Combining Drugs. Polytherapy and the Association of Medicinal Substances in Asia




combining-drugsThe paradigm shift that saw pharmaceutical production and biomedicine enter their molecular era in the middle of the twentieth century might be challenged today. On the front line stands the crisis of innovation, characterized by increasing attrition rates and a declining number of new molecular entities put on the market, and recognized by both industries and regulatory authorities. A number of “new” treatments thus account for the reorientation of existing molecules towards new therapeutic targets. In this context, active substances are also combined for an increasing range of disorders, as in the case of HIV tri-therapy, treatments for epilepsy and tuberculosis, or Artemisinin Combination Therapy for malaria. While it holds a marginal place in the global practice of biomedicine, the use of these composite pharmaceuticals is of significant material and epistemological, as well as social and sociological relevance. This is particularly true in Asia. Whether it concerns the innovative hybrid formulas stemming from the industry of traditional medicines, the physicians’ clinical practice aiming to answer novel epidemics and drug resistances, or the extemporaneous drug assemblages made in pharmacies and other (illicit) outlets, pharmaceuticals are often combined with the intention to create original, poly-molecular therapeutic entities. These practices are not to be confused with, or understood as medical ‘prescriptions’ but as producing single yet composite materials on their own. This panel takes these objects as a privileged vantage point for the study of material culture and economy, regimes of knowledge production, and social and regulatory environments. It brings together a multidisciplinary panel (anthropology, history, social pharmacy) in a collective attempt to shed light on the many dimensions of polytherapyas it faces epidemiological, medical, legal and sociocultural challenges in India, China, Cambodia, Thailand and The Philippines.logo-icas10

The Panel will be held during the 10th International Conference of Asian Scholars (ICAS10).

Download the programme and the abstracts


Stefan Ecks (University of Edinburgh)

Jean-Paul Gaudillière (CERMES3, Paris)

Anita Hardon (University of Amsterdam)

Niyada Kiatying-Angsulee (Chulalongkorn University, Bangkok)

Laurent Pordié (CERMES3, Paris)


Laurent Pordié (CNRS-Cermes3, Paris)


The Panel is funded by the ERC GLOBHEALTH and the Research Centre on Science, Medicine and Society (Cermes3 – EHESS, CNRS, Inserm), Paris.



Chiang Mai International Exhibition and Convention Center, Chaing Mai, Thailand


Slow Medicine in Fast Times: Tibetan Medical Responses to Disaster

By Sienna Craig (8 December 2015, Paris)

This seminar is part of the lecture series "Global Health: Knowledge, Infrastructures, Politics", held at the EHESS in Paris from October 2015 to June 2016. 


Nepal Earthquake 2015 01It is often said that traditional medicine, including Tibetan medicine, succeeds in the treatment of chronic conditions, whereas biomedicine is a better option for acute care. Such a distinction is raised not only by biomedical practitioners and patients but also by Tibetan physicians. Indeed, it is part of how Tibetan medical ‘neo-traditionalism’ (Pordié 2008) operates. However, this framework is incomplete and limited. The limitations of this dichotomy become particularly apparent when considering health care needs that are biological, psychological, and social. Such health care needs present in particular ways during states of emergency, such as natural disasters. While multinational biomedical institutions have only relatively recently begun to acknowledge a ‘bio-psycho-social’ framework, arguably this type of understanding has been long present in the practice of Tibetan medicine. Even so, determining how, where, and to what ends to deploy traditional medicine in such moments remains debated in global health circles and under-represented in scholarship. This paper uses ethnographic examples of the role that Tibetan medicine has played in response to earth- quakes in Yushu Tibetan Autonomous Prefecture, China (2010), and in Nepal this year (2015) to suggest a rethinking of what traditional medicine is ‘good for’ within the context of emergency response.

Short film exploring the use of traditional Tibetan medicine as part of reconstruction efforts following Nepal's 2015 earthquake.

Extra reading


Sienna Craig (Dartmouth College)


Ecole des Hautes Etudes en Sciences Sociales (EHESS), salle 015, bât. Le France, 190-198 av de France 75013 Paris.


Date and time

8 December 2015, 2-5 pm

Vietnamese medicine for Vietnamese people

BY Ayo Wahlberg (12 APRIL 2016)

This seminar is part of the lecture series "Global Health: Knowledge, Infrastructures, Politics", held at the EHESS in Paris from October 2015 to June 2016. 


AyoOver the last six decades or so, a state-led effort to modernize, industrialize and integrate traditional herbal medicine has been underway in Vietnam. At the same time, national and international health authorities have long pointed out that most general health indicators in Vietnam surpass those of other countries with a similar per capita income. In this talk, I ask what place does traditional herbal medicine have in a country which is continuing to struggle with “an unfinished agenda in infectious, vector-borne and communicable diseases” (WHO 2003) while also coming to terms with “the adverse impact on health due to changes in lifestyles, environments and working conditions in the processes of industrialization and modernization” (Communist Party of Vietnam 2005)? I suggest that, mobilizing traditional herbal medicine to address Vietnam’s double burden of disease has required not so much a colonization as a normalization of its practice, production and use. Finding a ’Vietnamese’ way to tackle health challenges has been and remains a key trope in politics of health in Vietnam.


Ayo Wahlberg(University of Copenhagen)


Ecole des Hautes Etudes en Sciences Sociales (EHESS), salle 015, bât. Le France, 190-198 av de France 75013 Paris


Date and time

12 April 2015, 2-5 pm

Circulation et industrialisation des matières médicales traditionnelles. L'artemisinine, un médicament anti-malaria

Mardi 24 mai 2016, PARIS, France

Special session of the seminar series “Globalization of East-Asian Science and Knowledge”, held at the EHESS in Paris from October 2015 to June 2016. 


