KAUSHIK SUNDER RAJAN
Indian Clinical Trials and Surplus Health
Two prominent indian physicians recently described the clinical trials of new drugs in India as a ‘new colonialism’. In an article published by a leading us medical journal, Samiran Nundy and Chandra Gulhati drew particular attention to ‘illegal and unethical trials’ conducted without regulatory approval.  Samiran Nundy and Chandra Gulhati, ‘A New Colonialism?—Conducting Clinical Trials in India’, New England Journal of Medicine, vol. 352, no. 16 (2005), pp. 1633–6. But a moral critique of this kind, however legitimate in its own terms, does not adequately grasp the network of economic and social relations that the international health industry has established on a global scale. Even if all clinical trials conducted in India or other Third World countries adhered to the letter of the law and the spirit of ethical codes, the very structure of this network would remain one of exploitation. I shall outline here the dynamics of clinical trials in India, focusing especially on the huge capacity currently being built up in anticipation of the transfer of global trials to the subcontinent. This will provide a basis for interpreting the phenomenon in terms of concepts developed by myself and others currently researching this field, particularly those of biocapital and surplus health.
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