Kristin Peterson‘s new ethnography looks carefully at the Nigerian pharmaceutical market, paying special attention to the ways that the drug trade links West Africa within a larger global economy. Speculative Markets: Drug Circuits and Derivative Life in Nigeria (Duke University Press, 2015) takes reads into a story that is part medical anthropology, part careful analysis of global economy, and shows that understanding one is vital to understanding the other in the modern West African pharmaceutical landscape. Peterson pays special attention to the Idumota market, an area that was strictly residential in the 1970s and has since become one of the largest West African points of drug distribution for pharmaceuticals and other materials from all over the world. Peterson looks at the consequences of major local and global historical factors in that transformation, including civil war in the late 1960s and migration that followed, a 1970s oil boom and bust, and changes in the global pharmaceutical market in the 1980s. By the early 1980s, Nigeria was deep into an economic crisis that had profound implications for the production, circulation, and marketing of pharmaceuticals. The pharmaceutical industry remade itself by becoming tied to the speculative marketplace, with wide-ranging implications that included the rise of new professional relationships & market formations in Nigeria, new relationships with firms in China and India, new forms of speculation, and new questions about the ontology of markets. Peterson demonstrates that these transformations continue to have important consequences for the bodies of individual Nigerians, including major problems with drug resistance and a mismatch between existing drug therapies and existing diseases. The book avoids the usual discourse of corporate greed, instead focusing on the “structural logics of pharmaceutical capital through which corporate practices can be understood.” It is a timely and fascinating study.
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I want to tell you about a new book, Public Success Private Grief, an extraordinary personal account by Peter Cowley. It's about Peter's life of professional accomplishments alongside extreme personal tragedies, cancer, suicides among his closest family members, and alcoholism. Peter spoke about public success private grief on the NBN recently. Alas, Peter has been diagnosed with cancer and I urge you to read this compelling book. It's open, honest, and filled with life lessons. Visit ps-pg.com to learn more and buy the book. Hi, I'm Carla Nappy and this is New Books in Science, Technology, and Society. Welcome and thank you very much for joining me on what is a very wet and rainy day in Vancouver today. I just got off the Skype phone with Chris Peterson to talk about her new book, Speculative Markets, Drug Circuits, and Derivative Life in Nigeria. This came out in 2014 with Duke University Press and it's a really interesting study of a very particular market in West Africa in Nigeria specifically that looks at the context of pharmaceutical traders and pharmaceutical trade there as a way of opening up how we understand global markets, the ontology of markets, the ways that particular forms of market behavior are shaped by particular historical circumstances and really how we might take these more nuanced, more rich, more open understandings of how, what, where, and why markets are and bring those to studies well beyond this particular case study of pharmaceutical markets in Nigeria. It's a really, really interesting story that's very, very careful about the weaving together of the particular pharmaceutical history, the drug history, the drug trade story and ethnography here with a really, really, really thoughtful exploration of what it can mean to think with markets. So it's a fascinating story, it was great to talk with Chris about it and I hope you have a chance to get your hands on the book and take a look because there's a lot of stuff in here, a lot of oral histories, a lot of personal accounts, a lot of descriptions of historical and conceptual phenomena that we didn't have time to get to. So really, really great study, great time talking with Chris and thank you as ever for taking the time to listen to the conversation. Thanks for your support and I hope you enjoy. I'm here today to talk with Kristen Peterson about her new book, Speculative Markets. Welcome to new books in STS. Chris and thanks very much for making time to talk with me today. I'm really looking forward to it. Thank you Carla, thanks for having me. So let's start us off as is traditional for the channel by saying a little bit about your background and specifically how did you come to work in anthropology and on Nigeria in particular? Well, I began as an undergraduate in biology at UC Santa Barbara and I was trying to actually get a job after I graduated and at the time that was in the early 90s, we were seeing the beginnings of the biotech industry taking off and so I moved to San Francisco along with a lot of other people at the time and got a job in the biotech industry working for Genentech and I got a bit disillusioned there and while I was in undergrad, I got very interested in critical theory and feminism and things like this. I was an activist at the time as well and so after working about a year, a year and a half at Genentech, I switched to get a degree in women's studies at San Francisco State and from there, I returned back to the science and technology because it was something I had already been long interested in and decided I wanted to understand science and technology from a different perspective and so one thing led to another and I moved into anthropology after I had done a master's thesis on one of the biotech companies in the Bay Area and so that's how I got into it. I kind of fell into these different fields and landed very nicely and happily in anthropology. So the book looks specifically at West Africa and it's about West African pharmaceutical circulation that's integrated into transcontinental trades. I'm taking that from the beginning of the book. It situates the drug market in Nigeria in the context of what we'll look into later on in the book as speculative capital and it looks very carefully at the ways that not just market interactions and practices but also what's happening outside of Nigeria is really impacting not just how we understand the drug market in pharmaceuticals but how we understand what it is to be a market more generally speaking. It's a fascinating book. It's right on the cusp of I think a whole new wave of work that we're going to see more of that's trying to integrate really careful, meaningful attention to economics, to markets and to a deep