Clinical Trials, Private Sector Influences

Petryna's article on off-shored clinical trials impressed upon me the problems that occur in our current system of pharmaceutical development industry. Having no background in public health or medicine, it was strange to me to suddenly learn more about how drugs are tested and approved. It is a somewhat discomforting idea that clinical trials are off-shored to developing countries that need healthcare, and that people in those countries get so much of their healthcare from clinical trails. The idea that people are getting their healthcare from experimental drugs being tested by private companies who ultimately judge their success by drug approval and profits, is disturbing to me. Thus bringing into question reliability, liability, accountability, and ethics. And yet the sense that these people and economies also benefit in some way from this kind of healthcare does not comfort me as much as it reminds me of how capitalism exploits or appropriates the resources of the developing world.

It reminds me a lot of what I learned from Glenn Stone's class, Brave New Crops, which talked about the anthropology of the agri-biotech industry. The agri-biotech industry and the pharmaceutical industry seem to have many things in common. They both concern matters of genomics and public health. Both see a trend towards increasing privatization and are shaped by market forces and profits. Both are shaped by intellectual property laws and laws concerning trials and approvals. In particular, an idea from Brave New Crops that immediately comes to mind is the idea of companies in the first world, which are in many ways resource poor, using their economic and technological influence to appropriate from the resource rich third world. In terms of agri-biotech, that resource is genetic in nature, in that the crops, landraces, and genes of the third world are being modified and patented by companies at home (eg. Monsanto). Hybrid seeds and contracts are then used to protect their intellectual property. For the pharmaceutical industry, that resource seems to be people. Petryna describes how it is very hard to recruit people for clinical trials in the Western world, and thus companies recruit in Eastern Europe and Latin America.

It is also simply uncomfortable that the production of technoscientific knowledge in clinical trials, which are supposed by be scientific in nature and reliable, and more importantly concern our own health and bodies, are so influenced by profit margins and investments abroad.