The Commodification of Mexicana/o Bodies from the U.S.-Mexico Border
On the “Beldon Farms” in Northern California, the local chapter of the American Diabetes Association staff and volunteers (one social scientist included) conduct a free screening for diabetes among farmworkers. Translating for the English-speaking monolingual public health nurse, several of us would fill out a card for each employee that lists his or her name, weight, age, sex, and time of last meal. The men and women would line up to get their finger lanced and fill a tiny pipette with their blood. The blood would then be transferred to a glucose meter that would calculate sugar levels. While waiting for the results, workers were screened by the Lion’s Club volunteer ophthalmologist for retinal abnormalities. Of the hundred or so workers we screened that day, the public health nurse referred two to a doctor.
Screening is an important element in diabetes surveillance. For type 2 diabetes, many of the effects of blood sugar abnormality are not detected until retinopathy, angiopathy, or neuropathy has developed. Damage to the eyes, nerves, kidneys, and feet are the most common complications. Because diabetes can be stealthy, screening takes place around the world as a preventative measure. Mr. Beldon had welcomed the volunteers, providing lunch and many expressions of gratitude. On this day he donated $10,000 as a way to say thank you to the Lions and ADA.
The donation symbolizes that the health of his workers is important to the landowner. Of course, anything that prevents laborers from missing work because of illness has the added benefit of making the harvest go smoothly. Yet the exchange of screenings for money is emblematic of a larger set of technoscientific relations. Arguing that Mexicans have for more than a century endured the imposition of an identity as commodity, Vélez-Ibañez writes, “In a capitalistic economic system, things such as labor, materials, and processes can be bought and sold for a price, and conditions are created in which some populations may be regarded primarily as a type of price-associated group to be used and discarded not unlike disposable materials or any used manufactured goods.”1 To be sure, diabetes research practices conform to Vélez-Ibañez insight, but they are much more. Ethnographic evidence illustrates that as both subjects of state-corporate interpellation and as necessary actors in disease research, U.S. minority and immigrant DNA donors serve as a form of global human capital. However, they also are participants in their own biological commodification, and this requires closer analyses of both their participation and the processes of that commodification.
This chapter will deploy the theory-method intervention of following DNA samples and data sets through time and space to illustrate how the ethnicity of donor populations becomes a valuable commodity in the world of genetics research. Unlike Mr. Beldon’s screening and donation in the fields of Northern California, no such benefactor exists in Sun County, and screenings are coupled with the taking of DNA samples. Further, as the samples are circulated to research partners in wet labs around the globe, their value to the careers of sample handlers grows.
It has already been shown that diabetes is framed as a racialized disease and that this reflects the unequal weight given to the incidence rates of diabetes at the expense of its prevalence. The consequences of this slippage must be understood as the first step in transforming the political and social conditions for Mexicanas/os in Sun County into attributes of the Mexicana/o body itself. Portrayals of epidemics such as AIDS, Black Death, or kuru, Lindenbaum notes, predictably create carriers who become scapegoats in the collective political and ritual actions that precede the eventual fading of the disease from our consciousness.2 Diabetes, as a disease already framed by race and ethnicity, has additional implications in the era of genetic epidemiological research.
I argued in chapter 2 that the incidence of diabetes in the Mexicana/o populace must be viewed as strongly associated with the national political and economic transformations on the border over at least the last three decades—transformations that are a result of the mechanization of agricultural production, urban industrialism, corporate agribusiness, and the concomitant regimes of labor control.3 Also noted earlier is the fact that Mexicanas/os are now used for a genetic research enterprise that is directed by Anglos funded by the state. This chapter explores the consequences of a scientific enterprise that fits the pattern of Anglo-Mexican relations in the U.S. Southwest over the past century and a half. The pattern is one of exploitation, in this case the unequal distribution of benefits accrued from the extraction and circulation of DNA from Sun County Mexicanos/as. To begin, let us turn to the various ways that racialized DNA samples operate as commodities within research transactions.
