Continuing his pioneering theoretical explorations into the relationships among biosciences, the market, and political economy, Kaushik Sunder Rajan introduces the concept of pharmocracy to explain the structure and operation of the global hegemony of the multinational pharmaceutical industry. He reveals pharmocracy's logic in two case studies from contemporary India: the controversial introduction of an HPV vaccine in 2010, and the Indian Patent Office's denial of a patent for an anticancer drug in 2006 and ensuing legal battles. In each instance health was appropriated by capital and transformed from an embodied state of well-being into an abstract category made subject to capital's interests. These cases demonstrate the precarious situation in which pharmocracy places democracy, as India's accommodation of global pharmaceutical regulatory frameworks pits the interests of its citizens against those of international capital. Sunder Rajan's insights into this dynamic make clear the high stakes of pharmocracy's intersection with health, politics, and democracy.
Introduction. Value, Politics, and Knowledge in the Pharmocracy 1
1. Speculative Values: Pharmaceutical Crisis and Financialized Capital 37
2. Bioethical Values: HPV Vaccines, Public Scandal, and Experimental Subjectivity 62
3. Constitutional Values: The Trials of Gleevec and Judicialized Politics 112
4. Philanthropic Values: Corporate Social Responsibility and Monopoly in the Pharmocracy 157
5. Postcolonial Values: National Industries in Pharmaceutical Empire 193
Conclusion. Constitutions of Health, Responsibility, and Democracy 229
"This book offers the most incisive, compelling analysis yet of the multinational pharmaceutical industry—of the mechanisms by which health is appropriated by capital, and the empirically distinct ways in which this takes place in different locations across the globe. As Kaushik Sunder Rajan makes plain, the 'pharmocracy' thus produced is no mere instrument of profit maximization: it also yields complex regimes of governance, knowledge, and ethics that are contested and rendered political in unpredictable, polarizing ways. The account is a tour de force in the study of bioscience, value, and the nature of power in our times."
Jean Comaroff, coauthor of
The Truth about Crime: Sovereignty, Knowledge, Social Order
"Pharmocracy is deeply unsettling, taking world systems ethnography and postcolonial science and technology studies in new directions with its intricate account of how the global pharmaceutical industry is making its mark in contemporary India. Superbly written and argued, Pharmocracy examines the fate of science and innovation, public health, and democracy while telling of next-generation imperialism and of the many nodes and modes of politics engendered by contemporary structural conditions. It is also a story about and a call for governance. One comes away both sobered and impressed by Indian institutions."
Kim Fortun, author of
Advocacy after Bhopal: Environmentalism, Disaster, New Global Orders
"Through extensive ethnographic interviewing of a range of individuals from patients to parents, from the producer of generic drugs in India to civil society advocates in both the Gleevec and Gardasil cases, Pharmocracy provides a rich account of some of the more complex emotive concerns surrounding these moral, legal and financial questions of knowledge, value and politics. These are substantiated with in-depth triangulation of policy and legal documentation and philosophical thought. It is expertly researched and presented by a world-leading academic in the field who has devoted considerable research to the moral and philosophical concerns of the biomedical."
LSE Review of Books
"Kaushik Sunder Rajan’s highly anticipated book Pharmocracy is a rich, multilayered look at the pharmaceutical industry in India. . . . Sunder Rajan provides an insightful analysis of the regimes of value of the Indian pharmaceutical industry as it has become increasing aligned with the multinational pharmaceutical industry."
Medical Anthropology Quarterly
"Pharmocracy draws attention to the myriad forms of labor mobilized by the pharmaceutical (legal, clinical, volunteer, affective, and political) as well as the unruly properties of biological life itself and the growing ability to harness its (re)generative energies. These are vital questions, given how much pharmaceuticals have come to matter—as economic force, governmental conundrum, and active agent in the lives of humans and increasingly the environment— and to Pharmocracy we owe the debt of having begun to ask them."
"Pharmocracy is an important and essential book, one that pays attention to these multiple iterations of power across institutions, industries, legal regimes, and place. It is one of the first ethnographic studies that articulates the politics of global biomedicine through several sites of analysis: clinical research, treatment access, trade-related intellectual property, and the future of generic drug manufacturing."
"Presents an impressively holistic view of the world. . . . There is much to be praised in this book. The aims are very ambitious, and Sunder Rajan lays out no fewer than nineteen points of intersection around value, knowledge, and representation in the introduction. . . . It is in these representations of scale that Sunder Rajan’s work really shines."
Jennifer J. Carroll
Journal of the Royal Anthropological Institute
"Pharmocracy is an important discussion of events involving the Indian government, pharmaceutical companies—Indian and multinational—and civil society organizations. . . . A valuable addition to the social science of global medicine, its political economy, and its limitations."
American Journal of Sociology