Zahra Hayat

ZAHRA HAYAT, then a graduate student at University of California, Berkeley, California, was awarded funding in April 2017 to aid research on “Intellectual Property’s Futures and the Limits of Law: Access to Cancer Drugs in Pakistan,” supervised by Dr. Cori Hayden. During the research period, the grantee carried out ethnographic fieldwork in the Pakistani cities Lahore, Karachi and Islamabad. Key sites were the Drug Regulatory Authority of Pakistan (DRAP); the drug courts, intellectual property court, and High Court in Lahore; pharmaceutical companies; and a cancer hospital. The evidence gathered at these sites enabled the grantee to hone in on the central research question, emergent during fieldwork itself: what are the key vectors determining consumer access to medicines in Pakistan? Drug price, quality and intellectual property status emerged as the main determinants of access. Key findings included an unexpected relation between price and access: in many instances, prices that are too low, instead of too high, impede consumer access to medicines, by reducing pharmaceutical companies? incentive to manufacture and market these drugs. At the same time, prohibitively high prices for certain categories of drugs — anti-cancer drugs, in particular –impede the ability of public hospitals to offer them, and of patients to buy them independently. This has resulted in complex, crisscrossing networks of access to cancer drugs, which most patients are ill-equipped to navigate. In relation to drug quality, the study is articulating questions of evidence and the body, to capture the minimal regulation of drug quality before drugs appear in the market, and the interpellation of patient bodies as providers of evidence of drug quality, after their ingestion. Vis-a-vis intellectual property, a case study of Sovaldi, a revolutionary hepatitis-C drug, shows how Pakistan?s financial insignificance as a market for Big Pharma became an unexpected guarantor of Pakistanis? access to a brand-new, lifesaving therapy.