Generous corporations? A Maussian analysis of international drug donations
| Published date | 01 June 2018 |
| Author | Auriane Guilbaud |
| DOI | 10.1177/1755088217752199 |
| Date | 01 June 2018 |
https://doi.org/10.1177/1755088217752199
Journal of International Political Theory
2018, Vol. 14(2) 203 –222
© The Author(s) 2018
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DOI: 10.1177/1755088217752199
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Generous corporations?
A Maussian analysis of
international drug donations
Auriane Guilbaud
Université Paris 8, France
Abstract
In this article, I claim that using Marcel Mauss’ The Gift can prove fruitful in analyzing
pharmaceutical donations, the role of interests in gift-giving, the complex intertwining of
the domains of the gift and commerce, and in contributing to a theory of social justice.
Drug donations refer to the practice of giving medicines “for free,” outside of the drug
market, with the ultimate goal of reaching populations in need. So an object (a drug)
otherwise sold on the market (even if sometimes at a subsidized price), and usually
subject to a specific commercial process, enters a different circuit and distribution
system. Yet, even if drug donations seem to break with the logic of exchange constitutive
of the market, they are intimately linked to market dynamics. This is especially true in
the case of corporate drug donations, because of the nature of the donor and the
presence of ulterior motives. Accordingly, this practice can be explained with the help
of a Maussian understanding of the gift, where gift-giving is not disinterested and does
not have to result from pure altruism, but can very well be part of a larger process of
accumulating wealth and power.
Keywords
Drug donations, gift, global health, Mauss, philanthrocapitalism, social justice
Introduction
On 10 October 2016, the US branch of Doctors Without Borders published a letter online
entitled “There is no such thing as ‘free’ vaccines: Why we rejected Pfizer’s donation
offer of pneumonia vaccines.” The letter explains why drug donations are inadequate, as
Corresponding author:
Auriane Guilbaud, Université Paris 8, Cresppa-LabToP (CNRS, UMR 7217), 59/61 rue Pouchet, 75849 Paris
Cedex 17, France.
Email: auriane.guilbaud02@univ-paris8.fr
752199IPT0010.1177/1755088217752199Journal of International Political TheoryGuilbaud
research-article2018
Article
204 Journal of International Political Theory 14(2)
they often “involve numerous conditions and strings attached” and can be used “as justi-
fication for why prices remain high for other” drugs (MSF Access Campaign, 2016). Yet,
drug donations are a traditional tool used in the fight against global diseases. In front of
the World Health Organization (WHO) headquarters in Geneva, a sculpture represents an
African child leading a blind man, symbolizing the success of the fight against onchocer-
ciasis, also known as river blindness, made possible through Merck & Co’s donation of
ivermectin, brandname Mectizan, since 1987. In-kind drug donations are unrelentingly
popular among pharmaceutical companies. They represent about 90% of the $7.6 billion
in US corporate giving (Currie-Alder et al., 2014: 807) and enable US pharma companies
to “routinely dominate the list of the most generous companies in America” (LaMattina,
2013).
But can corporate actors be “generous”? Is it not paradoxical to call this philanthropic
practice donation, which suggests that it belongs to the sphere of gift-giving, when, as
the statement by Doctors Without Borders makes clear, instrumental interests are at
play?
Drug donations refer to the practice of giving medicines for free, outside of the drug
market, with the ultimate goal of reaching populations in need. There are three different
forms of drug donations by pharmaceutical companies (Bates, 1999: 89): inventory
donations of soon-to-be expired or over-produced drugs (the most frequent case); dona-
tions of commercial drugs at the request of an organization to respond to a humanitarian
disaster or contribute to health development programs; and donations of specifically
produced drugs, not otherwise available on the market (a rare case). They can be of two
kinds: emergency relief donations and long-term aid donations. The former are short-
term, following an emergency situation due to a natural disaster (earthquake, tsunami,
etc.) or crisis (war, epidemic outbreak, etc.). The latter are long-term donations more
akin to development aid and tend to take the form of institutional programs. For instance,
Merck has donated Mectizan (ivermectin) since 1987 through the Mectizan donation
program to fight onchocerciasis (also known as river blindness) in West Africa.
When a donation occurs, an object (a drug) otherwise sold on the market (even if
sometimes at a subsidized price), and usually subject to a specific commercial process,
enters a different circuit and distribution system. Yet, even if drug donations seem to
break with the logic of exchange constitutive of the market, they are intimately linked to
market dynamics. This is especially true in the case of corporate drug donations, because
of the for-profit nature of the donor and the presence of ulterior motives.
In The Gift, Marcel Mauss provides an analysis of the reproduction of society through
a triple obligation to give, receive, and reciprocate. Thus, the gift is characterized by a
combination of freedom and obligation and shaped by reciprocal expectations, although
there is no guarantee, since reciprocity here is not contractual. Contradicting Bronislaw
Malinowski’s insight from his fieldwork in Melanesia that the domains of commerce and
of the gift are separate, Mauss shows that there is no pure gift and no free gift, and that
gift-giving is a form of social interaction that is neither on the side of self-interest nor of
morality (Adloff and Mau, 2006: 95). A free gift does not exist: it would be asocial. The
triple obligation initiates a perpetual cycle of exchange intertwined with the whole soci-
ety. Gift-giving is an interaction involving cycles which “engage persons in permanent
commitments that articulate the dominant institutions” (Douglas, 1990: ix–xii).
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