ASA14: Anthropology and Enlightenment

(P49)

Commercialization, experimentation and health in low-resource countries: pharmaceuticals, collaborations and global philanthropy

Location Quincentenary Building, Seminar Room
Date and Start Time 22 June, 2014 at 14:00

Convenor

Salla Sariola (University of Oxford) email
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Summary

In the 21st century publicly funded health services have come under challenge from commercialization of various forms. This panel will explore experimentation and health care in global contexts, welcoming papers that critically explore ethnographic accounts of these processes.

Long Abstract

In the 21st century the idea that wealth leads to health through the introduction of publicly funded services has come under increasing challenge. We have seen the rise of new international donors, new models of health care - including public-private so-called partnerships - and the growing influence of neo-liberal ideologies and practices. These ideas conflict with both classical economic theories of public goods and with previous ideas and models of how health care should be delivered. This panel will explore how these challenges have impacted on how health care services are organised, funded and delivered, and how 'evidence' is produced to influence these processes. We welcome papers that consider topics such as neo-liberal clinical encounters; the blurring of lines between clinical trials and health care; the workings of the global health philanthropy industry; how medical knowledge, data, personnel and patients cross borders (including, for example, medical tourism and data sharing in multi-centred trials); the moral economy of generics drugs; and disputes around intellectual property rights. This panel will critically explore ethnographic accounts of these processes involving low-income countries. How can local or global wealth lead to local or global health in the current circumstances?

This panel is closed to new paper proposals.

Papers

Austerity and neoliberalism in Greece: a "sickening" combination for public health

Authors: Angeliki Kerasidou (The Ethox Centre)  email
Patricia Kingori (The Ethox Centre, University of Oxford)  email

Summary

This paper examines the effects of austerity and neoliberal policies on the healthcare system of Greece and the health profile of its population. It argues that austerity and neoliberalism adversely impact on the health and wellbeing of the Greek population.

Long Abstract

The financial crisis that began in 2008 has created a myriad of challenges for Europe. Greece tackled the crisis with the adoption of severe austerity measures and neoliberal policies that led to huge increases in unemployment, decreases in incomes, and rapid shrinkage in State welfare. Greece's public health profile was also affected, with increases in: mental health problems, suicides, incidences of infectious diseases, such as HIV and malaria; and infant mortality.

The causes of the 2008 global financial crisis remain debatable. Some argue that State intervention in the US housing market was the primary reason; while others name the deregulation of the banking system. Proponents of the latter theory argue for stronger state control over markets, whereas those in favour of the former argument advocate for less State intervention and neoliberialism. Such neoliberal ideals are not new in Europe. However, the recent fiscal crisis coupled with austerity measures have been catalytic in moves towards a neoliberal agenda aimed at shrinking the State and liberating Greek market.

This paper will: (i) look at how austerity and neoliberalism has changed the Greek healthcare system; (ii) compare the public health profile of the Greek population before and after the crisis, and; (iii) discuss the effects of neoliberalism on the health profile of populations. We will argue that severe austerity, neoliberal economic models in healthcare, the withdrawal of public spending and the privatisation of public health have adversely affected the health and wellbeing of the Greek population.

Community engagement in neo-liberal biopolitics: health care and clinical research in Kenya

Author: Salla Sariola (University of Oxford)  email

Summary

Community Engagement is an increasingly common requirement in international medical research. It builds direct relationships between research institutions and patients, by-passing the state. This paper explores such relationships and the role of community engagement in health research in Kenya.

Long Abstract

Community Engagement, also known as 'public engagement', 'patient and public involvement', and 'public participation', is an increasingly common requirement in 'ethical and socially relevant' international medical research. In practice, public participation has meant including lay members in policy making boards and other committees, hearing social movements in health-related knowledge production, and involving communities in the management of Global Health research. This normative demand by many medical charities and international research funding bodies to involve of publics in design, knowledge production, and science policy is believed to democratise these processes by pushing for accountability, and redefine expertise and ownership.

Meanwhile, when operating in resource and research poor contexts, community engagement facilitates neo-liberal biopolitics by building direct relationships between research collaborations including international and Kenyan medical research institutions, and patients and communities. Community engagement acts as a contract that legitimates clinical research while individual patients and communities use clinical trials as ways of accessing health care. Hence, community engagement contributes to the ways in which research works to compensate ill-resourced state health care systems, but also replaces the role of the state as the main health care provider.

Based on three months of ethnographic field work in Kenya, this paper explores and analyses the relationships between medical organisations and communities, and how terms 'community' and 'engagement' are understood and employed. What do these relationships tell us about the role of community engagement in health research?

Pharmaceuticals in daily lives: biomedical drugs and the marketing behind its effectiveness

Author: Silvana Matassini (University of Southampton)  email

Summary

This paper suggests a causal relationship between the widespread usage of biomedicine and its efficaciousness. Two topics of debate are discussing: Are biomedical drugs the most widely used form of healing? Why do people use biomedical drugs around the globe?

Long Abstract

In suggesting a causal relationship between massive usage and effectiveness of biomedical drugs I propose an analysis about the relationship between pharmaceuticals and: biomedicine; marketing and daily realities.

Biomedicine is the official provider of national health services. This political power places the discipline in a favorable position (West 2006) and preserves such authority with the collaboration of pharmaceuticals, which through biomedical drugs they channel this power to the population.

At one time the most successful pharmaceuticals were those with the brightest scientists searching for cures (Petersen 2008). However, the industry has become a marketing machine to grow profits.

In Africa the sleeping sickness is caused by a small parasite that leads to a serious infection in the brain and the meninges. The parasites are carried by the tsetse fly killing thousands a year (Petersen 2008).

The company that manufactured the medicine (eflornithine) abandoned it in 1995, seeing no profit in selling it in Africa. Nevertheless, in the United States, another company began selling eflornithine in the form of a cream to minimize female mustaches.

The industry introduces profitable medicines for a range of daily activities.

And in the present where there is no time to be sick, drugs 'effectiveness' is convenient for many people and for the industry.

Medicines can and do save lives, however, the relationship between pharmaceuticals and marketing makes us think that this effectiveness could be overdimensioned in order to target the ones who could afford to buy rather than the ones who truly need it.

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This panel is closed to new paper proposals.