Ethics and markets of postgenomic drug development

Ethics and markets of postgenomic drug development

Journal of Ethnopharmacology 108 (2006) 158–159 Book reviews Making Medicines. A Brief History of Pharmacy and Pharmaceuticals, S. Anderson (Ed.). Ph...

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Journal of Ethnopharmacology 108 (2006) 158–159

Book reviews Making Medicines. A Brief History of Pharmacy and Pharmaceuticals, S. Anderson (Ed.). Pharmaceutical Press, London and Chicago (2005). 318 pp., Numerous B&W figures, 24 colour plates. Bibliography (for each chapter), Index, Hardcover, £24.95, ISBN 0-85369-597-0 While a lot of scholars have worked on the history of medicine, the history of its sister discipline pharmacy has always been the interest of a selected few and neither practising pharmacists nor students seem to have a keen interest in it. Making medicines offers a concise overview on the history of therapeutic agents and pharmacy focusing in particular on the developments in the UK. After a general introduction (part 1), part 2 looks at the history of pharmacy in general from the ‘Ancient world’ until 1986. However, two of the four chapters focus practically exclusively on the development in the UK and especially as it relates to the professional boundaries (i.e. apothecaries as compared to pharmacists/chemists and the developments within the NHS). In the four chapters of the third part the development of the practice of pharmacy is covered and the fourth part looks at medicines or the products of pharmacy (four chapters). In a final part two perspectives on pharmacy today and tomorrow are offered. So despite of what the title offers it is more of a history of pharmacy on the British Isles than one of ‘making medicines’. Large traditions like the Asian, Australian, African and American ones have been excluded and the real benefit of book lies in a discussion of the historical development of the interplay between pharmacists and other health care professions and how a profession is formed by the expectations of the respective state system of health care. There are only a few experts on the history of pharmacy in the UK and Stuart Anderson—a Senior Lecturer in Organisational Behaviour at the London School of Tropical Medicine and Hygiene has been able to get contributions from experts on the relevant topics. Some excellent colour plates and many black and white figures provide a good illustration for the various chapters. Specifically with respect to ethnopharmacology, it is fascinating to see how recent the development of licensed (chemically defined) medicines has been. Of course, this had largely been triggered by the thalidomide scandal in 1961. The risks of medicines which had not been evaluated for safety (and quality) had been underestimated until then and afterwards rigorous procedures were put in place. Some of the discussions which are currently going on with respect to herbal medicines reverberate ones from the 1960s summarised in 0378-8741/$ – see front matter © 2006 Elsevier Ireland Ltd. All rights reserved.

the book. At least as importantly, the book also highlights the huge historic and modern importance of natural products and thus also of ethnopharmacology to the development of medicines. A reader on the history of pharmacy in the UK has certainly been a desideratum for all who are keen to see broadening of the discussions about the role of health care professionals in making, prescribing and dispensing medicines. This goal is certainly achieved and the book will be of particular interest to all practising pharmacists but will also hopefully highlight the importance of the historical developments for understanding today’s practice. Anyone interested in the historical development of drug discovery, development and use will also find the book of interest. Michael Heinrich ∗ Centre for Pharmacognosy and Phytotherapy, The School of Pharmacy, University of London, 29–39 Brunswick Sq., London WC1N 1 AX, UK ∗ Tel.:

+44 20 7753 5846; fax: +44 20 7753 5909. E-mail address: [email protected] Available online 29 July 2006

doi: 10.1016/j.jep.2006.07.029

Ethics and markets of postgenomic drug development Global Pharmaceuticals. Ethics, Markets, Practices, A. Petryna, A. Klakoff, A. Kleinman (Eds.). Duke University Press, Durham and London (2006). 302 pp., Bibliography, index, US $ 22.95/£ 14.95 (pb), ISBN: 0-8223-3741-X Biocapital. The Constitution of Postgenomic Life, K.S. Rajan. Duke University Press, Durham and London (2006). 302 pp., Bibliography, index, US $ 23.95/£ 14.95 (pb), ISBN: 0-8223-3720-7 Both books deal with the modern process of drug discovery and development in a globalized economy. In some of the developed regions of the world the spending on pharmaceuticals is astronomical and novel products, often derived from postgenomic biotechnological research hit the market constantly. Other regions, especially ones many ethnopharmacologists are working in, still struggle to guarantee the basic health needs of

Book reviews

the populations. However, some developing countries most notably some Asian ones like India have developed an extremely successful pharmaceutical industry focusing in particular on generics. In order to understand the development of the biotechnology sector K.S. Rajan uses an approach combining Marx’s analysis of capitalism with Foucault’s focus on biopolitics and biopower. The link between biocapital and life sciences is analysed using the US and India as an example. His work is based on ethnographic research in biotechnology companies in these countries. The postgenomic technological opportunities are analysed in terms of how the genomic revolution has allowed us to change our basic conception of life: we now grammatically conceive life in a novel way and it can be calculated in terms of probability. The contributors to the book edited by A. Petryna et al. use an ethnographic approach in order to analyse the burgeoning international pharmaceutical trade and the global inequalities that emerge from and are reinforced by market-driven medicine. Questions about who will benefit from research and who will not are evident in all phases of drug development and in pharmaceutical production. Examples include: • The globalisation of clinical trials (A. Petryna). • The pharmaceutical market in the UK and North America for treating mental illness and industries’ impact on the development of therapeutic categories (DSM) (D. Healy). • The rise of antidepressant sales in Argentina during the economic crisis of 2001 (A. Lakoff). • The adoption of a novel class of antidepressants (SSRIS— selective serotonine reuptake inhibitors) in Japan (K. Applbaum). • The addiction market in France (A.M. Lovell).


• A critical anthropological evaluation of the concept of selfmedication (V. Das and R.K. Das). • The development of Brazil’s innovative AIDS treatment and prevention programme (J. Biehl). • The treatment of AIDS in Uganda and the inequalities associated with the access to treatment (S.R. Whyte et al.). It is difficult to see clear links between some of these chapters and such a reader has to leave many gaps. However, the book does highlight the considerable potential of rigorous social sciences analysis of medicines. Certainly the topics covered in these books are highly controversial and one should not expect a balanced analysis of the numerous aspects. Instead, both books centre on the inequalities associated with the provision of pharmaceuticals. The anthropology of pharmaceuticals has generally been the interest of a few selected scholars and hopefully both books can be used as teaching tools in post- and undergraduate programmes of anthropology, sociology, but also pharmacy practice and social medicine. It is not easy reading, but certainly one that reminds one of a crucial area, which should be of particular interest to ethnopharmacologists: Pharmaceutical anthropology. Michael Heinrich ∗ Centre for Pharmacognosy and Phytotherapy, The School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, UK ∗ Fax:

+44 20 7753 5909. E-mail address: [email protected] Available online 12 August 2006 doi: 10.1016/j.jep.2006.06.015