chapter  4
18 Pages

‘Since We are Taking the Drugs’: Labor and value in two international drug donation programs

WithAri Samsky

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