Bitter pill to swallow? The emergence and evolution of the Āyurvedic pharmaceuticals category
Guide(s)
Ojha, Abhoy K
Department
Organizational Behavior and Human Resources Management
Area
Organizational Behavior and Human Resources Management
University
Indian Institute of Management Bangalore
Place
Bangalore
Publication Date
3-31-2024
Year Awarded
2024
Year Completed
2024
Year Registered
2018
Abstract
‘Health for All’ has been declared a Sustainable Development Goal (SDG) by the United Nations (UN) but the road to ensuring its achievement is long. More than half of the world’s population lacks access to essential health services. The World Health Organization (WHO) sees an important role for traditional medical systems in plugging these gaps and for nearly fifty years, has seen India as an exemplar of integrating traditional medicine into national health policy. This dissertation seeks to understand the roots of medical pluralism in India with the larger goal of enabling the achievement of ‘Health for All’ through medical pluralism.
The first essay of this dissertation studies the emergence of the Āyurvedic pharmaceutical manufacturers category in colonial India. Literature on category formation has paid insufficient attention to category formation through the exercise of fiat by a central authority and to the response by dissenters of the imposed category. Fiat is exercised most often by the state, which is expressed through a complex of policy regimes, that are influenced by power and politics. Given that the political state is an entity legitimized to exercise fiat, the study uses the historical case study method and qualitative archival data to study the imposition of modern medicine by the colonial state in India, and the formation of a new organizational category by dissenters in response. Findings suggest that category imposition by the state involves exercising fiat to shape boundaries and practices associated with the imposed category, and legitimizing the imposed category through regulative legitimacy, along with disapproval of existing categories. The salience of this exercise of fiat and forced encounters with the imposed category give rise to category threat perception. This threat perception drives category formation by dissent through the emergence of action frames and category recognition by audiences. The essay contributes to the literature on category formation by offering elaborations of category formation by fiat, proposing a new mechanism of category emergence by dissent, and offering a linked model of category emergence by fiat and resulting dissent. It also contributes to the literature on categories by demonstrating the existence of values-based categories and of expert-producers, and by extending the idea of categories as political devices with a conceptualization of categories as sites of productive resistance.
Through the second essay, the dissertation investigates how the Drugs Act, 1940, which explicitly excluded traditional drugs from its ambit while defining the regulatory category of ‘drug’ in India, was modified to include Āyurvedic drugs through an amendment in 1964. The literature on regulatory categorization is nascent and lacks theoretical lenses. To that end, this study reconceptualizes regulatory categorization as a case of discursive boundary work and focuses on the understudied aspect of boundary expansion therein. Using a qualitative approach that analyses the text of legislative debates from the Indian parliament, the study finds legislators engaging in three new mechanisms of expansionary boundary work – redefining boundary conditions (by shifting focus to the audience, reflecting legitimacy among audiences and addressing audience needs), problematizing boundaries (by highlighting how existing boundaries enable breaches and restrict the scope of actors) and reconceptualizing boundaries as sites of justice(by facilitating equality and equity through inclusion). The essay contributes to the literature on discursive boundary work, regulatory categorization, policy change and medical pluralism.
The third and final essay analyses the modernization of Āyurveda using Max Weber’s framework of rationalities, which facilitates the analysis of social change processes. Weber’s core concern was the rationalization underlying the modernization of Western civilization, which he found to be dominated by means-end rationality. However, Weber and Weber scholars have posited that rationalization processes may proceed differently in other contexts and cultures. Using this as the point of departure, the third essay treats the ‘Āyurvedic pharmaceutical’ as the material manifestation of the modernization of Āyurveda, and the Drugs Act, 1940, as a codification of this modernization. It then interprets clauses of the Drugs Act using Weber’s framework of rationalities to derive the rationalities underlying the modernization of Āyurveda. The study finds that the modernization is driven by the theoretical rationality of Āyurveda but formal rationality of modern medicine leading to what I term as an ‘enchanted rationalization’ of Āyurveda and to state-sanctioned decoupling through the material dimension of institutional work. The essay discusses implications of enchanted rationalization for our understanding of modernization itself as well as for the future of Āyurveda and medical pluralism.
Pagination
xv, 260p.
Copyright
Indian Institute of Management Bangalore
Document Type
Dissertation
DAC Chairperson
Ojha, Abhoy K
DAC Members
Mani, Dalhia; Fortin, Israel; Srinidhi, V
Type of Degree
Ph.D.
Recommended Citation
Kondayya, Anupama, "Bitter pill to swallow? The emergence and evolution of the Āyurvedic pharmaceuticals category" (2024). Doctoral Dissertations. 3.
https://research.iimb.ac.in/doc_dissertations/3
Relation
DIS-IIMB-FPM-P24-03
