Markets and Molecules: A Pharmaceutical Primer from the South

ABSTRACT

The Indian pharmaceutical industry has historically manufactured low-cost drugs for the global poor. Activist mobilizations at the height of the HIV/AIDS epidemic revealed a vast cost gap between global brands and Indian generics, much to the embarrassment of Euro-American corporations that were in the habit of pricing drugs for only the wealthy or well insured. As new drug access controversies focus on anticancer therapies, they reveal new flows of international capital, emergent genetic technologies, and increasingly coercive trade regimes. Together these favor multinational corporate oligopolies, which imperil the legacy of HIV/AIDS activism and the future availability of essential life-saving drugs for the work of global public health. In this essay, I describe how the future of the right to drug access rests uneasily, and potentially calamitously, on a shifting balance of power between global south interests and Euro-American pharmaceutical capital.

KEYWORDS:

• Cancer
• India
• law
• pharmaceuticals
• science
• technology

Acknowledgments

I thank Emily Martin, Tejaswini Ganti, Rayna Rapp, Faye Ginsburg, Helena Hansen, Sienna Craig, Cori Hayden, and the science studies working group at New York University, all of who provided invaluable commentary on early versions of this article. Many of the findings that appear here were presented as a Grand Rounds lecture at Dartmouth-Hitchcock Medical Center, The Annual Conference on South Asia at the University of Wisconsin, the Science Studies in South Asia Conference at the University of Hawai’i, the American Anthropological Association annual meeting in Chicago, and the University of Chicago Center in Paris.

Funding

My research for this project was supported by residency fellowships from the Mellon Foundation at the Leslie Center for the Humanities at Dartmouth College, and from the Humanities Initiative at New York University. I also received funding from the National Science Foundation and the Wenner-Gren Foundation.

Notes

1. In this article, the loosely defined term “Big Pharma” will refer to about 15 of the world’s largest multinational pharmaceutical companies, each of whose annual revenues exceed US $15 billion.

2. In tracking Big Pharma’s strategies and their contestation, I do not equate health care rights with the legal mandate to ensure drug access. In their work on the changing forms of public health in Brazil, anthropologists Biehl and Petryna (2011) described how universal public health has increasingly been reframed as a matter of the legal right to access a global pharmaceutical market. In the face of failing public health infrastructures, increasing health care costs, and fragile medical collectivities, such a narrowing judicialized and pharmaceuticalized vision of health care rights distracts attention from basic health infrastructure and access.

3. In 2013, India’s largest drug manufacturer—Sun Pharma—filed litigation in New Jersey to try and employ reasoning similar to the India Patent Office to bring generic Gleevec to the United States in 2014. Novartis claimed that its patents over the drug were valid until 2019. After a year of negotiations, the two companies settled on February 1, 2016 as the release date for generic Gleevec in the United States.

4. This coalition included the Africa Group, Barbados, Bolivia, Brazil, Dominican Republic, Ecuador, Honduras, India, Indonesia, Jamaica, Pakistan, Paraguay, Philippines, Peru, Sri Lanka, Thailand, and Venezuela.

5. I am using the word overdetermined here in the sense given to us by Kaushik Sunder Rajan in his introduction to Lively Capital. Situating Marx as an epistemologist (among other orientations), Sunder Rajan uses overdetermination not to indicate economic determinism, but how configurations of political economy set the stage for not only value, but the epistemological frameworks through which we understand value.

Additional information

Funding

My research for this project was supported by residency fellowships from the Mellon Foundation at the Leslie Center for the Humanities at Dartmouth College, and from the Humanities Initiative at New York University. I also received funding from the National Science Foundation and the Wenner-Gren Foundation.

Notes on contributors

Dwaipayan Banerjee

Dwaipayan Banerjee is an Assistant Professor at the Program in Science, Technology and Society at MIT. His research interests include the anthropology and history of science, technology and medicine in South Asia.