Risk and Drug Regulation: the Transforming Osteoarthritis in Taiwan
May 15 2009
Seminar Room 2,
Chrystal Macmillan Building,
15a George Square,
All welcome, no need to book
Joint Seminar - Social Anthropology & Innogen, Edinburgh University
"Risk and Drug Regulation: the Transforming Osteoarthritis in Taiwan"
Osteoarthritis is estimated to affect between 10 to 20% in Taiwanese over 60 years of age, and has been recognized as a significant public health problem with the designation by WHO of the years 2000-2010 as the Bone and Joint Decade. This paper examines how osteoarthritis has been transformed through the commodification processes involved the state, medical professionals, academics, and the media in the regulation of drugs for osteoarthritis in Taiwan. Data were drawn from major newspapers and four popular health-related magazines dated from 1951 to 2006, as well as official documents from the health department in Taiwan.
The results show that the attribution of causes of the condition equivalent to osteoarthritis shifted from occupational hazards in the early 50s, to organic degeneration attributed to aging in following decades. It was taken up into medical realm claimed to be lifestyle factors (e.g. obesity, malnutrition) during the mid-1980s to mid-1990s, and finally to molecular and biochemical instability of tissues such as cartilage in the body. The prominence of lifestyle factors in preventive discourse initially led to a rapid increase in the consumption of glucosamine. In addition to be mediators between consumers and drug companies in facilitating the commodification of glucosamine and osteoarthritis, medical physicians and academics who were recruited by drug companies as representatives promote their own expertise and legitimacy. With the recategorization of glucosamine as a health food rather than a prescription drug under new drug regulation in 2002, state expenditure on glucosamine leveled out. However a commercial drug company importing "Viartril-S" (an Italian-made glucosamine preparation) turned the controversy to its advantage by advocating new preventative uses of "Viartril-S". Claims on behalf of "Viartril-S" cited risk factors among younger individuals and those at earlier stage of osteoarthritis. Furthermore, the transformation of the cultural meanings of glucosamine as gift, especially absent grown children to their home-town dweller parents, in the Taiwanese society also facilitated its commodification. The interplay between state regulatory practices, medical professions, new family relations and drug trade companies has shaped the risk of osteoarthritis and aging in the Taiwanese society.