The rapid growth of pharmaceutical markets has led to increased demands for human subjects for drug research, particularly in low‐income countries. For regulatory, economic, and even biological reasons, new populations are being pursued as human subjects for pharmaceutical trials. In this article I consider the evolution of commercialized clinical trials and ethical and regulatory environments as they contribute to a dramatic growth of human‐subjects involvement in research. I focus on the operations of U.S.‐based contract research organizations (CROs), which make up a specialized global industry focusing on human‐subjects recruitment and research and the on ways in which they expedite drug testing to low‐income contexts. Specifically, I analyze how these transstate actors interact with regulatory authorities in the United States and how they recast international ethical guidelines as they organize trials for research subjects abroad.

In the transition out of socialism to market capitalism, bodies, populations, and categories of citizenship have been reordered. The rational-technical management of groups affected by the Chernobyl disaster in Ukraine is a window into this contested process. Chernobyl exemplifies a moment when scientific knowability collapsed and new maps and categories of entitlement emerged. Older models of welfare rely on precise definitions situating citizens and their attributes on a cross-mesh of known categories upon which claims rights are based. Here one observes how ambiguities related to categorizing suffering created a political field in which a state, forms of citizenship, and informal economies were remade.

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This chapter provides an overview of the book's main themes. This book brings together an international group that includes anthropologists, historians, and an epidemiologist and human-rights scholar to produce an ethnographic critique of the contemporary global health enterprise. These contributors are engaged in both empirical and theoretical investigations of global health-related initiatives and epistemologies, and are concerned with the actual impacts of these initiatives on care, health systems, and governance. The book emphasizes ethnography as a crucial methodological tool for achieving better comprehension of health services at all levels of analysis and advocates anthropological case studies and cross-cultural analysis as foundational to a much-needed critical global health perspective. The book offers innovative ways of thinking about older debates in light of emerging realities, and it sets a new agenda for research in global health, one aimed at a more comprehensive framework for understanding the human, technical, and political issues involved.

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