sort of knowledge and understanding of these phenomena within a broader study of history of medicine, anthropology of medicine, history and anthropology of science and STS. So it's fabulous. Congratulations. Thank you. Let's talk about how you came to this topic. What brought you to work on pharmaceutical markets in Nigeria specifically and how did you come to decide to run a book-length project about this? After I had done this master's thesis on bioprospecting in 1997, I decided that in anthropology as a graduate student, I wanted to study bioprospecting and that actually, at first I thought I would be going to the Andean region to study this because there were a lot of companies that were getting interested in bioprospecting in the Andean region. But then I also discovered there were several graduate students following that trend and I ended up taking a look at the advice of a friend of mine of what kind of bioprospecting activities were actually happening in Africa and I looked around and found some very fascinating things going on in the late 90s, early 2000s in Cameroon in Nigeria through some NIH-funded research that was basically led by a team of Nigerians who had pulled together a number of institutions including the Smithsonian and the U.S. military to bioprospect. It's one of these sort of stories where everything looks good to go, you have this project and you go into the field and everything falls apart and so I had done some preliminary research there and so I no longer had a project but when I had arrived to Nigeria that first time and I was there for about two months in 1999 or 2000, it was at a time that Nigeria was transitioning out of a very long period of military rule into civilian rule and I was very fascinated by what people had to say about that at the time and so my interest remained with science and technology but then suddenly I kind of you know this whole notion of an area and you know a region and you know started to open up to me and I just got interested in Nigeria and after the project fell apart I decided well what can I do to you know to stay here and I ended up actually working on for a dissertation on AIDS policies and AIDS activism since that was a kind part of an original component of the first project and so I just tweaked it and turned it in a little bit of a different direction and got interested in thinking about how the science and technology sort of land you know land in a place like Nigeria that is in such remarkable and dramatic transition and so that's how I ended up in that region. So it sounds like there were some pretty significant transformations from dissertation to book that just given the nature of the projects can you talk a little bit about that for you maybe specifically what are some of the most important ways that the project changed from one stage to the other? Yeah mine was a bit exceptional because I did not turn the focus of the dissertation into a book when I returned home and spent you know a couple of years writing the dissertation this way and again it was on AIDS and AIDS policies and right after I returned we saw the George Bush administration now launch the PEPFAR program which stands for the president's emergency program for AIDS relief and what that program essentially did in relation to my project was everything that I had documented during that year like no longer existed after that program was implemented and so I felt that in order to do justice to the dissertation project I had to also you know start looking at this PEPFAR program but then when I did I thought it turned out to be pretty overwhelming it required a lot it required a longer term perspective and research project and given that I was you know coming up for tenure I needed to figure out how I was going to you know turn this into a project so I had one chapter in the dissertation that was about private you know drugs circulating in private drug markets that was that was not based on any ethnographic research I did that was based upon the research that a number of Nigerian academics and sort of and the business community the drug manufacturing community had had produced over the years and I also thought well if I'm going to do this long-term project now kind of what really is turning out to be the rise and fall of the antiretroviral drug I would have to understand this totally different and separate space that nobody in the AIDS community ever deals with in in Africa actually and that is private drug circulation so I started going into those markets and once I did I realized this is a project in and of itself and so it was a bit of a spin-off with a you know with a real in-depth look of the original dissertation but in no means was you know the same conceptually or even in terms of my object of study it dramatically changed and so it's it really was that tender that also kind of pushed some of those decisions as well isn't that interesting yeah so when you're accounting of how the project transformed is actually really interesting and I'll just mention one of the things one of the many things and we'll talk about this in the course of our hour that I really love about the book is it's taking a concept that market right that you know a lot of people use that word you know the drug market the medical market market and really asking us to explode that notion and get inside of it and think about even okay well what are the assumptions that we're bringing to the notion of market itself and what happens you know when we probe those assumptions and open them up and we really have to do that in order to be able to talk about anything on a global scale honest and also anything local anyway there's lots of fascinating really really important stuff that's happening here that I think is potentially extendable well beyond how we understand Nigeria specific yeah I you know it's interesting because one of the things one of the reasons why I continue to go to Nigeria is because every time I go it's it's a place that really trips up our notions of market of capitalism of neoliberalism of risk of so many different terms and and you know I mean what we find in our literature is here about that just doesn't even map on to what I constantly find there and so in taking the market and what happens there I that yes you're right but one of the main objectives was to constantly unsettle our assumptions about what's happening but I wanted to also do it in a way that didn't make the Nigerian pharmaceutical market the other right of economics but and so that's why I did a you know a lot of work around talking about the way that speculative capital becomes important that offshore manufacturing becomes important the book also spends some time in one chapter