Samples are the raw material of the diabetes enterprise. Their possession, their collection, and their conversion to a data set for use in wet lab experiments and dry lab computational analyses operate within an economy of scientific knowledge production infused with Carl’s humanistic ideals of finding a cure for future diabetics. Carl’s sampling occurs as a result of a complicated relationship with his research participants. His care for the people is expressed in his protocols that require referral to a physician whenever necessary. He often hounds his staff to follow up with participant care issues. Yet the samples are not given freely. In exchange for their participation, people get a cotton tote bag, some pens, a monogrammed beverage cup, and a free ride to the field office and home again (which for about one-third of the participants means crossing the border). They receive food, some receive money, and those who need a referral to a doctor and diabetes education classes receive it. Participants get screened for diabetes and a host of other conditions determined by what research is funded at the time. For most, this screening is the only way they can keep track of their blood sugar. In Sun County, health insurance is a luxury few can afford.
For the consortium, Carl’s field office is the initial moment in a long chain of research processes. The collection of Mexicana/o DNA samples forms the backbone of the collaborative exchanges for consortium scientists. However, DNA samples are not readily exchangeable. We saw in chapter 4 how blood samples are quickly converted into stable currency for laboratory research by field staff in the tiny lab with kitchen counters for bench space. At this stage in DNA processing, staff transform the samples into bits of purified protein placed in microcentrifuge tubes, which, if filled, hold 2.mL (about half a thimble) of material. In this form, the arrays of samples are placed in Styrofoam or plastic trays and are labeled with various population identifiers, the name of the recipient and other data. Samples are divided up and shipped to collaborators around the country who then test and sequence the samples for a variety of diabetes-related experiments. The transformation from a wet lab material into a dry (computational) lab data set enables, with a few keystrokes, the global circulation of the genetic information derived from the DNA.
In their analyses of the ways scientific knowledge is standardized, Fujimura and Fortun observe that molecular biologists must convert their data into the language of genetic sequences “in order to cooperate and collaborate”4 with scientists across disciplinary social worlds. Befitting this observation, the thousands of samples Carl has collected in the past three and a half decades have always traveled across social worlds. The present collaborative venture includes, among others, physicians in Mexico, epidemiologists in Texas, statisticians in Michigan, quantitative geneticists in Chicago, molecular biologists from Sweden, and postdocs and researchers in wet and dry labs from the NIH, academic, and corporate laboratories. It also includes Mexicana/os who participate through donations of blood and time.
I earlier described the ways Mexicanas/os are continually recruited for Carl’s research. Most participants have done so for many years and thus do not need the reminder calls each staff member offers. However, at any given time, there are as many as four different research projects taking place. To accommodate work schedules, participants begin arriving at 7 A.M. and are seen into the evening and on weekends. Each research protocol requires its own set of measurements and attendant forms. For a diabetes and blood pressure study, there are 20 pages of forms that staff are required to fill out. Enrollment data, health history, medications, doctors, one form called Sun Female Form, a physical activity and lifestyle form, family history, blood pressure, and laboratory test forms are part of the packet. Judi and her staff spend hours on each participant. Their days are spent making appointments, arranging transportation, and in many cases driving to their homes or fields to collect follow-up blood samples or to bring the participant to the center for tests. The labor of collecting participants is a necessary part of the production of diabetes knowledge, as is the labor of participating in the research.
Contemporary research of late capitalist cultural transactions and power relations increasingly attend to the interaction of the material and semiotic, of the human and the nonhuman. Organs, networked devices, cell lines, data sets, prostheses, weapons, infectious agents, and drugs increasingly orient our analyses and research practices. Yet, mapping the ways the social and the material are co-configured begs reconceptualizations of the novel and persistently unequal distributive and consumptive networks through which material matters are produced. The present chapter assesses the ways that blood samples taken from racially marked populations operate within a regime of value production and are transformed into commodities.
The mix of voluntary donation, of humanistic disease prevention, and of material exchanges within the diabetes enterprise affords an opportunity to retheorize the manner in which value is produced. In this instance, value refers less to the ethicomoral questions of the donation encounter and more to the material, symbolic, and social capital that are bundled into the exchanges of donated DNA.5 To examine this process requires that we follow the life history of a sample from its original donation into wet lab collaborative networks and out into the broader context of the corporate uses of knowledge derived from research partnerships. Following Clarke’s and Fujimura’s attention to the objects of scientific research directs my own thinking to what the materials (blood samples) within the diabetes enterprise reveal.6
In his analysis of the circulation of indigenous art forms in Mexico, Garcia Canclini points out that the meanings of an object as it moves between producer, consumer, and broker make tracing the social course of an object ideal for understanding “the manner in which capitalist development redefines identity as it combines various forms of production and representation.”7 This process is made all the more visible when the objects at hand are racialized population DNA samples, the biography of which this chapter will detail.
