Paper long abstract:

Since the late 1990s there has been a proliferation of 'product development partnerships' (PDPs) in the field of global health in which commercial and philanthropic actors respond to the problem of 'neglected diseases'. This paper is based on ethnographic fieldwork conducted with The Global Tuberculosis Alliance, the main initiative focused on developing new anti-TB medicines that are affordable in the Global South. To this end, it is engaged in complex and highly choreographed practices of 'partnering' with commercial pharmaceutical firms, something all parties narrate as a 'win-win' scenario in which market-driven drug development is harnessed for the benefit of diseases such as TB. Drawing on anthropological gift theory to analyse one specific partnership, the paper unpacks the symbolic and material exchanges of 'good press' and intellectual property that underlie this model. This analysis supports the argument that one of the major functions of the TB Alliance is to carve out markets from tuberculosis, the neglect of which is paradoxically presumed to be the product of 'market failure'. To this end, the partnerships undertaken by the Alliance seek to purify tuberculosis in ways that isolate the more lucrative aspects of the disease, here corresponding to compounds reserved for drug-resistant TB. Yet if one of the major problems in this field is the rise of bacterial resistance to newly developed drugs, here 'win-win' models of drug development are seen to condition investment in ways that are unlikely to result in the new multi-drug regimen needed to halt the cycle of resistance.