in India and China to sort of look at this sort of as an intersecting point between the Nigerian pharmaceutical trade and the brand name industries global pharmaceutical circulation and so it was a way of trying to show that you know this isn't just some sort of you know notion of or rehashing the discourse that Africa is deemed linked from the rest of the world but to really show the immense ways in which pharmaceutical trade is integrated to the global drug trade and so that was but to also maybe also make strange in many ways how we understand the market to be working here and how we understand neoliberalism to be working here so that was yes that was the those were ultimately a lot of the objectives to sort of track some of that stuff and you know and in doing so I also had to look at the ways in which you know pharmaceuticals along with many other commodities are traveling through these shadow economies as well and to and that becomes also quite important in understanding you know what we mean when we say things like generic drugs or illicit drugs or standard or substandard drugs so yeah right and this all starts from chapter one right so chapter one looks at several factors that made it possible for a couple of transformations to happen we have a transformation of control over the market so you chart here a transformation in control over national drug distribution that switched from Nigerian pharmacists in North American and European multinationals to Igbo traders from Eastern Nigeria and to generic drug manufacturers in China and India and the major case study here is a place called Edomota market it I don't know if I'm pronouncing anything you are so can you introduce that as a space for us in terms of your experience with it during your fieldwork. Edomota market is located on Lagos Island the city of Lagos in Nigeria is right on the coast and it is a city of 20 million people it's considered one of the it is the largest city in Africa it is also considered probably the one of the most chaotic cities on the planet and so Edomota is one of I would say exemplifies these these these stereotypes so to speak and it's a site where almost all of the secondhand goods that enter into the country which you know makes up the bulk of products that are traded within Nigeria and so it is the you know the first place where drugs are received and inside of the market where all kinds I mean every single kind of commodity you can imagine is available for sale in this place and it's a it's a massive market that's basically overlaps in what was one of the real old neighborhoods of of the city and in about 10 square blocks is where pharmaceuticals are traded about at least a million dollars worth of drugs are traded in that market every day so we're talking about a massive amount the traders who work in that market as you pointed out come from most of them come from the eastern part of the country they're evil traders and they essentially are the are the main traders in the country so there are you know large markets like Edomota some are even much larger than Edomota in the country where there are pharmaceutical traders but what's unique about Edomota is that the all of the manufacturers around the globe whether generic or or patented drugs are or brand name I should say there's not many patented drugs in the country they sell mostly to these traders and from there the traders sell to the rest of the country traders through you know throughout both Nigeria as well as to the West African region and even as far as countries in central Africa such as the Congo and Kinshasa and so it's a it's a very significant place because it's the entry point for the entire wholesale system throughout the region for private private circulated drugs now many of these traders actually came to this work as a result of civil war migration so late 1960s civil war migration so how did what do we need to understand about that basically to understand how they came to work it in this job and why that's significant for understanding the pharmaceutical market in Igbo more general yeah so there was a civil war in Nigeria in the late 1960s and these pharmaceutical traders the bulk of them come from one town in Emo state which is called Orlu and Orlu at the time of the civil war was where the Red Cross and various churches and Oxfam arrived to administer humanitarian care so you know sort of medical field triage during the war and so the folks who are from this town instead of actually going to fight in the war they got trained by these international organizations to also deliver you know medical triage and stuff like that now when the war ended many of them left town and they moved to other parts of Nigeria where they became patent medicine dealers so basically I'm selling over the counter drugs by the time the early 1980s arrive and then by the mid 1980s we start to see the entire pharmaceutical market crash as a result of structural adjustment and also as a result of the new speculative term that the drug industry was taking outside of Nigeria and so what happened was pharmacists Nigerian pharmacists who had been working for and been trained by the global brand name companies who had been doing really really good business in Nigeria was an exceptionally good foreign market for them up until this moment they lost control of the system and the e-botrators basically stepped in and took over and so this is and that so this is the how that whole trajectory works and so we as you as you point out this Nigerian pharmacists and the brand name companies basically completely lose ground to e-botrators and new networks that they develop then with generic companies around the world so as this transformation is happening this actually really nicely takes us into the next chapter so what we just talked about right this post-late 1960 civil war migration is one of a couple at least of factors right responsible that you chart here for the transformation of Idomota into this massive market from what it had been right which is like strictly residential in the 1970s so as a or in addition to this migration after the Civil War there's also a 1970s oil boom right by OPEC and then a bust and by the early 1980s as you've just described a little bit Nigeria is deep in an economic crisis there's a crash of global commodity and oil markets there's a devaluation of the Nigerian currency widespread poverty and one of the reasons this is really important is that it meant that most Nigerians couldn't afford brand name drugs right so brand name companies right abandon the Nigerian pharmaceutical market and this low purchasing power meant it was too much of a risk for these companies to participate in the market now I'm emphasizing