Global Pharmaceuticals contributes to a relatively recent group of books that provide an informed critique of the pharmaceutical industry 1 . Its freshness lies in the disciplinary perspective, which is not predominantly biomedical or ideologically driven.
In the introductory chapter, 'The Pharmaceutical Nexus,' commercial images of arthritis victims who are celebrating their pain-free state (having taken the latest blockbuster anti-inflammatory) are juxtaposed with images of millions infected by HIV who have no access to life-saving drugs. After World War II the pharmaceutical industry transformed itself, using increasingly sophisticated marketing techniques which have been astonishingly effective because of the high degree of information asymmetry and supplier-led demand that exists in the health sector generally. Global Pharmaceuticals will help readers untangle the 'morass of economic and moral paradoxes' behind economic and market statistics about the industry. Readers with a practical focus may be frustrated by the lack of explicit policy implications in the book. However, this not an uncommon characteristic of anthropological and ethnographic work. The cross-national essays and studies are both substantive and engaging, and readers can, based on their own disciplinary perspectives, draw their own policy conclusions.
The next chapter, 'Globalizing Human Subjects Research' raises relevant concerns about a clinical trials industry that is growing rapidly because of a combination of factors, including US regulatory requirements and a 'drug pipeline explosion.' Alongside legitimate hand-wringing about the ethics and incentives of drug research, this chapter would be stronger if it had devoted more critical attention to the need for such research and the scientific methods that are normally required for rigorous investigation.
'The New Medical Oikumene' considers industry's role 'in structuring expert and popular understandings of mental illness over the last two decades, specifically focusing on North America and Great Britain.' It explores marketing strategies related to what has become known as 'disease mongering'-the marketing of panic, the rise of depression, and marketing of other mental health 'disorders.' It