Paper short abstract:

Since the 1970s, pharmaceuticals based on immunosuppression have been produced, distributed, and consumed worldwide. By focusing on the reception of immunosuppressants in Brazil, I discuss how multiple actors in a Global South setting have problematized their contemporary as self-evident.

Paper long abstract:

Since the 1970s, pharmaceuticals based on immunosuppression and made in the Global North have been produced, distributed, and consumed worldwide. As such, immunosuppressants have become the hegemonic biomedical model to treat autoimmunity. Comprising drugs as diverse as cyclosporine, monoclonal antibodies, and corticosteroids, they are used to palliatively treat conditions like arthritis and lupus, which are considered incurable and consequently categorised as chronic. Through an anthropological analysis of the reception of immunosuppressants in Brazil, I seek to understand in this paper how multiple actors in a Global South setting have problematized the contemporary use of immunosuppressants as self-evident.

Enthusiastically adopted and widely prescribed in Brazil, immunosuppressants tend to be formally approved by local medico-legal authorities without constraint. Found at every pharmacy in the country, even chronic patients with modest incomes can acquire them through state subsidies and lawsuits. Yet, despite the naturalization of immunosuppressants’ use in Brazil, a significant number of local actors question the efficacy and logic of immunosuppression-based treatments. Many among them call attention to their numerous side effects, whilst simultaneously others informally adopt marginalized biomedical therapies based on the opposite principle of immunostimulation.

Combining literature review, archive research and participant observation, I highlight how aspects of immunosuppression as a hegemonic therapeutic model are being substantially contested. For it, I focus on disputes about immunosuppressant and immunostimulants, carried out by their respective stakeholders and networks, and issues concerning the innovativeness of immunosuppressants’ last generation as biopolitical artefacts.