the word risk because as we move into the next chapter chapter two you talk specifically about how the notion of risky populations can help us understand something important about what's happening here so maybe let's pause and move there can you talk about what is a risky population in these contexts and why is it important to understand what's happening yeah I use that term to mark the transition that you're referring to here so on so when I'm talking about risk here I'm referring to both the government's perception of risk and as the Nigerian government that is and also the pharmaceutical companies conception of risk so in the 1970s the government is basically providing you know things like pensions and free education the drug company and you know to basically to its population the drug companies are also you know seen the Nigerian population as some you know as buoyant consumers right and so here are two entities that are essentially providing services you know in a buoyant economy to the Nigerian population once the economy begins to really go down as a result of structural adjustment all of these things start to get taken away and so for example it's not just simply that Nigerians begin to lose things like free education but that they are now protesting the fact that they've been you know that the majority of the population has essentially been rendered impoverished as a result of structural adjustment implementation and so there's a number of protests and and the same thing goes with the corporations people can no longer purchase drugs and so the market is looking quite risky and so there's a the result is market abandonment on the government and there's there's intense military violence that's unleashed upon upon the general population and so I'm interested here in how both the pharmaceutical companies and the governments go from seeing the population as one for which that you know they provide services for the most part to you know becoming completely risky such that you know violence and market abandonment become the answer and so that's basically I use that term to capture this transition because it's it was exceptionally quick that this wasn't slow going and it was exceptionally violent. So the pharmaceutical industry remakes itself right as a result of all this by becoming tied to the speculative marketplace and you talk in this chapter and we won't have time to talk too much about it but I just want to mark it because it'll I'm sure come back up later you talk about the importance of the industry pursuing speculative capital. Yeah and then take us through a couple of examples of two companies, up job advisor that both abandoned the Nigerians. Yeah yeah I talk quite extensively about those two companies they're they're good examples to show what was also at risk for these companies so I wanted to show that it wasn't just simply that the Nigerian market as it was tanking and that people could no longer buy drugs that that was the sole just reason that drug companies took to pull out of the Nigerian market but that there was this other thing on the horizon in the early 1980s and that was you know the companies who were not doing very well remember there was a you know it's coming out of a 1970s global recession and and they themselves didn't exactly have a lot of drugs in the pipeline they had a lot of patents expiring generic competition you know things like this and so as they themselves were struggling to stay afloat the opportunity to actually you know excuse me get finance capital from like Wall Street banks etc presented itself and so and one of the things that okay so there was a number of sort of factors that were involved in pursuing speculative capital that ultimately led to this consolidation frenzy because one of the things that the you know that investment firms said to companies was in exchange for this finance capital though you're going to have to show short-term games which we know that drug companies can't exactly do because it you know it takes you know 10 to 15 years to bring a drug to market and so to actually show short-term games in terms of not just profits but rates of growth become pretty impossible so the way to actually meet those those demands was to do things like acquire other companies merging consolidate and so we saw this huge consolidation frenzy that happened in the 1990s and at the same time that all of those mergers and acquisitions took place companies were also massively dumping assets so including entire markets like Nigeria and you know the end game was to basically come out top out on top and so I show how up John at this time was basically the ninth largest company in the world Pfizer was number one and being the ninth in the world wasn't even enough because at the end of the day Pfizer and other companies basically ate up John up so what I tried to demonstrate was that you know the stakes of sort of lose using a buoyant population that is buying drugs is also converging with these other higher stakes to stay completely on top of the game in the 1990s because otherwise you could basically lose everything so I'm so the point in that chapter was to show the ways that both structural adjustment and speculative capital become completely important to how the drug companies make decisions about abandoning the Nigerian market. Great thank you so much now as we move through this story we move through the brand name market crashing in the 1990s now this results in a drug scarcity problem and this prompts new actors to step in and you talk in chapter three in a way that we won't have time again to talk too much about but I just want to mark because it's important to understanding this sort of global reach right of this story this prompts Nigerians involved in the international narcotics trade to build a new generic market which attracts Asian pharmaceutical firms and so there's a whole part of this story that's about China and India and beyond and the ways that they are intimately and integrally enmeshed in what's happening in Nigeria. Yes so one of the things that's happening though as well in this chapter is a consideration of markets and this isn't just you know let's look at different markets this is really taking stock of what it is that a market is and so there's really fascinating discussion in this chapter of the ontology of markets. Now unofficial markets by the late 1980s as a result of all this are growing up in what you call the interstices of urban space and neighborhood public spaces in traffic jams on roads and there's a whole discussion about these markets are they legal are they illegal are they markets at all and take us into this really fascinating court case in 2001 between Edomota traders and