Publications

NEW BOOK JUST OUT!

EDITED BY PROFESSOR SUSI GEIGER

Screenshot 2021 09 06 at 10.58.23 - Publications

Chapter 1 – Geiger, Susi (2021) Healthcare Activism, Marketization, and the Collective Good.

Chapter 2 – Galasso, Ilaria and Geiger, Susi (2021): Preventing “Exit,” Eliciting “Voice”: Patient, Participant, and Public Involvement as Invited Activism in Precision Medicine and Genomics Initiatives

Prof Susi Geiger, Principal Investigator

Global Access to Medicines and the Legacies of Coloniality in COVID-19 Vaccine Inequity

Geiger, Susi and Ciara Conlan (2022)

Policy & Practice, Vol. 34.

Abstract

This article, written by two members of the advocacy organisation Access to Medicines Ireland, analyses current discourses and practices around global COVID-19 vaccine distribution.  As vast imbalances in vaccination coverage continue to characterise global vaccine distribution, we argue that some of the public discourses and distribution mechanisms are coloured by a colonial legacy, which substitutes local capacity building in low and middle-income countries with donations, and substitutes a transparent public debate around how to tackle these inequalities with a discourse that explains them away through perpetuating such tropes as ‘vaccine hesitancy’ or ‘wastage’.  Even though such claims have been continually refuted by scientific evidence, the pharmaceutical industry and many high-income country governments keep reiterating them.  By dismantling such myths, we point to the legacies from which they have emerged.  Flagging the possibility of alternative discourses and practices in global health, we trace the recent history of the access to medicines movement.  We argue for a need to suspend intellectual property rights rules around COVID-19 health technologies through the so-called Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver, citing positive exemplars of vaccines developed through an open science paradigm as a counterpoint to the pharmaceutical industry’s claims that such a waiver would have chilling effects on the global pharmaceutical innovation system.  We close by highlighting development education opportunities around global access to medicines and universal healthcare.

Organizing the sharing economy through experiments: framing and taming as onto-epistemological work

Chimenti, Gianluca and Susi Geiger (2022)

Organization Studies

Prior work on performativity has illustrated how theories intervene in economic organizing. We expand this body of research by studying how concepts, and particularly those that are loosely defined and/or not widely understood, provoke their own realities through experiments. We examine how different experimental set-ups allow these concepts to be seized by a multitude of actors all wishing to instantiate worlds in their own interests, and how they potentially open up multiple competing realities as a result. We follow the concept of Mobility-as-a-Service as it mobilizes various experiments across public and private realms in Stockholm and Dublin, and we analyse how specific types of experiments co-produce epistemic and ontological work. Our results illustrate how different experimental designs can be conducive in taming and/or framing ambiguous concepts through interconnected processes of such onto-epistemological work. This highlights the distributed and relational but also the ‘provocative’ facets of performing ambiguous concepts through experiments. We discuss the consequences of these insights for how we think about scaling from experiments to broader socio-economic realities.

Anticipating hopes, fears and expectations towards COVID-19 vaccines: A qualitative interview study in seven European countries

Katharina Paul, Bettina Zimmermann, Paolo Corsico, Amelia Fiske, Susi Geiger, Stephanie Johnson, Janneke Kuiper, Elisa Lievevrouw, Luca Marelli, Barbara Prainsack, Wanda Spahl, IneVan Hoyweghen (2022)

Social Science and Medicine – Qualitative Research in Health

Abstract

Vaccine uptake is essential to managing the ongoing COVID-19 pandemic, and vaccine hesitancy is a persistent concern. At the same time, both decision-makers and the general population have high hopes for COVID-19 vaccination. Drawing from qualitative interview data collected in October 2020 as part of the pan-European SolPan study, this study explores early and anticipatory expectations, hopes and fears regarding COVID-19 vaccination across seven European countries. We find that stances towards COVID-19 vaccines were shaped by personal lived experiences, but participants also aligned personal and communal interests in their considerations. Trust, particularly in expert institutions, was an important prerequisite for vaccine acceptance, but participants also expressed doubts about the rapid vaccine development process. Our findings emphasise the need to move beyond the study of factors driving vaccine hesitancy, and instead to focus on how people personally perceive vaccination in their particular social and political context.

 

An analysis of the institutional landscape and proliferation of proposals for Global Vaccine Equity for COVID-19:Too Many Cooks or too many Recipes?

Geiger, Susi & McMahon, Aisling (2021)

Journal of Medical Ethics.

Abstract

This article outlines and compares current and proposed global institutional mechanisms to increase equitable access to COVID-19 vaccines, focusing on their institutional and operational complementarities and overlaps. It specifically considers the World Health Organisation’s (WHO) COVAX model as part of the ACT-A initiative, the WHO’s COVID-19 Technology Access Pool (C-TAP) initiative, the proposed TRIPS intellectual property waiver, and other proposed WHO and World Trade Organisation (WTO) technology transfer proposals. We argue that while various individual mechanisms each have their specific merits – and in some cases weaknesses – overall, many of these current and proposed mechanisms could be highly complementary if used together to deliver equitable global access to vaccines. Nonetheless, we also argue that there are risks posed by the proliferation of proposals in this context, including the potential to disperse stakeholder attention or to delay decisive action. Therefore, we argue that the relevant institutions and in particular the WHO and the WTO must be clearer in how various proposed mechanisms could interlink and work together to achieve global vaccine equity. Alongside this, there is now also a clear need for concerted global multilateral action to recognise the complementarities of specific individual models proposed and to provide a pathway for collaboration in attaining global equitable access to vaccines. The institutional infrastructure or proposals to achieve this amply exists at this point in time – but much greater co-operation from industry and clear, decisive and co-ordinated action from States and international organisations is urgently needed.