Discussion of the extraction of biological samples from vulnerable populations attained new visibility with the debates about the treatment of the Yanomami peoples. Thrust into the academic headlines by journalist Patrick Tierney’s account of blood sampling by James Neel and his colleagues for genetics-based research, the discussions were inflammatory, heated, and politicized.8 Among the issues that surfaced in the debates and formal investigations was that of the ethics of sampling for genetics research. Within the American Anthropological Association’s formal report was the finding that Neel’s team followed the new informed consent and ethical guidelines in place in 1968, the year the samples were acquired. However, members of the Yanomami people reported that “they (or their parents) had assumed that they would receive short-term health benefits from having their blood drawn in 1968.”9 In another case, the Havasupai people of Arizona prevailed in legal action against Arizona State University for using blood samples in ways not officially approved or without individual consent.10 These debates and lawsuits highlight that the donation of biological samples is fraught with concerns about exploitation, most notably that informed consent and an equitable exchange occur between donor and recipient.11
Andrews and Nelkin survey the disturbing ways the body has been and continues to be configured as a commodity.12 This oftentimes results in immense profitability for some and great distress or even harm for others. Whether it is the now famous case of Moore v. Regents of University of California,13 genetic tests for rare diseases made unaffordable by patent royalties, forced forensic sampling, or organ snatching, the common theme is one of a profit made from the bodies of vulnerable or incognizant donors. Andrews and Nelkin highlight the political, ethical, and legal vexations of a science too closely wedded to commerce. They write, “The body has become commodified, reduced to an object not a person.”14
In their analysis of a new materialism for an anthropology of the body, Lock and Farquhar remind that the discrete, structured, individual body mythologized by European modernity inaccurately portrays the social multiplicity of bodily life.15 Further, drawing our attention to post-Cartesian materialism, they note that in scholarly and practical life, human experience must be imaginable as “at once subjective and objective, carnal and conscious, observable and legible.”16 Earlier analyses of the body include the social, experiential, and political body; the production of bioengineered tissues; the trade in organs for donation; and, what concerns us here, the interrelations between the body and political economy for which Paul Farmer’s structural violence is a notable founding concept.17 With special attention to the materiality of the body, we might ask; What can be learned when the objectification of racialized bodies evoked by Andrews and Nelkin, but not fully explained, is fleshed out ethnographically?
One morning, Lena draws blood from Jaime, a farmworker, in the backseat of the minivan. The crews are weeding the peppers at dawn. We had stopped to get Jaime some tacos to break his fast, and the smell of chorizo filled the van on our drive along nameless dirt roads that abut the Rio Grande. Five vials are drawn; three are placed in the portable centrifuge, the rest on ice in a cooler. Before week’s end, the vials of whole blood or buffy will be labeled, added to a shipping container, placed on dry ice, and shipped to awaiting lab techs. “Mex/Am” reads the label on the Styrofoam shipping cube containing Jaime’s sample.
Like clockwork, samples are processed according to protocol. At Gary’s lab, techs handle everything but genotyping and analyses. Postdocs take over once the samples are ready to run through the sequencer. Once sequenced, Nora’s team takes over converting the genotypic data into data sets that she sends to collaborators or compares with genotypes developed by collaborators in England, Japan, Utah, or Massachusetts. Jaime is now a subject number on a data set with other “Mex/Ams,” although now ethnicity might be coded by numbers like those that identify the researchers who collected the data, a specific study, or eventual storage catalogue number.
By examining the life history of a sample in the diabetes collaborative research enterprise, I am adapting Kopytoff’s cultural biographical approach to the process of DNA commodification.18 Kopytoff advances the notion that a thing’s biography, the shifting meanings it carries through time and space, reflects the broader social structure and cultural values of its origins. He argues that the shift in a thing’s status—as a commodity to one person at one time and not a commodity at another time—reveals a “moral economy that stands behind the visible economy of visible transactions.”19 By tracing the biography of DNA, the nonhuman actors20 in the diabetes gene research enterprise, the symbolic and material value of a sample emerges. The production of value, as revealed in the exchange situations, troubles the bipolar rhetoric of persons versus property and offers ethnographic insight into the value generated within scientific practices. In this section, I will begin with a review of diabetes and DNA sampling. Then I will discuss the ways biological samples from racialized populations are transformed into materially and semiotically valuable objects within various corporate, academic, and state-funded collaborative research transactions.
