Paper short abstract:

The paper uses assemblage theory to examine social networks promoting misoprostol for postpartum haemorrhage

Paper long abstract:

Misoprostol was added to the WHO Model Essential Medicine List (EML) for the prevention of postpartum haemorrhage (PPH) in 2011.The ideal is that the decision to add a medicine to the List is based on science following the procedures of Evidence Based Medicine. In 2012 and independent review of the evidence for the use of misoprostol for PPH, which included the studies that formed the basis of the WHO EML Committee decision, found it deficient in a number of areas; the trials had serious limitations in the study design, did not show evidence of efficacy, and confirmed misoprostol related side effects (Chu et al 2012). It is clear that along with its life as a scientific object misoprostol also has a life within a complex social field, and the addition of misoprostol to the WHO EML in 2011 was deeply connected to wider social, political and economic conditions. This paper aims to understand the nature and influence of this network and assess how it developed. The network was global in scope and involved a diverse range of activists. It is an example of a global health assemblage, a transnational public health pattern which has become increasingly common in the last few decades. This paper will use assemblage theory to analyse the development of the components of the network as 'regimes of value'. It will document how they have coalesced and emerged into a specific social form which has had a major impact on health policy.