Measuring Mumbai’s Market and Counting Cotonou Coughs: Tuberculosis Drug Sales Data in an Era of Unlikely Health Globalization and Leaky Global Health Metrics

• In Event: Global Medicine from the South? Emerging Markets and Indian Ocean Medical Worlds - II

Abstract

This paper engages one of global health’s efforts to make a world of data by looking to the production, use, and subvention of drug sales data to approximate the number of people afflicted by tuberculosis in India. The paper outlines the ways these data are created by a multinational firm and used by epidemic modelers and global philanthropy to build metrics for global health interventions. Taking Mumbai as a case it becomes clear that much of the pharmaceutical sales reported in the city represent illicit export to wholesale markets in East and West Africa. Ethnographically tracing these flows of TB medicines and their epistemological effects on India, the paper argues that illicit flows of medicines reveal a health globalization which overflows and outstrips global health’s aspiration for a global metric, equivalence, and population. The paper argues that global health’s tools are insufficient to describe much of health globalization. It reveals, instead, global health’s staunchly local metrics that capture only fragments of the intense market flows of health-related commodities between India and Africa.

Author

• Andrew McDowell, Tulane University