The DNA collection process is so central to genetics research and pharmaceutical developments that the Wall Street Journal featured it on the front of its business section. The article describes the collection of DNA in rural Texas and was written by a staff reporter assigned to developments in the pharmaceutical industry. While no drugs are mentioned, the human-interest coverage speaks volumes as to entanglements of the industry’s financial and social interests. Webster’s definition of a commodity, “Something useful or capable of yielding commercial or other advantage,” illustrates the wholesale fetishization of things exchanged for other things. For to say that a thing is “capable” is to impute agency to an inanimate object. Such a definition denies the human role in the process of commoditization. It thus ascribes, as Marx said, “a social relation between objects, a relation which exists apart from and outside the producers.”21 Unfortunately, such a fetishized definition also permeates discussions of biopiracy, bioprospecting, and critiques of patent case law and benefit sharing. The present analysis seeks to unpack the practices of DNA acquisition and exchange by suggesting a more anthropologically robust definition of a commodity: an object in which a social, cultural, and material investment is made with the expectation of a return on that investment.22 This definition seeks to highlight rather than take for granted the social requirements for and of commodification and thus prevent the objectification of bodies and the fetishization of DNA.
Appadurai (1986) argues that “a commodity is not one kind of thing but one phase in the life of some things.”23 Further, he avers that politics, the social relationships that control the flow and desirability of a thing, “is what links value and exchange in the social life of commodities.”24 I have thus far briefly sketched the political and historical context of Carl’s sampling along the U.S.-Mexico border, that is, the politics of the initiatory exchange of DNA. I now turn to the symbolic and material regimes of value generated in the next stages in the life history of blood samples.
Carl’s NIH biographical sketch reveals that his career has been enriched by his U.S.-Mexico border samples. Ninety-five percent of his publications and all of Carl’s research grants are based upon his collection, exchange, and analyses of “Mexican American” samples. Additionally, Carl’s research has been funded by grants from the state of Texas, the American Diabetes Association, and the NIH. His annual budget for the period I reviewed exceeds $1 million. Commenting on his current budgets Carl remarked, “I’ve got more money than I can use right now.” I witnessed Carl practically begging his field office staff to spend money to replace equipment. “It costs you nothing to replace the global positioning system and blood pressure units,” he would scold his all Mexicana staff, for whom doing without was easier and more familiar than the luxury of buying something new.
Samples are part of a material and symbolic economy that profoundly shapes and is shaped by a researcher’s relationship to the diabetes enterprise. Carl ships his samples to collaborators who are part of numerous research grants in Carl’s portfolio. In fact, the geographic distribution of DNA samples maps perfectly onto the collaborative partnerships indicated on various research grants. These grants form a complicated web of state, corporate, and privately funded research enterprises that require the collection, storage, exchange, and sale of DNA samples. Carl is not alone. Many researchers profit by providing DNA samples to others in exchange for being credited as a coauthor of an article.
A postdoctoral fellow in Gary’s lab recounted a story about the leveraging of samples for her career advancement, which will illustrate the point I am making. Pilar, a postdoc who is from Mexico, called Gary, by then a renowned diabetes geneticist, in search of a job in the United States. Gary called her the next day inviting her to his lab. Pilar said that she motivated Gary to accept her as a postdoc because of her rare Zapotec samples. Pilar recounted that she had heard rumors of a doctor who was doing work with Zapotec peoples. She tried unsuccessfully to contact him and decided to just go to Oaxaca, a region in south-central Mexico where she had heard he was working. She found him and, after some negotiating, was able to collect 23 samples of his (note the possessive pronoun) diabetic patients. Of the potential for collecting more samples in Mexico for genetics research, Pilar said emphatically, “Mexico es una riqueza” [Mexico is a treasure].25 However, after some time conducting her postdoctoral research, Pilar needed some additional samples to use as controls. Pilar and the doctor were in conflict, she reported. A combination of Mexican medical establishment red tape and Pilar’s assertiveness in accessing the population had caused a strain in their relationship. As a consequence, she could not access “her” samples, “mis muestras.” The doctor was resistant to forwarding them to her, Pilar explained, but warmed up to the idea when she informed him that by providing the samples he would get published in Nature Genetics. While “Pilar’s” 23 samples were used in a groundbreaking publication, no nondiabetic Zapotec samples were used, and the doctor was not listed as a coauthor. Pilar, however, was a coauthor.