the pharmacists council of Nigeria that really hinged on one central question was Edomota a market. Can you talk a little bit about that case and what's for you important about that case in terms of how it informs our understanding of the ontology of markets. Yeah that case was very interesting because once the pharmaceutical market began to crash and we see new drugs coming in alongside all of these new generic products that are completely unfamiliar to Nigerians but are nevertheless coming in are a barrage of fake products and their entryway into the country is usually through what are called unofficial markets and so and and the unofficial markets are you know just basically grew as a result of structural adjustment people who were struggling to survive this remarkable and massive transformation of the economy found themselves in you know the markets trying to you know make their way for the most part and so what we begin to see then is this growth of what you know one can call an unofficial market right as you were talking about and so the case then well in the process of the growing of the markets we start to see in a largely unregulated environment new regulations come down to try to control fake drugs and so one was the establishment of the pharmacist council of Nigeria which was meant to regulate drug premises meaning they're trying to eradicate the unofficial drug markets that are now popping up everywhere and they did this in part not only to eradicate fake drugs but also pharmacist wanted to take back the system that they once controlled this was another motive so what they did was they said to eat a motor drug traders who at the time would probably amount it to anywhere between four and 500 or so traders this is in the early 1990s they said well we're going to take your your licenses away because you're not allowed to sell in what they called an open market and so the traders took the PCN to court and said well we don't sell in a market and PCN and so you know this this is what became very interesting was that a case that was about licenses and drug premises suddenly turned into this question but as to whether or not the market is actually a market and the reason why I found this debate completely interesting and important was the fact that the law itself in regulating fake drugs cannot account for this transformed urban space right and and so that's part of the issue but the other part of the issue was that there are also all of these other kinds of politics that are going on that transcends the law anyway so even if the PCN were to get its way which it didn't at this time and shut down it a motor market it would also mean shutting down the the the entire wholesale you know a trade throughout the West African region and you know this is a place where the Yoruba traditional elite also own all the property so they're making rents you have you have hundreds if not thousands of people who are dependent upon this lucrative trade who provide various kinds of services who would lose their livelihood so there's a lot at stake in both keeping these markets open because then you run the risk of fake drugs traveling through and then also a lot at stake and shutting it down meaning that the whole drug supply could just get stopped throughout the West African region so the stakes were very high so thank you so much so as we move from here we move into another form of speculation so we've talked in the previous chapter about this idea of speculative capital we move in in moving to chapter four to looking at speculation on life's chances as you put it here so this is a chapter that looks at the situation in light of profound unpredictability and volatility of the market there are new forms of valuation you describe here there are unofficial markets changing credit structures debt negotiations high-risk entrepreneurialism and I was taking this from the chapter right pricing strategies price wars okay so what does that mean for the individual what does that mean for the person working as a you know in this industry in this context and this chapter explores what it looks like to as you call it hustle the day in pursuit of cash right and you take us into the experience of individuals who are doing this now the chapter in taking us into the experience of these individuals introduces the idea of derivative life right these are forms of speculation that are involved in this hustle that are tied to what you call speculating on life's chances so can you talk about this form of speculation so that we can understand this in this broader context of speculation more generally here yeah um and one of i think one of the things that's really important here is the way in which um what what we now have um is you know this extreme market volatility that underlies like all entrepreneurial action in the market and and so what i wanted to do was to show how um the ways that people you know market makers and folks working in the market the ways that they take action you know has um is about one it's always a risk i mean in fact right now um in Nigeria the the currency um ups and downs are so volatile and violent that there's there's many people are just going out of business because they're having trouble actually anticipating you know making a buy at a wholesale level and then trying to move it through the market when um the currency is moving up and down right so if it's if if you're buying something and the currency changes it you know in a way that works against your business then you can lose basically everything so i i talk i i i say that this is about speculating on life's chances that it's not just about business because everything becomes that thing that's at stake right every you know everything um and so one of the things that i do in the book is describe how um various you know folks who've been trying to deal with this business for a long time you know operate and try to um you know create situations where it's like all right i'm going to buy and sell this very sure thing that you know Nigerians are will buy and then they might think about taking risk on something else and what this ends up doing then is you know reproducing a particular kind of drug market structure that ultimately um doesn't match up with uh you know basically human needs and so um i got very interested in this this struggle to survive the way that the struggle to survive actually then creates these market conditions that are not so good for consumers um at the end of the day in terms of their health needs and so um it's just another example of thinking about you know you know really what is a market at the end of the day right um that we're very used to thinking about markets as these things you know