Sociology, Department of


Date of this Version



Published in Medical Anthropology Quarterly 29:2 (June 2015), pp b1-b3.

doi 10.1111/maq.12169


Copyright © 2014 by the American Anthropological Association. Published by John Wiley & Sons, Inc. Used by permission.


The pharmaceutical industry is—along with the financial and weapons industries—one of the most globalized and profitable business domains. But they wouldn’t make any profits if they weren’t able to recruit research subjects to test an increasing number of drugs. This global trial economy creates its own assemblages of clinical trials, often run by hired contract research organizations (CROs), who fight among each other in a rat-race competition, promising quick and effective trials; at the same time, enterprising countries, hospitals, and doctors jump on the drug trial economy bandwagon by promising quick, endless access to a large pool of research subjects, with little or no ethical oversight.

This is the world that Edison Bicudo has examined in Pharmaceutical Research, Democracy and Conspiracy. Based on dozens of interviews with pharmaceutical company representatives, CRO managers, clinical trial recruiters, physicians conducting trials, as well as staff and administrators for drug trial sites, the book aims to explore “the new relationships between global and local actors” (p. 6). Fieldwork was conducted in five countries: the UK, Spain, France, Brazil, and South Africa. The first three are home to the largest number of pharmaceutical companies, or “sponsors,” and their CROs, while the last two accommodate the largest number of hired physicians and patients/subjects.

The focus of the study is on the “initial stages, in which studies are yet not running, investigators not yet dealing with clinical matters and research with subjects not yet undergoing the study procedures” (p. 7). Bicudo justifies this choice with the reasoning that it allows him “to surprise the trials industry forging the social chains with which clinical trials are made not only scientifically and legally feasible but also socially and culturally possible” (p. 7). One potential pitfall of this choice is that we never learn about subjects’ experiences as research subjects. Bicudo draws attention to what he calls “mediational actions,” which he argues are instrumental to the success of the clinical trials enterprise because they enable the pharmaceutical industry to navigate the translation from the global to the local contexts.