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The Private Market for Anti-TB Drugs in India

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The Private Market for Anti-TB Drugs in India
Chapter for:
When People Come First: Anthropology & Social Innovation in Global Health,
João Biehl & Adriana Petryna (Eds.) Durham, NC: Duke University Press.

DRAFT PAPER – PLEASE DO NOT CITE OR CIRCULATE WITHOUT
AUTHORS ' PERMISSION

Stefan Ecks & Ian Harper*

"There is No Regulation, Actually":
The Private Market for Anti-TB Drugs in India

*This paper emerged from the collaborative research project Tracing Pharmaceuticals in South
Asia (2006-2009) that was jointly funded by the Economic and Social Research Council and the
Department for International Development (RES-167-25-0110). The project team comprised:
Soumita Basu, Gitanjali Priti Bhatia, Samita Bhattarai, Petra Brhlikova, Erin Court, Abhijit Das,
Stefan Ecks, Ian Harper, Patricia Jeffery, Roger Jeffery, Rachel Manners, Allyson Pollock,
Santhosh M.R., Nabin Rawal, Liz Richardson, and Madhusudhan Subedi. Martin Chautari
(Kathmandu) and the Centre for Health and Social Justice (New Delhi) provided resources drawn upon in writing this paper. Neither ESRC nor DFID is responsible for views advanced here. We would also like to thank Amy Davies and Reena Ricks for sharing their Edinburgh
MSc dissertations on public-private mixes with us.

1

Introduction: "74%"

Ten years ago, Paul Farmer called tuberculosis the "forgotten plague" (Farmer 2000:
185). While millions of people were dying every year of TB, the disease had become invisible for people living in rich countries. TB used to be at the forefront of public interest when it was rampant in the richer industrialized countries. But thanks to better nutrition, healthier living conditions, and more effective drugs, TB "ceased to bother the wealthy" (2000: 185). Against this forgetfulness, Farmer urged anthropologists to listen to the voices of the poor and to record their stories of deprivation and discrimination.
But he also said that ethnography was insufficient to grapple with the problem. A comprehensive perspective on



References: Chaganti, S.R. 2007. Pharmaceutical marketing in India. New Delhi: Excel Books. Chaudhuri, S. 2005. The WTO and India 's pharmaceuticals industry. New Delhi: Oxford University Press. Das, V. & Das, R.K. 2007. How the body speaks: Illness and the lifeworld among the urban poor Ecks, S. 2008. Three Propositions for an evidence-based medical anthropology. Journal of the Royal Anthropological Institute, S77-S92. Ecks, S. 2010. Near-liberalism: Global corporate citizenship and pharmaceutical marketing in India Farmer, P. 2000. The consumption of the poor: Tuberculosis in the 21st century. Global Fund for AIDS, Tuberculosis and Malaria. 2010. [About the Global Fund] http://www.theglobalfund.org/en/about/ Hacking, I. 1995. The looping effects of human kinds. In D. Sperber, D. Premack, A.J. Harper, I. 2005 Interconnected and interinfected: DOTS and the stabilisation of the tuberculosis control programme in Nepal Hayden, C. 2007. A generic solution? Pharmaceuticals and the politics of the similar in Mexico Rangan, S. 2008. India 's revised national tuberculosis control programme: Looking beyond detection and cure Kleinman, A. 1980. Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry Latour, B. 1987. Science in action: How to follow scientists and engineers through society. Latour, B. 1993. We have never been modern. Trans. Catherine Porter. Cambridge, MA: Harvard University Press. Latour, B. 2005. Reassembling the social: An introduction to actor-network-theory. Oxford: Oxford University Press. Lupin. 2009. Annual Report 2008-2009. Mumbai: Lupin Limited. (download at www.lupinworld.com; last accessed 27 June 2010) Prasad, R., Nautiyal, R.G., Mukherji, P.K., Jain, A., Singh, K., & Ahuja, R.C. 2002. Ryan, F. 1992. Tuberculosis: The greatest story never told. Swift Publishers. Singla, N., Sharma, P.P., Singla, R. & Jain, R.C. 1998. Survey of knowledge, attitudes and practices for tuberculosis among general practitioners in Delhi, India. TB Alliance. 2007. Pathway to Patients: Charting the dynamics of the global TB drug market. Uplekar, M.W., Shepard, D.S. 1991. Treatment of tuberculosis by private general practitioners in India World Health Organization. 2010a. Stop TB strategy.

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