- Speculative Markets: Drug Circuits and Derivative Life in Nigeria by Kristin Peterson
In this ambitious and innovative book, Kristin Peterson analyzes pharmaceutical markets in Nigeria, successfully connecting multiple empirical arenas, scales of inquiry, and temporal trajectories to make sense of a seemingly chaotic situation. She presents a persuasive argument that Nigeria’s contemporary drug markets are a product of—and a revealing window onto—an array of intersecting local and global policies, politics, and processes. Speculative Markets is a boldly compelling example of ethnography that is at once thoroughly grounded in extensive fieldwork in one place (in this case, the massive Idumota pharmaceutical market in Lagos), but also situated in a rich and impressive historical narrative and a remarkably comprehensive account of relevant large-scale political-economic forces. The book weaves together a seemingly disparate array of phenomena, such as the livelihood strategies of Nigeria’s Igbo people after the 1960s civil war, the boom and bust cycle of Nigeria’s oil-dependent economy, shifting international trade policies and global debt regimes, and the evolving business models of multinational pharmaceutical companies. Peterson’s outstanding book will be of interest to historians, anthropologists, sociologists, and political scientists, equally worth reading if one is an Africa specialist or a student of the history of medicine, public health, or global political economy.
Speculative Markets challenges much of the conventional wisdom about how drug markets work. Moving with dexterity across social scales—from international patent laws to the everyday calculations of individual traders regarding what product lines to pursue—Peterson demonstrates that these levels of social and economic life must be understood together if we are to grasp the complexity of Nigeria’s pharmaceutical markets and the consequences for the health of 170 million Nigerians and many millions of other West Africans. For as Peterson shows, the Idumota market supplies drugs throughout the region. The situation is serious. Major multinational brand-name drug companies have essentially abandoned the Nigeria market. To the extent that they are still engaged, like the generic manufacturers—mostly from India and China—that now supply the bulk of drugs to Nigeria, the drugs they sell are a mismatch for the health problems at hand. Antibiotics and antimalaria medications are types that have long been [End Page 844] considered obsolete in the West. Drugs to address many Africa-specific diseases are rarely researched or developed. New and effective medications for an array of important contemporary diseases from cancer to diabetes are either not marketed at all in Nigeria, or so expensive as to be effectively unavailable to most people. Alarmingly, a huge proportion of the drugs that do reach Nigeria are fakes.
Peterson’s treatment of the problem of fake drugs is emblematic of the overall complexity of the analysis in the book. Rather than reducing the problem to greed, corruption, and poor government regulation (though she does not shy away from acknowledging that there is enough of those to go around), her argument is much more nuanced. Fake drugs are put in the context of international political economic forces, global trade and patent policies, Nigerian government practices, and the dynamics of Nigeria’s popular markets, including the demands of consumers. Her account does not exonerate manufacturers who produce fake drugs, the marketers who sell than, and a government that fails to stop it, but Peterson helps the reader understand the forces at work that explain why it all happens in the first place. Indeed, in her deft hands, even the definition of fake drugs and the procedures that produce them are effectively scrutinized and rendered both more complicated and more legible.
A full appreciation of this book requires reading the whole. It is not a book written in a way that one could read just the introduction, or assign only that to students for a class, and have faith that the overall contribution could be grasped. Indeed, my sense was that the introduction did not do full justice to the book, which ultimately unfolds as...