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Paper short abstract

This paper dissects the 'unequal ordinary' in global health by showing how waste products from pharmaceutical manufacturing become the raw materials for the careful reproduction of everyday life (fences, firewood, etc) in central Madagascar.

Paper long abstract

In Fianarantsoa region of southern-central Madagascar, a pharmaceutical factory produces necessary antimalarial ingredients from the leaves of the Artemisia annua bush. Finished antimalarials often leave the island, an enduring symbol of global health inequality and the slow violence of resource extraction. But much is left behind in the villages where these medicinal plants are grown – like artemisia’s dried stems, which remain heaped up behind local houses once the valuable leaves are beaten off and sold to the drug company. This paper follows what that waste wood becomes: a woven fence protecting a village garden, struts for a new roof after cyclone damage, firewood for daily pots of rice and greens. In showing how medical industries furnish the raw materials for the fabric of everyday life in zones of production, it argues for ethnographic methods that decenter the consumption of therapeutic commodities or practices as core objects of analysis. Nuanced methodological attention to biomedical industries’ enmeshment with unfolding ordinariness – to how making medicine is in some ways also always making and remaking banal inhabited landscapes – in turn enables new theorizations of the relationship between medicine, global health inequality, and ‘the normal.’ Dominant conceptual toolkits focus on the ways that modern medicine expands modes of being deemed pathological and shrinks modes of being deemed normal. But medicinal-wood fences, roofs, and fires from Madagascar instead suggest the many ways that medical industries open unexpected grounds for the reconstruction of ordinary life even as they maintain conditions of profound inequality.