SASE 2021

The Covid19 pandemic disrupted the global status quo, creating an opening for transformative approaches to improving human health and the health of communities, healthcare provision, governance over the use and pricing of drugs and medicines, and medical innovations in biotechnology. For example, open innovation systems and sharing in the commons have introduced healing medicines and medical innovations (e.g. current national and institutional boundary-spanning Covid19 vaccine collaborations). The pandemic has however, exacerbated inequality in who gets access to medical care and medicines, and at what price.

In the global race to launch a Covid19 vaccine, millions of people suffering from other equally devastating (non-communicable epidemics of) chronic conditions and acute illness have been neglected. We have yet to reckon with this untold impact on human health. Further, market competition has in part led to human subjects abuses in developing countries in the race to develop new drugs (including Covid19 treatments and vaccines), and a decline in the discovery of radical new innovations in medicines for poor populations. The pandemic also revealed supply shortages in many markets and the struggles between states to get access to medicines and medical devices (masks, tests, ventilation devices…), revealing the inequalities between and within countries in access to health.

Finally, the numerous uncertainties and controversies about the efficacy of some treatments (such as hydroxychloroquine, remdesivir, yet-to-come vaccines…) of Covid-19 and the value of peer-reviewed publications or expert regulation have revealed the scientific but also political and social dimensions of medicines valuation, opening new fields of investigation for scholars working on valuation, expertise and regulatory capture.

This mini-conference aims to convene a group of related panels around issues in global health and medicines, to facilitate useful critical discussion and reflection on participants’ works-in-progress. Driving questions include:

• What theoretical advances are being made in understanding causal mechanisms in improving, or undermining human health and community health, for example, through state policy and firm and organizational strategy? What new frameworks and methods are being developed to identify key actors and explain actions (e.g. improving, or undermining health, broadly defined)?

• What is the evolving role of the state, healthcare systems and professions, and other actors (multilateral bodies, firms, non-profit organizations) in medical and medicine provision and innovation? Are we seeing a shift from traditional dominant blocks (North America and Europe) to new actors (Asia and the Global South)? Likewise, how have states and healthcare organizations been effective (or ineffective, indifferent) in the valuation and pricing of medicines (fair, equitable, and affordable access to life saving medicines)?

• What should be the responsibility, if any, of the global intellectual property rights regime as arbitrated by such powerful organizations as the World Trade Organization and global corporations in monitoring access and benefit sharing of profits resulting from research and development into new drugs and medicines?

• What are the roles for regulation and institutionalization of markets for such boundary-products between medicine and health food as probiotics, herbals, so-called nutraceuticals, and other dietary supplements – in ensuring the health and safety of consumers and patients?

• In what way is current research and policy aiming for “inclusive” innovation (e.g. in healthcare provision, new drug discovery) focused on distributive aspects versus stakeholder inclusion, or both (e.g. under the United Nations Sustainable Development Goals (SDGs))? What is the relative role for (social) entrepreneurs, large firms, and other actors?

Our mini-conference encourages submissions of papers exploring emerging frameworks and theories, as well as empirically rich original data from the developed and developing world and at various levels of analysis (e.g. local community, firm, state, multilateral institution). Scholars at all levels are welcome. In the spirit of innovation and creativity, the panels will have an interactive workshop format around discussant feedback and moderated audience participation.

TH01-01 | Norms of Equity and Inclusion for Access to Health and Healthcare 

Moderator: Étienne Nouguez

• Clinical Uncertainty and the Physician-Patient Relationship during the Covid-19 Pandemic, Larry Au, Columbia University 
• The Moral Economy of Home-Made Masks in the Times of COVID-19, Alya Guseva, Department of Sociology, Boston University and Ya-Ching Huang, Boston University 
• Organizing Healthcare through the Government of Prescribing Conducts: An Analysis of Drug Regulation for the Care of Mental Illnesses, Tonya Tartour, Sciences Po – CSO 
• Ethical Governance of Access to COVID-19 Treatment and Vaccination – Triage or Randomization?, Anja Bodenschatz, Techincal University of Munich, Tim Büthe, Technical University of Munich, Kenan Institute for Ethics, Duke University, Thomas Burri, University St. Gallen, Andrea Rachow, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, German Centre for Infection Research, Matthias Uhl, Technical University of Munich, Technische Hochschule Ingolstadt, Faculty of Computer Science, Gari Walkowitz, Technical University of Munich 

TH01-02 | The Role of State in Response to Market Failure 

Moderator: Kathryn Ibata-Arens

• The Health Consequences of Labor Market Disintegration: Deaths of Despair and Deindustrialization in Postsocialist Eastern Europe, Gabor Scheiring Bocconi University 
• Births of Death: When the World Institutionalized (Differently Defined) Deaths, Wan-Zi Lu, University of Chicago 
• Perspectives in the Study of the Political Economy of COVID-19 Vaccine Regulation, Elize Fonseca, London School of Economics, Fundação Getulio Vargas, Holly Jarman, University of Michigan, Elizabeth King, University of Michigan, Scott Greer, University of Michigan 
• Transformations of the Supplementary Health System in Brazil Under the “Reins” of Financialization, Marcela Ribeiro de Albuquerque, State University of Northern Paraná, State University of Maringá, Mauricio Reinert, State University of Maringá 
• The Impact of Market Incentives on Academic Biomedical Research in Global Health, Steven Casper, KGI, Claremont

TH01-03 | Regulatory Stakeholders and Medicines Valuation 

Moderator: Kathryn Ibata-Arens

• Price As an Epistemic and a Political Object: An Inquiry into “the Most Expensive Drug Ever” Liliana Doganova, MINES ParisTech (CSI), Vololona Rabeharisoa, Mines ParisTech (CSI) 
• Patents, Corporate Decision-Making & the Engaged Shareholder: A Pathway to Encourage Socially Responsible Patent Use in Healthcare, Aisling McMahon, Maynooth University, Edana Richardson, Maynooth University 
• Inventing the Medicine of the Microbiota: Boundary-Organization, Products Valuation and Market Architecture, Étienne Nouguez, Sciences Po 
• COVID-19: Public Health, Objectivity and Profits, Boris Hauray, National Institute for Health and Medical Research (INSERM)

TH01-04 | Innovation Commons and Moral Economy of Intellectual Property Governance 

Moderator: Étienne Nouguez

This session is also our closing session and informal networking

• Strategizing Global Vaccine Commons. Does Covid 19 Temper with Practices of Intellectual Property?, Konstantin Hondros, University of Duisburg-Essen 
• Patenting Life for Profit: How Far Is Too Far?, Kathryn Ibata-Arens, DePaul University