Global Pharmaceuticals: Ethics, Markets, Practices

by Adriana Petryna (Editor), Adriana Petryna (Editor), Andrew Lakoff (Editor)

In some parts of the world spending on pharmaceuticals is astronomical. In others people do not have access to basic or life-saving drugs. Individuals struggle to afford medications; whole populations are neglected, considered too poor to constitute profitable markets for the development and distribution of necessary drugs. The ethnographies brought together in this timely collection analyze both the dynamics of the burgeoning international pharmaceutical trade and the global inequalities that emerge from and are reinforced by market-driven medicine. They demonstrate that questions about who will be treated and who will not filter through every phase of pharmaceutical production, from preclinical research to human testing, marketing, distribution, prescription, and consumption. Whether considering how American drug companies seek to create a market for antidepressants in Japan, how Brazil has created a model HIV/AIDS prevention and treatment program, or how the urban poor in Delhi understand and access healthcare, these essays illuminate the roles of corporations, governments, NGOs, and individuals in relation to global pharmaceuticals. Some essays show how individual and communal identities are affected by the marketing and availability of medications. Among these are an exploration of how the pharmaceutical industry shapes popular and expert understandings of mental illness in North America and Great Britain. There is also an examination of the agonizing choices facing Ugandan families trying to finance AIDS treatment. Several essays explore the inner workings of the emerging international pharmaceutical regime. One looks at the expanding quest for clinical research subjects; another at the entwining of science and business interests in the Argentine market for psychotropic medications. By bringing the moral calculations involved in the production and distribution of pharmaceuticals into stark relief, this collection charts urgent new territory for social scientific research. Contributors . Kalman Applbaum, João Biehl, Ranendra K. Das, Veena Das, David Healy, Arthur Kleinman, Betty Kyaddondo, Andrew Lakoff, Anne Lovell, Lotte Meinert, Adriana Petryna, Michael A. Whyte, Susan Reynolds Whyte

Genres: Anthropology, Medicine, Ethnography

312 pages, Paperback

First published February 22, 2006

Reviews

[Tobi ﾄﾋﾞ · Rating 2 out of 5]

This is an edited collection that brings together anthropological and sociological perspectives on the pharmaceutical industry, tracing how medicines move through production, marketing, prescription, distribution, and consumption in different global contexts. The chapters cover a wide range of topics from the adoption of SSRIs in Japan to the politics of AIDS treatment access in Uganda, and engage with themes of medical governance, pharmaceuticalisation, the commodification of health, and the interplay between global markets and local practices.

While the book succeeds in assembling quite diverse case studies, the overall framing often feels heavily American in tone, even in sections that ostensibly address other countries. Much of the analysis carries the cultural and political preoccupations of US public health debates, particularly around "overdiagnosis", direct-to-consumer advertising, and consumer-driven medicalisation. This is not inherently a flaw, I understand that the American pharmaceutical landscape is unique and worth studying, but the lens can overshadow the specificities of other regions, making some comparative material feel filtered through that too-common US-centric sensibility that I'm exhausted of.

For readers interested in the anthropology of pharmaceuticals, the book offers valuable conceptual tools, such as the idea of medicines as socially potent “things” that concretise otherwise intangible health states, or the examination of how drugs acquire cultural meaning and political weight beyond their biochemical effects. However, in my case, coming from a UK perspective where the primary issue is not "over" prescription but long waiting lists, systemic scarcity, and structural barriers to access, many of the central critiques felt only partially applicable and sort of confusing at times, because they're so dethatched from my experience with and impressions of pharmaceuticals.

In short: a rich but geographically skewed collection, best read with a critical awareness of its underlying vantage point.

[Monica · Rating 3 out of 5]

read this for my globalization class' book review assignment. i always gravitate towards medical anthropology centered ethnographies, and this was exactly it, although i found the selected essays a bit difficult to read. i liked the very multilevel perspective the selection of essays provided, but it's a bit difficult to tie them all together. anyhoo, this was an intriguing crash course into the world of big pharma and why we must always be critically aware of the varying social processes that inform our understanding of health, wellbeing, and treatment!!! ps i am very thankful for the anthropological perspective i've gained from one of my previous professors which really really helped me understand the ethnographic writing in this book tyty

[Weavre · Rating 4 out of 5]

Eye-opening, well-referenced exploration of who profits by treating (or not treating) whom ... the contexts and paradigms of modern drug testing processes ... the social disparity between those who take the risks of participating in questionable studies and those who benefit from the knowledge gained--especially those who benefit financially.

Worth reading.

[tay · Rating 5 out of 5]

a must read for anyone interested in the anthropology of pharmaceuticals, with a really good introduction.