Critical perspectives on international pharmaceutical innovation: Malthus, Foucault and resistance

This paper aims to argue that certain insights offered by Kuhn and Foucault may be of use to those seeking to resist a global paradigm of inequality in access to the outcomes of pharmaceutical development. It is further argued that these relationships are not independent of certain power relationships. This critical review seeks to highlight certain of these power relationships, and to suggest how they might be better managed to ensure more equitable outcomes for those in society that are most vulnerable to innovation failure.

This research takes the form of a critical review paper, seeking to develop theory though a synthesis of literature.

Unlike market incentives, it might be the research process itself that is most vulnerable to stakeholder resistance to slow and unequal delivery of life-saving pharmaceutical development. Given that a lack of responsiveness to societal needs can itself be considered unethical, Kuhnian theory predicting pharmaceutical innovation failure is related to what Foucault describes as a system of oppression, whereby power relationships disadvantage those most vulnerable and powerless.

Given the rise of movements like citizen science and participant-led research, as well as new ethical frameworks premised on increasing accountability in science, Foucault’s principles are considered to echo a general trend towards the democratisation of science, and towards increasing the responsiveness of pharmaceutical development to societal needs.

A novel synthesis of literature is undertaken, offering useful theoretical insights into how social actors might contribute to enabling a more responsive system of international healthcare business.