where um supply and demand are are matching each other in some kind of even way when in fact um you know the market is just used as this tool for people to actually try to survive the day and the chapter it pays really careful attention to something we don't really have time to talk about what is really important here and that is sort of theories of the market more generally specifically there's a lot of really wonderful stuff here on non-equilibrium theories of the market um and you look at a range of them right your rupa eco and also Chicago and Austrian neoliberal market theory so there's a really interesting stuff in terms of market theory and non-equilibrium ideas specifically that's happening here but you mentioned um just before that these circumstances are not so good for consumers in terms of their health need and this is very much a focus of the next chapter now as drugs are priced lower and lower to appeal to a relatively impoverished market price differentials disappear pretty soon down the road right because the drugs are already priced so low so the next bit to change if you want to make money on this whole thing is the chemistry of drugs and you talk about strategies for changing um the active pharmaceutical ingredients so they become kind of cheaper and more competitive and you um talk about this in the context of chemical arbitrage here so it's really really interesting yes as we move um into the chapter though you look at the ways that the structure of a Nigerian pharmaceutical market and the need for the treatment of diseases don't match up right on the right these two things don't match up now the drug classes that were marketed since the 1970s in Nigeria simply don't match with changing microbial and human biology so existing drug therapies aren't um effective at treating existing diseases well we need to talk about that so yeah um so at this point i'm just gonna um kind of open this up back to you can you talk about for you some of the most important implications of that in terms of the larger arguments of the book and of the project yeah i'm i think that when we talk about access to drugs for um various kinds of neglected diseases or access to drugs that are usually expensive for you know diseases like HIV and etc that um i think in the past the biggest debate has revolved around like patents and price and stuff like that but i but you know i think there's just been little attention paid to how people actually you know get their drugs and where are those drugs and are they even available and so for me trying to really detail the the way that local biology's and um market structure are linked up or not or how or what kind of relationship they actually have becomes really important because um it for me it you know it's it we have to ask these questions about um you know what are the structures of these markets you know how exactly do they work how are people actually accessing and in accessing this what kinds of other problems are arising things like um the use of substandard drugs or the use of fake drugs or the problem or immense problems with these older generation drugs that are very cheap and that end up on the market and produce drug resistance right and so these are kind these are the kinds of questions that don't often get asked in global health circles and so i think the implications then are ultimately quite huge once we start looking at you know these other sort of economic issues in line with global health concerns you talk about some of these problems specifically in terms of understanding these dynamics of drug resistance and also market structure as a social life of bioequivalence yeah or a dream of bioequival right this is really fascinating can you just explain what that means for listeners yeah i um it's a very simple you know sort of idea that um that there's a perception you know in that part of the world where um um you know where well actually there's an experience i should say of taking drugs that um where one is always at risk because one doesn't know if you know you're taking a substandard drug a fake drug you know or it's right you know so you you just you just don't really know even if it's coming from the manufacturer and so i talk about you know the way that the people consumers it's my one place in the book where i deal with consumers because i mostly i'm dealing with sort of wholesale drug distribution systems across continent and locally and it's just this it's this thing where people just um they imagine the pharmaceutical metropole to be something very different right where we're all getting our good drugs and and it's it's just not wanting to deal with this anymore and it and it falls into a more generalized kind of you know precarity in life and um so you know a social life of my equivalence is about that but i um the way that i enter into talking about it is to think about the sort of the openness or the flexibility of markets alongside with a number of STS scholars have talked about the openness of chemistry and the ways in which those two things really need to be thought together because it is the market structure that actually produces or gives rise to these variations in drug chemistry and so um and so you know i i take that and swing it back into you know consumers dreams of having some safety and the drug supply that's right this is really fascinating um moment in this chapter this is something that for me was stars you know circles right in the margins make sure to make note of this just fascinating a moment where you're relating this idea um of kind of you know the openness of chemistry to whitehead and the idea of a molecules relationship to its environment so there's this really i mean the book is full of moments like this but for me this was one of the really striking moments where you're asking us to even um kind of rethink not just what a market is but what a molecule is in terms of relationality um in a in a way that um i think is not going to be um self-evident for a lot of readers i'm certainly wasn't for me and that really changed the way i think about molecules so thank you thank you for that too away from this with a different notion of molecules even okay so as we move into the book and we move into the next chapter um we move into a chapter that looks at the processes through which new types of monopolies are arising in the context of this international pharmaceutical industry so there's this new speculative market right um and you describe the ways in which there's new debt intellectual property and drug marketing regimes that are implemented in the context of this um speculative market connection in the 1980s so there's a lot going on in this chapter um that i'll just name and