The project takes a historically informed ethnographic approach and uses several research methods, including literature review and trade data analysis and an ethnographic study in India involving the collection of data from qualitative interviews, informal conversations, and observations at pharmaceutical trade fairs.
The ethnographic study for the project was conducted over approximately seven months in India during 2022, mainly in the pharmaceutical industry hub of Hyderabad in southern India. Here, I interviewed and engaged with pharmaceutical industry representatives, scientists and people involved in advocacy work on the issue of antimicrobial resistance. Hyderabad is a city particularly known for its IT industry, but it has also been called the “bulk drug capital” of India. Hyderabad’s history as a pharmaceutical industry hub started in the 1960s with the establishment of the public sector company Indian Drugs and Pharmaceuticals Limited (IDPL). Today, Hyderabad is a centre for India’s private health care and pharmaceutical industry, with large-scale production of vaccines, bulk drugs and generic pharmaceuticals that are marketed towards both domestic and export markets. While the growth of Hyderabad’s pharmaceutical industry has led to economic development and employment opportunities locally, it has also led to environmental pollution in the areas where pharmaceuticals are being manufactured. Previous studies have indicated that the release of antibiotics into local waterbodies has accelerated the emergence of antimicrobial resistance in these environments. The science-policy response to this issue in Hyderabad and India is something that I also explore in this PhD project.
The first article based on this PhD was published in Social Science & Medicine in 2022, titled Antibiotic geographies and access to medicines: Tracing the role of India's pharmaceutical industry in global trade. In this article, I offer a novel approach to trace antibiotic and pharmaceutical geographies, using international trade data from publicly available resources combined with a secondary literature review. I trace the changing role of India’s pharmaceutical industry for the global export of antibiotics, by mapping and describing changes in Indian antibiotic exports and discussing these in light of historical processes and events. The article shows that India has become one of the world’s biggest exporters of antibiotics but that the country’s pharmaceutical industry is also highly dependent on China for the import of antibiotic ingredients. This is something that Mingyuan Zhang and I explore further in the article Antibiotics “dumped”: Negotiating Pharmaceutical Identities, Properties, and Interests in China–India Trade Disputes. Together, the two articles highlight how China, India and their pharmaceutical industries hold key roles in securing a stable supply of essential antibiotics globally.