In this article, the authors present an ethnography of biomedical knowledge production and science collaboration when they take place in developing country contexts. The authors focus on the arrival of international clinical trials to Sri Lanka and provide analysis of what was described as one of the first multisited trials in the country, a pharmaceutical company sponsored, phase 2, randomized, double-blind, placebo controlled trial carried out between 2009 and 2010. Using interviews with those who conducted the trial and six months of participant observation at the trial hospital, the authors describe the work that goes on to perform trials according to international standards. The article describes what happens when a randomized controlled trial encounters existing epistemic virtues and documents the impacts on ideas of authority, expertise and doctor–patient relationships found in Sri Lankan medicine.
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