i'll ask you to talk about maybe a bit of it so you talk about the ways that pharmaceutical pharmaceutical marketing strategies shape how drugs are distributed in west africa and you you take us into the process of um the kind of selection of which drugs to um to distribute in the region biomedical representatives so listeners who are particularly interested in that um can turn to the early parts of chapter six but then there's this discussion of intellectual property law now this is super fascinating um now in this discussion more generally of intellectual intellectual property law and patents specifically you remind us that people have argued that patents have been responsible for poor people's lack of access to drugs but here this doesn't really work because um in nigeria patented drugs aren't marketed there in any kind of a widespread way right now by this point in the book um we kind of we've have all this background to help us understand that right now it came that way so instead brand name manufacturers are not after patents they're instead after monopolies across markets but you don't need a patent for so can you talk a little bit about that um what's important about that um for the larger implications of this story yeah i sorry i wanted to um you know i think for many of us in the 1990s we thought that the patent was the thing that we needed to focus on but once i started to understand how this market works in nigeria excuse me i you know i was just you know i couldn't figure out how to explain intellectual property law when in fact um you know there are no drugs that are marketed no patented drugs that are martin marketed in in the country with with a few exceptions and so um my aim with that was to sort of talk about and you know what so what is going on here with intellectual property law and and so i went back to ip law and i and and started to ask well what is the thing that facilitates you know the you know monopolies in terms of you on the one hand you have you have a manufacturer's monopoly and then you have a consumer what is the thing that gets those monopolized drugs to the consumers and it's the market and so i go through and you know as you've mentioned in the book i describe the way that that market basically disappeared so if the market is disappearing here and it doesn't actually exist at a patented market to distribute drugs um then what can we say about intellectual property law um so i the one of the things i was trying to also get at too was to look at how um going back to price i mean there's throughout the book and i talk about how important price becomes in in drug circulation and that um a monopoly can be had um simply by you know on the one hand you've got um sort of mid-range markets like india and brazil which are quite strong because they have um pharmaceutical manufacturing that can challenge patented and brand-name drugs you don't have that in nigeria right and so one of the what the strategy for those mid-range markets are to basically get a patent and challenge the global companies right so that's why it works in that way in in india and brazil and other other countries like that but in a place like nigeria where you have manufacturers who are really only making like anti-malarials or or pain relievers like aspirin and paracetamol and things like that um they can't challenge the companies and so um the strategy there to maintain price across markets then is to simply not market the drugs and so this is why you see a huge absence of cancer drugs of HIV drugs where they do circulate or on like the the foreign donation market so this is where also the global health you know comes in because uh or the global health kinds of programs um whether foreign or domestic um come in because that's where those patented drugs then circulate they don't ever circulate on the private market and i would venture to say not only in nigeria but throughout africa and one of the reasons for this is to um especially in nigeria and this is what's told to me by marketers working in the country is that they do not want um patented drugs circular you know circulating in the market at a low price um and that could easily be smuggled back into europe because it would undercut those prices in europe and so the idea here is that when those patented drugs do come into the country and they might land in a few pharmacies they are actually more expensive than the drug prices in europe and the whole point of that is to discourage any smuggling back into on the european market which they'll do anything to protect so and then i did introduce debt and the only and i'll just mention briefly the the issue of debt regime becomes important because it does manage to um wipe out the competition from um you know ever you know challenging the brand name pharmaceutical industry which um it had i would say the nigeria manufacturers had a chance to do um in the 1970s but structural adjustment managed to sort of level that opportunity for them so there's yeah you're right there's a lot going on there but the idea was to show how debt and how intellectual property um are working together and also specifically with intellectual property to just show um that it's not that the patent that matters but that the strategy to obtain a monopoly is going to be different across markets but um the key here is to protect the price integrity especially in europe and north america where those markets um matter the most to the industry so thank you so much chris so we're now we're almost almost at the conclusion of our conversation but we're certainly at the conclusion of the book now there's some wonderful stuff happening in the conclusion you take us um on a trip with you and a friend to a laboratory right zenrex which is not the real name right but right zenrex laboratories um we meet um uh some really interesting people who have a sense of enthusiasm and it seems like optimism about the future so that's a really wonderful part of the first um bit of the the conclusion and then you remind us um later on in the conclusion what the book is not right the book this is not a story of big bad wolf corporations that are greedy right i mean this is not a story that's in those terms in fact it's asking us to avoid um explaining what's happening and understanding what's happening in terms of corporate greed and instead to think about structure to think about as you put it here the structural logics of pharmaceutical capital through which corporate practices can be understood greed's built into this system itself and actors are negotiating the the constraints of this structure and the constraints of these market conditions um so it's a very different way and i think a much more useful way of