Abstract

This paper explores the regulation of the pharmaceutical industry – as a question of ethical practice – in the context of Nepal. Specifically, it focuses on the release of the Nepal Government’s Department of Drug Administration’s (DDA) Ethical Guidelines in 2007 and the ways in which a number of institutions and organisations with vested interests in the pharmaceutical industry reacted to this. Drawing on ethnography of the pharmaceutical distribution chain – from producers to retailers, and marketers and medical practitioners – it highlights a number of exchange relations (like companies giving ‘bonuses’ and retailers ‘substituting’ brands on prescriptions, for example) that are deemed a problem for both internationally defined, and state sanctioned, best ethical practice. At stake in this contested domain of ‘ethics’ are struggles over the health and wellbeing of the consumers. Yet the introduction of the guidelines seems to have made little difference to practice, and the paper asks why, in the context of Nepal, this might be so.