NobelPrizeLe 5 octobre 2015, le prix Nobel de physiologie ou de médecine était attribué à trois chercheurs, l’Irlandais William C. Campbell, le Japonais Omura Satoshi et la Chinoise Tu Youyou 屠呦呦. Les trois lauréats ont été récompensés pour avoir développé de nouvelles thérapies contre des maladies parasitaires, les deux premiers contre des filarioses et la troisième contre le paludisme. Les recherches de Tu Youyou sur les traitements du paludisme l’ont conduite à isoler au début des années 1970 l’artémisinine (qinghaosu 青蒿素), un principe actif d’une grande efficacité contre les espèces de Plasmodium, parasites responsables de la malaria. L’artémisinine est la substance active d’une armoise, Artemisia annua, employée depuis longtemps par la médecine chinoise. Depuis lors, l’artémisinine est l’un des médicaments les plus importants pour lutter contre la malaria, en particulier en Afrique. Les intervenants se proposent lors de la journée d’étude d’aborder aussi bien l’histoire de l’artémisinine et des travaux de Tu Youyou que l’utilisation actuelle du produit et les enjeux géopolitiques liés à son développement et à sa circulation.


Frédéric Obringer (CNRS, UMR Chine, Corée, Japon CNRS/EHESS)
Jean-Paul Gaudillière (Inserm-EHESS, Cermes3) 
Sylvie Michel (UMR 8638, COMETE, Faculté de Pharmacie)
Kelley Sams (Center Norbert Elias / EHESS Marseille)
Annick Guénel (CNRS, CASE)

Download the Program


Center for Studies on China, Korea and Japan (CNRS-EHESS) and Research Center on Science, Medicine and Society (Cermes3), Paris.

CCJ logo-cermes3


Room 681, Bâtiment Le France, 190 av. de France, 75013 Paris.

Governance and Circulation of Asian Medicine

Workshop, 22-23 september, Singapore


singaporeThis workshop will explore the ways by which public and private institutions in various Asian countries regulate, control and market industrial Asian medicine since the 1970s to date. A special emphasize will be given to processes of production, distribution and circulation as they become increasingly dependent of biomedical know-how, categories and clinical targets. Thus subject to new forms of biopower, Asian medicines however developed their own innovation and protection models – sometimes critically engaging with the dominating, molecular pharmaceutical paradigm that prevails since WWII – and are found increasingly present in the global marketplace.

Either initiated by corporate firms or encouraged by the States, the industrialization and standardization of Asian medicines have entailed dramatic changes bearing on both medical epistemology and therapeutic practice. This situation led to new questions pertaining to safety and efficacy. Similarly, hybrid forms of manufacturing practices – often inspired by so-called universal models of GMPs – and peculiar modes of regulation and (scientific) marketing characterize this industry. On the clinical end of the spectrum, the depersonalization of care (mass-production vs. individual variability) calls for a new understanding of Asian Medicine in today's world.

A series of guidelines have been established to regulate and monitor these transformations. This process has long been described as political, as it usually takes place in relation to central governing structures and entails remarkable transformations of therapeutic power. It is also deeply economic; one of the chief aims is to foster market penetration and the accumulation of capital. This reorganization, however, cannot be reduced to a mere political or economic reading. It also involves the moral foundations of medicine and therapeutic power, as they concern values and the nature of right and wrong. While we will not lose sight of the social, cultural, epistemological and clinical dimensions of contemporary changes in Asian medicine, it is indeed important in this workshop to observe the normative character and the moral inflection of these transformations. And this is all the more true when speaking of norm-generating regulatory regimes.

The World Health organization is one typical actor in this field, alongside national institutions. However, the content, and degree of compliance to international guidelines varies considerably from one country or one manufacturer to the other, which are free to implement them or not. This variability also emerges from the loose nature of the controls, which in turn largely enables the circulation of unregistered or illicit herbal pharmaceuticals, which may comprise plants, minerals or metals banned in the national pharmacopoeias of targeted countries. To study this complex landscape therefore requires a collective, multi-sited and multidisciplinary approach, covering several configurations and geographic areas in Asia.

The aim of this gathering is to unpack the organized sets of practices that govern contemporary Asian medicine from their production in the lab to their circulation within circuits and networks of all kinds. The method put forward will merge history of science, medical anthropology and science and technology studies.

Download the programme and the abstracts.


Vijay Chauhan (Yuva Healthcare, New Delhi)
Liz Chee (Asia Research Institute, Singapore)
Céline Coderey (Asia Research Institute, Singapore)
Anita Hardon (University of Amsterdam)
Por Heong Hong (University of Malaya)
Wen-Hua Kuo (National Yang-Ming University, Taipei)
Eunjeong Ma (Pohang University of Science and Technology)
Karen McNamara (Asia Research Institute, Singapore)
Evelyne Micollier (Institute for Research on Development, IRD, Vientiane)
Sebastianus Nawiyanto (University of Jember, East Java)
Laurent Pordié (CNRS-Cermes3, Paris)
Martin Saxer (Ludwig Maximilian University, Munich)
Arielle Smith (Cermes3, Paris)
Ayo Wahlberg (University of Copenhagen)


Céline Coderey (Asia Research Institute, Singapore) and Laurent Pordié (CNRS-Cermes3, Paris).


Asia Research Institute, National University of Singapore.
Research Centre on Science, Medicine and Society (Cermes3 – EHESS, CNRS, Inserm), Paris.


Asia Research Institute, NUS, Singapore