From coastal to global: The transnational flow of Ayurveda and its relevance for Indo-African linkages

ABSTRACT

Driven by long-standing ties with India, and intertwined with global market interests, a growing influx of materia medica from South Asia is currently emerging in East Africa. To compete at a global level and framed within the language of ‘South–South cooperation for mutual benefit’, India presents itself as an appropriate exporter of medical products suitable for African clientele. The expansion of India’s medical sector into Africa is particularly relevant for Ayurvedic pharmaceuticals. Ayurveda’s diaspora into Africa exemplifies the emergence of new health interventions and medical assemblages in a transnationally interconnected world and implies innovative coalitions involved in the complex promotion of local/Global Health industries. By tracking the flow of Ayurvedic pharmaceuticals to East Africa, this paper aims to contribute to the understanding of medical practices as they are configured by the dynamics of global mobility. It interrogates the extent to which the industrialisation of Ayurveda occupies a strategic position in Indo-African discursive practices and the creation of new market opportunities. Moreover, it explores the ways in which South–South alliances between Indian and African actors produce (new) solidarities, but also hierarchies and power imbalances. Special attention will be directed to the political-economic implications of the expansion of transnational markets.

KEYWORDS:

• Global health
• Ayurvedic pharmaceuticals
• Indian–African linkages

Acknowledgements

For valuable comments and inspiration concerning my work I want to thank my colleagues from the GLOBHEALTH project in Paris. I am particularly grateful to Laurent Pordié, Andrew McDowell, Mathieu Quet, and Claire Beaudevin for their close readings and detailed feedback concerning earlier drafts of this article. My gratitude also goes to the editors, to the reviewers of Global Public Health as well as to the participants of the writing group at L’Ecole des Hautes Etudes en Sciences Sociales (L’EHESS), Paris, for their engagement and suggestions.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1 Between India and East Africa, such medicoscapes include medical consultancy services, in which Indian healthcare knowledge is shared with African counterparts (Duclos, 2012, 2014), private hospitals, and clinics offered by Indian practitioners abroad. Moreover, following a long tradition of diasporic ties, affluent African patients have been accessing health treatment in India since the late 1990s (Modi, 2010). Furthermore, India is emerging as a global healthcare provider through transnational pharmaceutical corporations that supply large parts of the world with generic drugs (Meier zu Biesen, 2013).

2 Data are based on fieldwork conducted between April and July 2015 in Tanzania/Kenya, and between November and January 2015/2016 in India (Bangalore, Mumbai, and Pune). In-depth qualitative, biographical, and expert interviews as well as informal conversations were conducted with Indian Ayurveda doctors, African practitioners learning Ayurveda, and representatives of Ayurvedic pharmaceutical companies and pharmaceutical regulatory boards. Participant observation was applied in Ayurveda therapy settings (clinics and pharmacies) and used to gain data on the relationships and hierarchies between different actors. Data were also generated from the study of WHO guidelines, policy documents, newspapers, and Ayurveda internet blogs. Interviews were conducted in Kiswahili and English and, if consent was given, audiotaped.

3 On research regarding the expansion of Chinese proprietary medicine to East Africa cf. Hsu (2002) and Cheru and Obi (2010).

4 India’s pharmaceutical regulators are spread across five key ministries; AYUSH – Ayurveda, Yoga, and naturopathy, Unani, Siddha, and Homeopathy – is one of them.

5 Pharmexcil promotes the export of pharmaceuticals, including herbal drug preparations, and issues registration certificates under foreign trade policy in India. The AYUSH advisory group of Pharmexcil identifies importers and (foreign) distributors interested in Ayurvedic pharmaceuticals and AMAM leads companies on issues related to quality control for global acceptability.

6 The market for Indian herbal remedies is expected to be worth $107 billion by 2017 and then touch $115 billion in 2020. India and China are the largest producer of more than 70% of the global diversity (Bhattacharya, Reddy, & Mishra, 2014). During interviews, information of individual Ayurvedic companies’ turnover was held in utmost secrecy.

7 Products from the company Dabur India Ltd, Zandu Pharmaceuticals Works Ltd, and Vyas Pharmaceuticals Ltd are also popular; however, they are not officially registered.

8 The Non-Aligned Movement formed during the Cold War served as the ideological repertoire for earlier forms of Indo-African cooperation, which embraced political solidarity with regard to issues such as anti-colonialism, anti-racism, and national independence, and promoted South–South solidarity and self-determination (Duclos, 2012, p. 212).

9 All names are fictitious.

10 The assemblage concept is here used and understood as a critical mode of inquiry into the varied manifestations of ‘the global’ beyond claims of totality and uniformity. Assemblage theory helps to explore new ways to frame spaces of inquiry that capture the heterogeneity of elements involved in the making of particular problem-spaces of life.

11 For more detail on this topic, see Pordié (2015, p. 16), Bode (2006, pp. 231–234), and Pordié and Gaudillière (2014a, 2014b).

12 These drugs are registered as an ‘Ayurvedic Proprietary Medicine’, which means that they are owned by the firm and marketed under a registered trademark name. See Pordié and Gaudillière (2014b) and Madhavan (2014) for details on this form of intellectual property.

13 The law makes a distinction between traditional medicine (dawa ya asili) and complementary and alternative medicine (dawa mbadala), a separation that follows the WHO’s Traditional Medicine Strategy (2002–2005), which largely employs these two primary – and vaguely pejorative – terms to refer to heterogeneous categories of medicines (Meier zu Biesen, 2013).

Additional information

Funding

This work was supported by the ERC-funded project called ‘From International to Global: Knowledge, Diseases and the Postwar Government of Health’ (GLOBHEALTH), under European Research Council [grant number 340510].