Nitsan Chorev's "Give and Take"

Nitsan Chorev is the Harmon Family Professor of Sociology and International and Public Affairs at Brown University. She is the author of The World Health Organization between North and South and Remaking U.S. Trade Policy.

Chorev applied the “Page 99 Test” to her new book, Give and Take: Developmental Foreign Aid and the Pharmaceutical Industry in East Africa, and reported the following:

On page 99 you will find a discussion on the historical origins of one important aspect of the local pharmaceutical industry in Kenya, Tanzania and Uganda – the fact that at least initially the industry was dominated by East Africans of Indian descent. On page 99 I discuss the case of Tanzania and show that it was discriminatory practices during colonial rule that led to the exclusion of indigenous Africans from commercial and industrial sectors. In addition to unequal educational opportunities (discussed on a different page), Africans were not given trading licenses at the same time that commerce was almost the only business opportunity available to Indians.

Would browsers opening Give and Take to page 99 get a good or a poor idea of the whole work? It depends! Possibly, page 99 offers a “poor” idea of what the book is about since it happens to focus on the colonial era whereas the main events of interest to the book take place much later, from the 1980s to the 2010s. And yet, page 99 also offers a great idea of the whole work because it points at what I consider to be one of the strengths of the study – my interest in the historical (both colonial and post-independence) roots of contemporary industrial production in East Africa.

Page 99 also happens to focus on domestic policies whereas the main argument of the book is about foreign aid. And yet, page 99 again offers a great idea of the whole work since it points at another potential strength of the study – my interest in the interplay between transnational (foreign aid) and local factors (state capacity, entrepreneurship) as they shape industrial production in East Africa.

I like page 99 exactly because it captures the complexity of what I try to argue. The book attempts to explain the presence of “pockets” of industrial capabilities in resource-poor countries by looking at local drug manufacturing. Why the emergence of pharmaceutical production in Kenya, Tanzania and Uganda in the 1980s/1990s? And how to explain the unlikely improvement of quality standards in that industry in the 2000s/2010s?

These questions led me to foreign aid. I find that foreign aid was instrumental for both the emergence and the upgrading of the pharmaceutical industry in East Africa (although, as page 99 begins to reveal, local conditions also mattered). This doesn’t mean that critics who argue that foreign aid is inefficient or exploitative are wrong. Rather, that under certain conditions foreign aid could be effective and valuable for the recipients. What the book tries to do is identify those conditions, that is, the policies and programs that benefited the pharmaceutical sector.

I found that it was a combination of three interventions: the creation of markets encouraged local entrepreneurs to produce the kind of drugs that donors would buy; effective monitoring encouraged local entrepreneurs to follow high quality standards; and mentoring in the form of technical transfer provided local entrepreneurs the necessary know-how to do so successfully. And although the book focuses on the pharmaceutical sector the lessons travel not only to other industrial sectors but to services as well.

Learn more about Give and Take at the Princeton University Press website.

--Marshal Zeringue