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The Impact of Financialisation on Global Health: A Series of Pharmaceutical Case Studies

English title The Impact of Financialisation on Global Health: A Series of Pharmaceutical Case Studies
Applicant Nguyen Vinh Kim
Number 189186
Funding scheme Project funding
Research institution The Graduate Institute PSIG
Institution of higher education Graduate Institute of International and Development Studies - IHEID
Main discipline Ethnology
Start/End 01.11.2019 - 31.10.2023
Approved amount 1'076'947.00
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All Disciplines (4)

Discipline
Ethnology
Methods of Epidemiology and Preventive Medicine
Infectious Diseases
Public Health and Health Services

Keywords (7)

HIV; Ebola Virus Disease; Finance (Financialization); Political Economy; Pharmaceuticals; Medical Anthropology; Antimicrobial Resistance

Lay Summary (French)

Lead
Ce projet examine l'impact des marchés financiers sur la santé mondiale. La « financiarisation » de la recherche et du développement (R & D) pharmaceutique implique l’utilisation croissante d’instruments et de stratégies financières (qui s’apparente à la spéculation); notre souci principal est que cela pourrait détourner l’innovation des priorités de santé mondiale.
Lay summary

Ce projet examine l'impact des marchés financiers sur la santé mondiale. La « financiarisation » de la recherche et du développement (R & D) pharmaceutique implique l’utilisation croissante d’instruments et de stratégies financières (qui s’apparente à la spéculation); notre souci principal est que cela pourrait détourner l’innovation des priorités de santé mondiale. Nous allons nous concentrer sur trois domaines d’intérêt majeur en santé mondiale, pour lesquels la recherche existante démontre que la « financiarisation » et la R & D sont clairement liés : (1) le «recyclage» des traitements antirétroviraux à des fins de prévention du VIH (2) la recherche de traitements et de vaccins efficaces contre la maladie à virus Ebola et (3) l’élaboration de solutions pour faire face à la menace mondiale croissante de la résistance aux antimicrobiens.

Pour chacun de ces domaines, nous allons rassembler des études de cas approfondies, en reliant la recherche sur les facteurs financiers affectant la R & D «en amont» aux réalités cliniques, épidémiologiques et sociales «en aval». Notre projet s’inscrit dans une approche ethnographique visant à cerner la ‘vie sociale des médicaments’. Cet approche fait également progresser la recherche sur la biomédecine en tant que système sociotechnique régi par des normes éthiques et pratiques, combinant formes sociales et technologies et permettant la circulation mondiale des produits, des pratiques, des idées et des identités.

Cette recherche nécessite une approche interdisciplinaire qui innove en associant des experts du fonctionnement du monde de la finance, des anthropologues étudiant la biomédecine, et des praticiens œuvrant dans les milieux cliniques. Nous souhaitons examiner la façon dont l’interaction entre les mondes de la finance et du pharmaceutique impactent les pratiques cliniques, et vice versa. Nos études de cas et le cadre théorique qu’elles vont approfondir nous permettront de dialoguer avec des universitaires s’intéressant à des questions plus vastes portant sur la santé mondiale et la finance, mais également avec des communautés de pratiques motivées par la question de l’accès au traitement et de l’équité en santé.

Direct link to Lay Summary Last update: 17.10.2019

Responsible applicant and co-applicants

Employees

Abstract

Background and Rationale: Since the 1980s, the structure of national and global economies has undergone a significant shift, characterized by “financialization” -- “the increasing role of financial motives, financial markets, financial actors and financial institutions” in economic, social and political life (Epstein, 2005). As financialization continues to shape economic growth, market stability, and inequality, it is critical to understand how financialization exerts influence on human health. We focus our research on processes of pharmaceutical development and use, where financialization plays a growing role, and trace the impact on global health through case studies of specific medications meant to secure health and sustain life.Overall objectives and specific aims: The central objective of our research is to examine the impact of financialization on the development and use of pharmaceuticals in three areas of global health significance, and where innovation has emerged as a central issue: HIV, Ebola, and antimicrobial resistance (AMR). Specifically, in each of these areas, we will examine how financial motives, markets, actors, and institutions exert influence on the pharmaceutical lifecycle, including through interactions with: ‘innovation hubs’ consisting of research universities and biotechnology companies, wherein public sector resources are leveraged to ‘de-risk’ capital investments in drug discovery; the pharmaceutical industry, in which firms shift strategies to commercialize drugs in different therapeutic areas; and health systems, where governments and health organizations craft public and private mechanisms to pay for medications, especially in response to local health demands. In addition, we will aim to evaluate trends in development and use across a set of high-, middle- and low-income countries (HMLICs). We also intend to lay a strong foundation for future research by developing a community of scholars in this area and producing a conceptual framework to be applied to future research.Methods: We will produce a series of case studies spanning the entire lifecycle of specific pharmaceuticals in each of these three therapeutic areas. We will first explore the clinical and commercial history of specific medications through desk research, through archival research and comprehensive reviews of academic and industry resources. This will inform subsequent fieldwork, including key informant interviews and participant observation among financial actors, pharmaceutical firms, clinical research teams, government officials, and health workers. Fieldwork will seek to capture ‘on-the-ground’ realities at sites of development (e.g. clinical trials) and of implementation (i.e. treatment programs, clinics). By integrating findings, we will construct a complete picture of the clinical and commercial history of these medications, and how they are used in HMLICs.Expected results and impact on the field: We expect to deepen understanding of the role of financialization across the pharmaceutical lifecycle and its impact on Global Health. For each therapeutic area, we will provide a typology of strategies used to de-risk capital investment and maximize shareholder value. We will also demonstrate how HMLICs are impacted differentially. Further, we intend to strengthen the intellectual, policy, and practice community, and foster scholarship in this important area. We will also raise awareness of these issues in the global health and financial communities, stimulate debate on policies to ensure health is adequately taken into account in financial-sector decision-making and uncover opportunities for collaboration between the two sectors, including the potential of financial actors to help achieve the Sustainable Development Goals through more effective investments in pharmaceutical development and use, which will in turn strengthen global health.
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