Submission ID 118476
| Issue/Objective | The global pharmaceutical industry has long been recognized for harmful practices such as price gouging, deceptive marketing, and fraud. A devastating example is Purdue Pharmaceuticals' (Purdue) mislabeling and mass-marketing of OxyContin, which catalyzed the opioid crisis in and beyond Canada. To advance understandings of global health systems' capability to address this issue, this study examines how accountability has been enacted within global health systems in response to the harms caused by Purdue. |
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| Methodology/Approach | This study was guided by Actor-Network Theory (ANT), which conceptualizes reality as a continuously generated effect of webs of relations. In applying these ideas to accountability, we can understand the concept as dynamic, enacted differently by various networks, each representing a co-existing multiple reality. To examine these multiple enactments, this study draws on data generated from a document analysis literature (n=36) and key informant interviews (n=18) with policy makers, academics, and industry representatives. |
| Results | Findings highlight the multiple co-existing versions of accountability enacted within global health systems organized as three separate but interrelated networks: social accountability, political accountability, and legal accountability. Activist and media networks, raised public awareness, prompting public officials to enact political accountability through congressional investigations and hearings examining Purdue's actions. This public awareness and political accountability led to forms of social accountability, such as the removal of the Sackler name (owners of Purdue) from cultural institutions. Finally, legal forms of accountability were also identified, including the 2007 proceedings where top executives at Purdue were fined for mislabeling OxyContin as mildly addictive. However, significant limitations to the reach and influence of legal networks were acknowledged, such as the failure of fines to address systemic flaws and the inability to prosecute companies beyond national jurisdictions. |
| Discussion/Conclusion | Through this in-depth examination of the complex interactions involved in global health and pharmaceutical systems, this study offers a nuanced understanding of the diverse actors mobilized and the unique strengths leveraged to enact accountability. In doing so, it highlights areas for collaboration and health system strengthening, emphasizing the need to prioritize stronger integrated accountability mechanisms to better address and prevent future harms. |
| Presenters and affiliations | Andrea Bowra University of Toronto Jillian Kohler University of Toronto Amaya Perez-Brumer University of Toronto Lisa Forman University of Toronto |