Carl’s and Pilar’s sampling practices are emblematic of the ways DNA and the data generated from it are exchanged for other forms of professional wealth. The polyvalence of biological samples is exemplary of the confluence of economic and symbolic capital in the sense espoused by Bourdieu by virtue of their translatability from one into the other and back again in a perpetual life cycle of circulation and value accumulation.26
“Exchange,” concludes Appadurai, is not “a by-product of the mutual valuation of objects, but its source.”27 Many significant exchanges occur with DNA samples after Carl or Pilar have acquired them. As Marx (and Appadurai) reminds us, value is the result of the amount of labor necessary to produce the commodity.28 Thus acquiring samples and bringing them to market are part of the labor required for their exchangeability. However, as the case of racialized diabetes DNA samples illustrates, both the political conditions of acquisition and the labor required for their production, acquisition, and exchange are concealed in the value they are given during their circulatory life history. Hence, a sample’s value is taken for granted. That is, the physical labor required to produce Mexicana/o DNA blood samples is concealed within the requisite transactions of scientific collaboration and career advancement. After all, Judi and her staff are not listed as coauthors on Carl’s publications, yet their labor is certainly required.29
Additionally, the meanings assigned to DNA do not reflect the social relations that made the donation possible in the first place. For example, blood samples circulate with only the ethnic taxon as a semiotic reference, “Mexican American.” Carl’s staff collects and processes samples for shipping according to weekly quotas. A shipment of samples is a sign of productivity. The deadline and quota are mere motivators against Carl’s ever-feared heightened scrutiny of the sampling operation.
Once at the wet lab, it takes ethnographic prodding to elicit the story of samples. Pilar’s story would not have been revealed had I not queried her. Additionally, one German physician, Klaus, painstakingly took two years collecting samples from his patients before coming to Gary’s lab as a postdoc. Only after some months, when I asked him about the data set, did he tell me the hours-long details of collecting samples. Both Pilar’s and Klaus’s stories demonstrate that in spite of the unseen labor required to collect them, the story of the samples is one that those responsible for collection are more than eager to tell.
The standardization of the biovalues of DNA samples as occurs in their exchanges for an array of professional wealth illustrates how exchange is the source of the value of a sample: It is not, as the dominant commodification theorem implies, the result of some inherent or potential downstream worth of the DNA. Understanding this biovalue requires attention to the processes of its generation but also of its consequences. “The bodies and vitality of individual and collective subjects have long had a value that is as much economic as political—or, rather, that is both economic and political,” write Nikolas Rose and Carlos Novas.30 In other words, to hold that DNA is inherently valuable is to default to a supply-side economic formula that fetishizes—read de-labors—the material exchanged (Mexicana DNA) and the social processes at work that imbue the codified information-rich genetic texts with meaning as it becomes a data set or scientific publication.
The labor required to bring DNA to its point of exchange has not by any means been fully delineated here. Still it is worth asking: Whose labor is involved in the production of a biological sample before it is extracted from a body? What are the material conditions that confer a value upon this sample? The answers preliminarily lie in the political and social context of the exchange relationship noted earlier. Further, I suggest that the circulation of blood samples within the diabetes research enterprise troubles the oft-used supply-and-demand formulas of value creation for scientific knowledge.31 The default to supply-side economics plays into the fetishized definition of commodification. The reductionistic parsing out of biological or technological processes with immediate exchange or downstream use values in this biocapitalist era is not novel.32 Enclosure and ownership have always gone together. What is new about the creation of biovalue is that this is done while articulating different forms of meaning—for example, individuals and groups are, as Sunder Rajan puts it, “bundles of genetic variations that can be targeted, tested, monitored and changed in new ways,”33 while structurally concealing that the biocapitalist enterprise writ large is working upon the meanings of “the biological” and life itself.
