In their reply to my commentary (Mason et al., Reference Mason, Roy and Singh2017; Simandan, Reference Simandan2017) Mason et al. provide a thoughtful and engaging discussion of my original points, and go beyond it, to offer a glimpse of the politics of current biomedical research. They highlight further evidence that neoliberal policies, such as structural adjustments (see also Simandan, Reference Simandan2010a, Reference Simandan2011a; Peck, Reference Peck2013), are a causal factor in the increased prevalence of tuberculosis. They point out how fear, shame and the anticipation of contempt have led tuberculosis patients to worry about disclosing their diagnosis to friends and family, and therefore, to compound their medical problems in the long term and to generate avoidable risks for their families and for public health. In sum, it becomes abundantly clear that tuberculosis cannot be understood simply as a biomedical problem, and instead requires a breath of social, historical, cultural and political dimensions of analysis (Mason et al., Reference Mason, Roy, Spillane and Singh2016). I have argued at length elsewhere that specialized research programmes are not sufficient for grasping the complex problems that confront our social world, and that we need to practise ‘the wise stance’ towards them (Simandan, Reference Simandan2002, Reference Simandan2010b, Reference Simandan2011b, Reference Simandan2011c, Reference Simandan2013, Reference Simandan2016). One of the attributes of wisdom is the ability to address a problem through multiple inter-related frames of reference (Sternberg & Jordan, Reference Sternberg and Jordan2005; Walsh, Reference Walsh2015). It therefore strikes me that the integrative framework Mason et al. have articulated is a welcome step towards practising the wise stance in biomedical research. I will follow with interest the development of their research programme and will only add here two suggestions for further enquiry prompted by their reply.

The first suggestion pertains to broadening the target of their theoretical framework. Tuberculosis is an infectious disease, and it is almost tautological to note that infectious diseases are inherently social phenomena. This fact opens up the prospect of generalizing Mason et al.’s framework to all infectious diseases. This would be no easy task, as it requires a careful negotiation between generalizing and remaining attentive to the unique signature of each infectious disease. But it would help inject a much needed social dimension to biomedical research, a field still mired in a problematic scientific imaginary that naively reifies the separation between the objective realm of science and the subjective realm of values, politics and morals (Rosenberg, Reference Rosenberg2015).

And this point brings me to the second suggestion for future enquiry: we need a more incisive analysis of the path-dependent processes (Simandan, Reference Simandan2012; Rixen & Viola, Reference Rixen and Viola2015) through which tuberculosis has been constructed and framed as a biomedical problem. The discursive construction of tuberculosis as a disease enables the apparently natural step of conceiving it as a problem to be addressed by medical researchers, as an issue of biomedical research (Abbott, Reference Abbott1988; Foucault, 2012; Rosenberg, Reference Rosenberg2014, Reference Rosenberg2016). This narrow framing is a power move that over decades has systematically legitimized the pattern of access to research funding mentioned by Mason et al.: whereas ‘hard science’ medical projects can secure such funding, investigators from fields interested in the social dimensions of this disease (health geography, health economics, medical sociology and medical anthropology) have often been left out. In other words, we need to become more cunning about the politics of biomedical research and the power wielded through the framing and reframing of tuberculosis and other diseases.