understanding how to enter into this story now perhaps the last question that i'll ask you before we come to the conclusion though it takes us forward i mean this is something that you touch on in the conclusion as well looking forward for you what are some of the most important implications of this study for motivating future work on global markets um like what would you love to see um coming out of this book or how would you love to see future work on global markets and pharmaceuticals um like what directions do you think are particularly exciting and what's your dream field look like after this yeah i it would you know one of the things that i tried to do was to really scale STS alongside markets and economies and things like that and i i would love to see um more work and anthropology that can you know figure out how do we think about ethnographies of systems and um so meaning that you know if you're studying in in one particular place how is it that you begin to understand that place and what's going on there situated more broadly you know in sort of some in and ask more macro questions about it and i think that um i think that that becomes really you know really i i it's i think it's really important in order to sort of reframe you know what we mean by neoliberalism or what we mean by capitalism and so just to take the example you mentioned you know i i i do say that i if the explanation of corporate greed is is not enough but that my details throughout the book is to suggest that things are actually far worse than just corporate greed but when we start to really examine the the violence of the system itself that corporate greed is like the last thing that we should really be caring about we should be caring about the ways in which all of this is functioning within a system and so i would like to see more ethnography um asking questions about um sort of multiple layers of systems whether or not it's even about pharmaceuticals but to be able to sort of link and scale you know um from an object of study through um more macro questions about systems themselves so chris for now at the end of our conversation i just have a couple questions for you now of course um there's a ton of material we've already signaled moments um a few of many moments in the course of our conversation where this is true but there's a ton of material we didn't talk about that's um that's in the book is there anything in particular that we didn't talk about but that you'd like to mention for listeners i think i just did here at the end um that you know i i really this was um trying to take up markets and fishers um suggestion of ethnographies of systems and and figuring out how to do it and um i you know i i would just i would like to see um more of that kind of work but it was something that i um very much tried to do and i think there's things that you lose in the process like some of i mean like going into edimota i could there was a moment where i just several moments where i thought i just want to study this market because every time i went in my learning curve was just exponential and it never really leveled off but it was the traders themselves who kept pushing me back to system because i would go in and they'd say things like oh last week when i was in Lebanon or let me tell you about the drug distribution system in Pakistan or you know things like this so always sort of signaling something broader to to what's going on and um and so it was uh it was a huge challenge but um it was and also very experimental and i would like to see other people come up and do and refine it and figure out how we can like you know do it better so now that the book is out what's next for you what are you currently working on um i am looking at um i'm looking at questions of the technological of what i'm calling the technological imagination in Nigeria and um perhaps throughout other parts of Africa and what i mean by that is sort of been talking to an interviewing scientist for um well over a decade now and i'm trying to make sense of some of the things that they have to say about their work including most of them who see their um their works as acts of social justice and also who um sort of speak as if they're coming out of that vision of African independence and the African liberation and so i'm interested in thinking about sort of technological imagination alongside these histories of African liberation and so we'll see where that goes best of luck without work and thank you so much for talking with me about this one it's really been a pleasure thank you so much Carla I appreciate it you've been listening to new books and science technology and society thanks for joining us and we'll see you next time
Kristin Peterson‘s new ethnography looks carefully at the Nigerian pharmaceutical market, paying special attention to the ways that the drug trade links West Africa within a larger global economy. Speculative Markets: Drug Circuits and Derivative Life in Nigeria (Duke University Press, 2015) takes reads into a story that is part medical anthropology, part careful analysis of global economy, and shows that understanding one is vital to understanding the other in the modern West African pharmaceutical landscape. Peterson pays special attention to the Idumota market, an area that was strictly residential in the 1970s and has since become one of the largest West African points of drug distribution for pharmaceuticals and other materials from all over the world. Peterson looks at the consequences of major local and global historical factors in that transformation, including civil war in the late 1960s and migration that followed, a 1970s oil boom and bust, and changes in the global pharmaceutical market in the 1980s. By the early 1980s, Nigeria was deep into an economic crisis that had profound implications for the production, circulation, and marketing of pharmaceuticals. The pharmaceutical industry remade itself by becoming tied to the speculative marketplace, with wide-ranging implications that included the rise of new professional relationships & market formations in Nigeria, new relationships with firms in China and India, new forms of speculation, and new questions about the ontology of markets. Peterson demonstrates that these transformations continue to have important consequences for the bodies of individual Nigerians, including major problems with drug resistance and a mismatch between existing drug therapies and existing diseases. The book avoids the usual discourse of corporate greed, instead focusing on the “structural logics of pharmaceutical capital through which corporate practices can be understood.” It is a timely and fascinating study.
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