The work of biovalue creation and its appropriation requires both the materiality of biological samples and the data-rich information generated from it, although it is often thought that only the information is the important part of value creation.34 However, as Franklin and Lock so accurately observed, it is the reproductive potential of the biological samples—that the cell can be converted to a cell line that can be sequenced or synthesized for further study and that a finding might affect subsequent generations—which gives biological materials the allure of something special.35 Helmreich’s classification of the concept of biocapital is useful here.36 My use of biocapital and biovalue is equal measure formalist and substantivist. That is, I am interested in the logics of value creation, their meaning systems, as well as the ways such substances as DNA or blood samples operate within, through, and because of those logics.37
We read in chapter 3 about the disturbing purity and admixture discourse that exists amongst diabetes geneticists. The case of sampling along the border shows the complex social and political conditions that allow Mexicanas/os to be targeted for disease research. In this light, the Mexicana/o population’s “race”—or bioethnicity, as I will discuss in the conclusion of this book—is itself a necessary part of the exchangeability of their samples. Put another way, without a history of conquest and dispossession, without the border as a zone of race wars, and most recently without the impoverishing conditions that have resulted from the permanent economic stagnation along the border, the extraction of DNA from Mexicanas/os would not likely exist because Mexicanas/os as a social formation would not exist in its current form. This is to say, the relational aspects of Mexicana/o history that have subjected border inhabitants to 150 years of racialized conquest and which, as was discussed in earlier chapters, must be implicated in diabetogenesis, would not exist.
I do not mean to infer that the mere existence of Mexicanas/os along the border caused them to be sampled. Rather, the argument is that each set of samples is acquired through a complicated set of social and political conditions that, for the most part, are rendered invisible once the sampling has occurred. These conditions include those that created the ethnic identity to begin with, the scientific rationale for sampling, the humanitarian justifications for sampling, and the local circumstances that make donors willing to participate in research practices. While all human groups are potential DNA donors, not every group has an equal chance of being targeted for genetics research.
Mexicanas/os are by no means the only racially targeted population for genetics research. Coriell, for example, contains a catalogue of numerous ethnically labeled sample sets for sale.38 Recall from the introduction to this book that the abstracts from 1998, 1999, and 2000 American Diabetes Association’s annual meetings showed that the different kinds of populations used jumped 15 percent, from 153 to 179 distinct ethnically labeled groups. Further, there was a 36 percent increase in the use of population-based data, with a 60 percent and 30 percent increase in such uses by geneticists and epidemiologists, respectively. The increase in ethnic labeling reflects an emergent trend in genetic science of complex diseases, in pharmacogenomics, and in forensics. Why is it that at the moment “race” is pronounced scientifically dead by many in the scientific community, researchers need population-based specificity to advance their research agendas?
One reason is that the use of populations reflects the race to join the human genome project. As Pilar’s “ownership” of her Zapotec samples illustrates, a rare data set can gain an investigator access to the rights and privileges of publication, collaboration, and research. A reportable finding derived from an ethnically labeled group can thus attract further opportunities and possibly serve to validate or confirm the findings of other researchers. As Carl’s field office indicates, DNA sampling is a capital-intensive enterprise for which some return on one’s investment is expected. For example, several of the authors on the polygene paper hold a patent on the discovery. The patent for the polygene notes, “Using this method, the inventors show that the interaction of genes . . . makes a major contribution to susceptibility to type 2 diabetes in Mexican Americans from Sun County, Texas.” The patent document is an exhaustive detail of every facet of the polygene discovery, including a myriad of wet and dry lab techniques and their potential application in the detection, selection, or alteration of a number of proteins and in the development of drugs.39
In this section, I will explore the ways that the use of population DNA is driven by the search for professional and other forms of profit. But more specifically, I will argue that DNA sampling along the U.S.-Mexico border is deeply infused with the acquisitive interests of the pharmaceutical industry. To be sure, pharmaceutical company representatives were present at consortium meetings. They were not special participants, however. They were involved in collaborations with Nora, took the lead on projects, and sponsored special meetings on current scientific topics, for example, the genetics of diabetes. Industry-sponsored research projects and its participation in collaborations of all kinds ensures their access to the latest research, if they choose their partners wisely.
