The Pharmaceuticalization and Judicialization of Health

IF 0.9 3区 哲学 Q2 HISTORY & PHILOSOPHY OF SCIENCE
Osiris Pub Date : 2021-01-01 DOI:10.1086/713426
J. Biehl
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引用次数: 2

Abstract

A major player in the political economy of pharmaceuticals in the Global South, and boasting a universal health care system, Brazil offers fertile ground for exploring the unanticipated ways people have mobilized for treatment access in contexts of stark inequality. In this article, I place the ever-evolving twin phenomena of the pharmaceuticalization and judicialization of health in a multilayered historical context: the post–World War II push for states to embrace the idea that their citizenry had a right to health, and Brazil’s particular embrace of a constitutional right to health in 1988; the turn of the World Health Organization (WHO) to essential medicines in the 1970s, and the responses of both governments and pharmaceutical companies in the ensuing decades; the advent of neoliberal forces as they swept the globe, landing in Brazil in the early 1990s; and the HIV/AIDS pandemic in Brazil with the government’s precedent-setting provision of lifesaving antiretroviral therapies in the late 1990s. This dynamic context sheds light on a bottom-up ethnographic inquiry of the ways the poor in Brazil have turned in increasing numbers over the last two decades to the courts to litigate access to medicines. Through their collective trust in the judiciary and their willingness to be a frontline force against the ill effects of neoliberalism, citizen-litigants are instantiating a kind of magical legalism, opening up new possibilities for the state to live up to its human rights and medical commitments. People’s quests for accountability reveal an ambitious vision of justice at a local scale and a distinct sense of politics in-the-making, even alongside a resurgent authoritarianism.
健康的药物化与司法化
巴西是全球南方制药政治经济的主要参与者,拥有全民医疗保健系统,为探索人们在严重不平等的背景下动员起来争取获得治疗的意想不到的方式提供了肥沃的土壤。在这篇文章中,我将不断发展的健康药物化和司法化的双重现象置于多层次的历史背景中:第二次世界大战后推动各国接受其公民享有健康权的观念,以及巴西在1988年特别接受宪法赋予的健康权;世界卫生组织(世卫组织)在1970年代转向基本药物,以及各国政府和制药公司在随后几十年的反应;新自由主义势力席卷全球,并于上世纪90年代初登陆巴西;以及巴西的艾滋病毒/艾滋病大流行,政府在20世纪90年代末史无前例地提供了挽救生命的抗逆转录病毒疗法。这一动态背景揭示了一项自下而上的民族志调查,即在过去20年里,越来越多的巴西穷人向法院提起诉讼,要求获得药品。通过他们对司法机构的集体信任,以及他们愿意成为对抗新自由主义不良影响的一线力量,公民诉讼当事人正在体现一种神奇的法律主义,为国家履行其人权和医疗承诺开辟了新的可能性。人们对问责制的追求揭示了一种雄心勃勃的地方正义愿景,以及一种独特的政治意识,即使伴随着复兴的威权主义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Osiris
Osiris 管理科学-科学史与科学哲学
CiteScore
1.10
自引率
0.00%
发文量
18
审稿时长
>12 weeks
期刊介绍: Founded in 1936 by George Sarton, and relaunched by the History of Science Society in 1985, Osiris is an annual thematic journal that highlights research on significant themes in the history of science. Recent volumes have included Scientific Masculinities, History of Science and the Emotions, and Data Histories.
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