‘SINCE WE ARE TAKING THE DRUGS’:

Abstract

This paper examines and compares conceptions of the place of labor, commodity, value, and gift in two pharmaceutical company-sponsored international drug donation programs. Drawing on ethnographic research done between 2006 and 2008, the paper tracks how medical-scientific architects of these donation programs (NGO and pharmaceutical executives, tropical medicine experts, Ministries of Health) understand the labor of the drug recipients, how they imagine community participation, and how they value their own participation in the program. The paper incorporates interviews with past and present pharmaceutical company employees, elaborating their understandings of the relationships and values created by the donations, and their obligations within the programs. Scientist-administrators involved with the program envision community participation as being joyful and self-interested, and they show great excitement and pride in the power of their donated drugs. In contrast, interviews with farmers and local health volunteers drawn from a research trip to the Morogoro region of Tanzania show the ambivalent, conflicted, and sometimes resentful understanding of labor involved with the drug donation programs, labor which arrives in the form of distribution tasks and hygienic strictures associated with free, powerful drugs. The local scene provides a critical counterpoint to positive imaginations of community ownership and participation in health interventions, and points to systemic misunderstandings within the reciprocal relationship between African drug recipients and the American and European scientist-administrators who design and direct these programs.

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