More broadly, drug companies are abundantly represented in the diabetes literature, in patient cookbooks, and in pamphlets of all kinds. But nowhere are drug companies more visible than at the American Diabetes Association’s meetings, which are the quintessential marketplace of diabetes knowledges and products. The industry’s role is most interestingly manifest in the exhibit hall for these meetings. The “product theater” as it is called, comprises six thousand square feet oozing with products, promotional gimmickry, 3-D simulations, and ritual enactments, all designed to capture the largely physician market share for an array of products and services. At the meetings in 2000, 114 corporate exhibitors compete for conferees’ attention. The 20 or so nonprofit exhibitors also vie for attention, but they are no match for the six-figure budgets of the biggest and brightest pushers in this surreal corporate technological “drugscape.” Two-thirds of the hall is dedicated to the product theater, the other third to the poster panels. Exhibits are packed into this carefully planned space. The largest exhibits occupy approximately three hundred square feet each and are spaced so as to capture maximum visual and interactive contact. Logos bombard the hall. Lilly, Bayer, Pfizer, Bristol-Myers Squibb, Merck, Becktin-Dickinson, Novartis, and Glaxo all beckon a consumptive gaze and ultimately a prescription, subscription, or clinical adoption in physicians’ practices. Smaller names abound. As the morning meetings of the drug and medical technologist representatives conclude, music fills the hall and, like the start of trading at the New York Stock Exchange, a voice—this one a woman’s—announces the opening of the exhibitions over an omnipresent PA system.
The biggest attraction was the five-hundred-square-foot exhibit for Bristol-Myers Squibb’s heavily promoted Glucophage. Set up to mimic ABC’s 1999 game show sensation, Who Wants to Be a Millionaire, the exhibit was a showstopper. Designed like a roundabout, the set was an open-air studio at which contestants “win” prescription pads for answers to clinical trivia. True to its original British version, Regis Philbin had been replaced by a British actress who seamlessly managed the choreographed music, trademark heartbeat bass soundtrack and all, to the game show format. What was it about that exhibit that enabled it to attract both physicians and health educators to Glucophage in a venue organized by an association devoted to curing diabetes?
If Regis Philbin’s prime-time ritual enacted for television audiences is the hyperreal simulation of the dot.com American dream,40 that which stock portfolios soon demonstrated was a bubble soon burst, Bristol-Myers Squibb’s “Millionaire” product theater is, in Beaudrillard’s words, “an idealized transposition of a contradictory reality” par excellence.41 For, if—as is the case—the stated objective of the American Diabetes Association is to end diabetes, and diabetes is a disease created by overconsumption, overproduction, overdevelopment, and excess upon excess, then the spectacle of the Glucophage product theater operated as a good simulacra must. It enacted the contradiction of disease through excess by celebrating the excess in a venue designed to eliminate the disease. The disease no longer is the point, but rather the excess, the fantasy of getting rich quick, as the ultimate foil for social dis-ease.
But more than the playful juxtaposition of materialist recuperations inspired by Marx or the messier explication of the “rules of the game in the fields of racialized knowledge production” that Bourdieu’s analyses enable, or even my rhetorical enactment of a simulacrum too salient to ignore, I mean to elaborate the relationship between the material and cultural forces at work within, upon, and constituent of the diabetes enterprise. The product theater, in which the Millionaire showpiece is only one of hundreds of displays, instantiates the blurring of natures and cultures occurring with increasing frequency in biomedical research writ large. A scientific conference is funded in part by its sponsors and the registration fees of the (captive) audience that stroll through the exhibit halls between scientific and other sessions. The audience are scientists and practitioners who likely accept the economies of conference finance and are unaware of the influence of product placement. The blurring of knowledge and capital accumulation can scarcely be more apparent than the product theater at the American Diabetes Association meetings.
By tracing the life history of DNA samples as they come to be valorized within the regime of scientific accumulation embedded in the shopping and swapping of DNA, I have tried to characterize a process that reiterates not only familiar forms of material exploitation but also unfamiliar mechanisms of sociopolitical and cultural meaning making.
The product theater can also be understood as an apparatus of biocapitalization that resocializes—denatures, so to speak—the bios in an effort to convert DNA into currency. Paradoxically, this requires both an erasure of the process of capitalization and the contingency of any knowledge claim derived with and through the population samples. And it is interesting that this conversion process also erases any ethnic specificity of diabetes: the drug works on all bodies, for all diabetics. Surely the drumbeat of tailored medicines now thrumming the corridors of disease enterprises writ large complicates this rhetoric.
