Exploring the Wicked Problem of Violence in Prison: Capturing the Complexity of Contexts

On Sunday, 8 November 2020, Albert Bourla, CEO of Pfizer, called his executive team into his office in Connecticut; tension was in the air. The outcome of a multibillion-dollar bet was about to be revealed. Nine months earlier, Bourla had driven his company—then best known for the production of Viagra—to produce three billion doses of a vaccine that had not yet even been developed. That Sunday, statisticians were able to unblind the trial; around 100 people had been naturally infected with the COVID-19 virus; the good news was the majority of cases were in the control group, not the vaccine group. The implications for the world, for Pfizer, and for Bourla were profound (Bourla, 2022). This is the power of randomised controlled trials, the acme of experimental designs.
In some sense, the empirical question being answered in the vaccine trial was straightforward. In epidemiological terms, the Agent (pathogen) attacks the Host. The host susceptibility is influenced by, amongst other things, genetic composition, nutrition, medication, physical and psychological state—and, crucially, by vaccine status. The causal pathway is not hard to discern when a powerful pathogen is in play; randomised controlled trials of interventions are essential in these circumstances (Victoria, Habicht & Bryce, 2004).

© 2024 selection and editorial matter, Armon J. Tamatea, Andrew J. Day and David J. Cooke; individual chapters, the contributors.