Introduction [3]
Hence there was a sense not just of violation, but of continued violation by
multinational corporate interests.
One resident of the slums told me that he does not go to the hospital any-
more, because “they do trials there, and we come out dead.”1 Satinath Sa-
rangi, who runs a free clinic in the slums for the gas victims, subsequently
described this to me as a continuation of the “circle of poison” that started
with chemical companies and continues to be propagated by phar maceutical
companies.2 He reminded me that a phar maceutical com pany is just another
kind of chemical com pany. Santosh told me, as our conversation continued,
that he wants to become a biologist when he grows up, because he wants to
do research that can improve the health of people like his who live in the
BOMBAY, 2008—
I was talking to Yusuf Hamied, the chairman of Cipla, India’s
oldest surviving phar maceutical com pany. I asked him about the impact of
World Trade Or ga ni za tion (wto)-imposed patent regimes on access to med-
icines in India. His response: “What a silly question, Professor Sunder Rajan.
What we are witnessing is selective genocide.”3
Repre sen ta tions of Health
It is an obvious truism that there are investments in health across social posi-
tions. These investments are variously monetary, bodily, and affective. But
what health might mean, how health might be achieved, and what imagina-
tions of social relations and relations of production underlie vari ous concep-
tions of health differs depending on institutional location, social hierarchy, and
power relations. Clinical trials are thought of as benefiting humanity even
as they are considered scandalous; hospitals are seen as spaces of cure but
also in certain situations as spaces of death; intellectual property rights
are argued for as necessary for innovation even as they are decried as being
This book seeks to understand the po litical economy of health in con-
temporary India as it operates in relation to global biomedicine. It concerns
emergent biomedical regimes of experimentation on the one hand, and
therapeutic production, circulation, and access on the other. These regimes
are operating in po litical economic environments that are highly capitalized,
albeit through diff er ent mechanisms, business models, and industrial forms. In
turn, these capitalized po litical economies foreground forms of biomedicine
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