Recall my working definition of a commodity, an object in which a social, cultural, and material investment is made with the expectation of a return on that investment. My point here is that racially marked DNA samples function, like all products of diabetes knowledge, as a kind of currency. It is a currency derived from bodies and fashioned to meet biomedical and economic ends. The value of samples and of the process of their commodification is derived in the social relations through which they are produced, exchanged, and consumed. For example, we have seen that samples are exchanged for rights, privileges, goods, and services. If a researcher has a set of samples, even a very few, they can apply for grants to conduct experiments upon them. Samples can be parlayed into a careerlong research program or into the keys to membership in cutting-edge research consortia. Samples can get a researcher’s name in print and they can be stored, banked, processed, and sold. For example, the Sun County DNA samples can be purchased at Coriel for $50, the cell culture is $250.
In thinking about the social, economic, and political consequences of DNA sampling, it would be easy to argue at this point that the samples and all knowledge derived therefrom belonged to the donors. The chair of the European Ethics Committee of the Human Genome Organization, Bartha Knoppers, argues that patent policy initiatives must focus on the equitable material transfer agreements between donors and scientists.42 But this would be acquiescence to the logic of possessive individualism often invoked in patent case law by suggesting that cells, organs, or tissue (and anything derived from them) were owned and could be exchanged—as if by magic—by one party or another depending upon their relationship to the biomaterial or its cognitive byproduct.
Further, in their critique of the ways biological samples are becoming like minerals, crops, and land referred to in the language of science as extracted, harvested, or procured, Andrews and Nelkin write, “Such language reflects a set of cultural assumptions about the body: that it can be understood in terms of its units, and that these units can be pulled from their context, isolated, and abstracted from real people who live in a particular time, at an actual location, in a given society.”43 Though these criticisms are important, they do not elucidate the process of value production that occurs long before patentability and in spite of any consent issues.44
The focus on profit taking or benefit sharing so removes the DNA samples from the conditions of their extraction and processing that no claim can be made for a benefit having occurred as a result of the acquisition and development of population samples in the first place. Thus, Andrews and Nelkin’s and Knoppers’s supply-side notions of valuation and critiques of unfair or nonexistent benefit sharing practices, while fundamentally important, misrecognize the social relations that make possible the production and circulation of DNA samples.45 Inattention to the social context of sampling and the social life of a sample overlooks the regimes of value generated by its exchange. This reification plays directly into the interpellative power of the academic-industry-state enterprise to enlist research subjects and their ethnicity as global human capital. Instead, I follow Strathern’s insight that one modality of making property out of bits of biological organism (animal or plant) requires the delinking of the product from its origins.46 This enables the reassignment of ownership at each stage in the development of knowledge. This is not magic. It is the emergent form of property relations manifest in intellectual property rights discourses.
Blood samples, like all things, did not appear out of nowhere. They must be understood in a context, which, as Johannes Fabian reminds us must be relative to “individually and therefore historically situated practices.”47 The context of DNA sampling does, I think, help explain the process of creating value. That DNA from certain populations enables the cultural process of valuation is the point. Why Mexicana DNA? Why now? Why from South Texas? The question is not what makes DNA valorization possible, rather, what does the valorization of DNA produce?
These questions are both broader and narrower than arguing that donors have rights. Corinne Hayden’s analysis of benefit sharing has carefully unpacked the problematics of this simplistic ethical claim.48 Rather, this book argues that DNA sampling produces a form of epistemological biopolitics that traverses the palpably local conditions of DNA donation and the regimes of genetic knowledge production. The biovalue generated in this life science biocapitalistic enterprise is an instance of Sunder Rajan’s biocapital par excellence.49 This case illustrates the means through which, like other manifestations of the making of wealth within capitalism, acceptable levels of ethnic differences in morbidity and mortality of disease are reinforced rather than addressed. That this occurs under the guise of universal incontrovertible good of the human genome projects, of the concern for public health along the border, or in an event organized around preventing disease, demonstrates both the perduring processes of social stratification and the quotidian means through which the processes of the accrual of return on investment are manifest within the research enterprise.