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Paper short abstract:

I propose to study the processes of distribution employing anthropological methods and contest pharmaco-regulatory common-sense of fake-ness that privileges chemical composition above all else, and contribute to the growing literature on the STS, science studies and anthropology of pharmaceuticals.

Paper long abstract:

This paper is based on my research on how questions of quality and fake-ness animate Indian pharmaceutical firms’ trade with partners in a number of African countries. There is a widely held assumption that the ‘fake-ness’ of fake pharmaceuticals is down to the processes of manufacture. However, closer investigation reveals that ‘fakes’ may also be produced during the processes of distribution. This becomes evident when we look at Indian drugs’ journeys as constituted through their paperwork—we find that the processes of distribution alters drugs’ quality. Through distribution, rather than simply manufacture, drugs become sub-standard or, in the words of Indian pharmaceutical traders, ‘sub-legal.’ Particularly for Indian pharma in African markets, this disjuncture between manufacture and distribution matters because there is a corollary and widely held belief among international regulators that the quality of India’s exported drugs is uneven, or simply ‘low’ (WHO 2017; Nayyar et al 2015; Glass 2014, Johnston and Holt 2014; Almuzaini et al 2013).

I argue that it is in these drugs’ dossiers—the bundles of paperwork that testify to pharmaceutical quality and adherence to regulatory standards—where drugs’ ‘quality’ or ‘fake-ness’ is both produced and understood by both traders and those tasked with enforcing quality regulations. I suggest and propose that understanding the processes of distribution reveals how pharmaceuticals are labelled as fake/sub-standard/sub-legal from the outside (paperwork, labels) rather than the inside (chemical composition of the drug) and it challenges the prevailing notions about ‘fakeness’ of Indian pharmaceuticals.