Global Biotech and the Asian Nation

Asian Biotech is a collection of ethnographic studies that seeks to complicate the popular narratives of exploitation often deployed in discussions of the rapidly expanding biotech sector in Asia. Many of the contributors—whose topics range from international human subject research to blood-banking practices, from stem-cell research to questions of genomics research and national identity—situate the influence of “the West” as the imagined “origin” of biotechnology, but they do not reproduce overly simplistic narratives of exploitation via Western outsourcing. To those familiar with debates, for example, in Western bioethics and the popular press about the negative consequences of outsourcing medical care from the West to Thailand (so-called medical tourism), with its divergence of funding and medical resources from the local population toward highly specialized surgical centers performing gender reassignments and organ transplantations on richer, foreign bodies, the partial defense of developments in biotechnology this book occasionally stages might seem puzzling. Indeed, if many have already become deeply skeptical of global narratives of pharmaceutical development and other biotechnological progress as life-enhancing (as widespread reactions against genetically modified foods attest, for example), and happily resort to the caricature of recent biotechnoscientific development as just one of the latest strategies for squeezing surplus value out of human bodies, one may ask what’s worth nuancing about these commercialized technologies and practices at this finer grain, cellular level, so to speak.

Some of the more theoretically oriented chapters reply, at least implicitly, that through the practice of ethnography and with an eye cast on conceptions of the ethics largely underpinning these developments, a crisper picture of the structural violence of “biocapital” comes to light. Kaushik Sunder Rajan’s contribution, on clinical trials performed in India, which he calls the “experimental machinery of bio-capital” (55), and conceived as a follow-up to his recent book focused on genomics, is the most satisfying in this respect. Focusing on the relatively young industry segment of “clinical research organizations” (CROs) in India, which contract with pharmaceutical companies and other entities to perform clinical trials, Sunder Rajan argues that something called “ethics” together with increasing regulatory rigor are precisely what enable and reproduce the violence of clinical trials in India—human “volunteers” who give proper “informed consent” participate in inherently risky Phase I trials of toxicity of new drugs in exchange for a modest remuneration, a situation nevertheless deemed ethical by global standards. The ethics are situated, Sunder Rajan argues convincingly, in such a way that value, rather than health, “over-determines the practices that emerge” (77); and as he notes, Indian CROs are the most important drivers of a developing regulatory infrastructure, in effect pressuring the Indian state to subject their work to more and more legally binding standards (68). A legalistic stamp of ethical approval then ensures the admissibility of research results in other venues, meeting, for instance, the criteria of the FDA in the United States, and also helps global biotech companies avoid any public relations fiascos that may arise were they to be caught “unethically” exploiting Third World populations (66). As a result, India has developed some of the most stringent legal regulations of clinical research of any nation on the planet (although its regulatory infrastructure is still in a process of development). What becomes clear in this chapter is the degree to which “ethics” has become largely synonymous with the limitation of legal liability in biomedical science—a situation in no way limited to India, Asia, or the non-West.¹

Sunder Rajan’s argument rests on the premise that pharmaceutical and other biomedical research in India mediate logics of capital, resulting in the accumulation of “not health but value” (76), which leads him “to privilege an analysis of value, rather than assume from the outset that biopolitics, or pastoral care, is what is at stake” (77)—all of this is easy enough to accept—and that the historical, structural violence of globalization exacerbates the violence of human experimentation in a uniquely Indian form...