Unstable pharmaceutical values: the grey political economy of drug circulation in Cambodia

This paper uses the circulation of drugs as a port of entry to understanding the fabric of pharmaceutical values. As they circulate, pharmaceuticals encounter a plurality of worlds ranging from the global spheres of transnational transactions to situated localities and their specific realities. A nexus of manufacturers, regulators, importers, distributors, middlemen, sellers and consumers all share a convergent centre of interest in drugs. Each of these actors value pharmaceuticals. Just as their motivations, means and practices of valuing are diverse and sometimes opposed, the resulting pharmaceutical values are multiple, variable and contested. Cambodia is a case in point since the production of pharmaceutical values in this country is entangled in licit and illicit circulation and practices. Value making brings to light matters of exchange and money, therapeutic efficacy and toxicity, prescription modalities and epistemology, location and aesthetics, and ultimately corruption, risks and justice. This entanglement sets the ground for the definition and study of a grey political economy, which is qualified as interstitial, multivalent and sensitive to circumstances. Here, pharmaceutical values are produced through creative agency and arrangements, unexpected social combinations, material and pharmacological heterodoxies. This situation opens up a rich terrain for the exploration of the relation between drug circulation, modes of valuation and pharmaceutical values.