Le Carré asserts the importance of independent medical research, saying that the important issue, in his novel, and more broadly, is that of "individual conscience in conflict with corporate greed" and "the elementary right of doctors to express unbought medical opinions, and their duty to acquaint patients with the risks they believe to be inherent in the treatments they prescribe" (570).

This novel might form an engaging way to provoke student discussion of these issues, not least in terms of the availability of information, the role of the media in raising awareness of global bioethical malpractices, and the status of popular fiction like this as a means of arousing public interest in the actual conditions to which it alludes. In his afterword, Le Carré makes this tantalizing and sinister observation about researching the novel: "As my journey through the pharmaceutical jungle progressed, I came to realize that, by comparison with the reality, my story was as tame as a holiday postcard" (568).


John Le Carré is a pseudonym for David John Moore.



Place Published

New York



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