If it’s free, you are the product – The perils of assetizing consumers’ genetic profiles

Geiger, Susi & Gross, Nicole (2021)

Business & Society 

There’s an old adage that encapsulates our relationship to many of the digital products we consume, from social media to apps to email programs: “If it’s free, you’re not the customer, you’re the product”. But what happens in an industry where this ‘you’ really means – well, you? Your genetic profile and other health information about you? Information that you may never thought you’d share?

alexander popov eXoXJrOGqG4 unsplash 1 - Publications
Source: Alexander Popov

Our paper ‘A Tidal Wave’ explores the business models of consumer genomics companies, such as 23andMe or Ancestry, to find out how the consumer becomes the product in this industry, or as we phrase it, how these companies ‘assetize’ their genomic databases. There’s a lot of talk about data privacy in healthcare, which is great; after all, information about our health really is the most sensitive of all data. However, we think that one can only really understand how privacy can be safeguarded when we understand how companies profit from this data.

 

Markets and institutional fields: foundational concepts and a research agenda

Mountford, Nicola & Geiger, Susi (2021)

Springer

Abstract

We borrow the notion of field from institutional theory to think through how markets and their ‘outsides’–or at least one particular manifestation of an ‘outside’–stand in a dynamic and interactive relationship. We distinguish the field and the market in terms of issues versus exchange and identity versus position. We argue that the lack of clarity as to how fields and markets differ, relate, overlap, and are bounded, jeopardizes our ability to address important societal debates concerning the roles of markets within and across other areas of social life. It also hinders a consolidation of insights across different approaches to studying markets, even though researchers from different disciplines often address similar concerns. Key questions for which both conceptual and analytical clarity are essential include how markets and their ‘outsides’ (here: fields) intersect; whether and how diverse sets of actors interact, work, and migrate between fields and markets; and what dynamics may be observable between field and market. We provide four illustrative examples of field/market relationships and a theoretical, methodological, and empirical research agenda for future research into markets and their ‘outsides’.

Market mash ups: The process of combinatorial market innovation

Geiger, Susi & Kjellberg, Hans. (2020)

Journal of Business Research

Abstract

This paper investigates market innovation that takes place at the intersection of previously weakly connected markets. Based on a longitudinal study of the development of the digital therapeutics market, we delineate the concept of combinatorial market innovation as a market innovation process that is characterized by the deliberate synthesis of market subprocesses from two (or more) existing markets. We develop a conceptualization of combinatorial market innovation related to five market subprocesses (configuring exchange agents, qualifying offerings, fashioning modes of exchange, generating market representations, and establishing market norms). Focusing on how these processes interact, we identify three distinct types of intertwinement – sequential interrelationmutual reinforcement, and interference. We also reflect on the need for market innovation studies to more strongly consider overlaps and adjacencies between markets and market systems.

Duos and duels in field evolution: How governments and interorganizational networks relate

Mountford, Nicola., & Geiger, Susi. (2020)

Organization Studies41(4), 499-522

Abstract

We live in an era where models of governing are changing rapidly under multifaceted evolutionary pressures and where, at the same time, organizational fields are becoming increasingly networked. With this paper, we add to the field dynamics literature, focusing on the space where these evolutionary pressures coincide – the interactions of Governments and interorganizational networks. We examine the roles that interorganizational networks play in relation to Government actors under particular long- and short-term institutional and governance conditions. We articulate four roles that networks may play in relation to Government: advocate, technology, judge and ruler. We argue that long-term institutional logics, combined with short-term Government action in response to a particular field evolution, may predict the role that the interorganizational network will assume in relation to Government in that particular field scenario. We discuss flows through the typology as conditions change and we conclude by presenting an agenda for future research in the field dynamics and interorganizational networks research domains that leverages our proposed network role typology.

Silicon Valley, Disruption and the End of Uncertainty

Geiger, Susi. (2020)

Journal of Cultural Economy 13:2, 169-184,

Abstract

This paper reflects on the relationship between high-tech disruption narratives and uncertainty. My main argument is that an economic sociology of the future is incomplete without addressing the ‘demonic’ or rather eschatological elements apparent in the promissory twin rhetoric of disruption and inevitability that a number of contemporary technology firms employ. The conjuring up of liberatory high-tech futures implicates a political-philosophical perspective of the end game. It utilizes at once the productive power of uncertainty to create visions of ‘absolute riches’ and societal gain but at the same time narrows these futures down to one inevitable alternative to the status quo. Through the examples of two Silicon Valley disruptor firms, I argue that these eschatological narratives need to be opened to social scientific critique in order to examine their potential societal consequences above and beyond the narrow geographic confines of ‘the Valley.’

A tidal wave of inevitable data?
Assetization in the consumer genomics testing industry

Geiger, Susi – University College Dublin, 
Gross,Nicole – National College of Ireland
(2020)

Business & Society

Abstract

We bring together recent discussions on data capitalism and bio-capitalization by studying value flows in consumer genomics firms – an industry at the intersection between healthcare and technology realms. Consumer genomics companies market genomic testing services to consumers as a source of fun, altruism, belonging and knowledge. But by maintaining a multisided or platform business model, these firms also engage in digital capitalism, creating financial profit from data brokerage. This is a precarious balance to strike: If these companies’ business models consist of assetizing the pool of genomic data that they assemble, then part of their work has to revolve around obscuring to consumers any uncertainties that would potentially impinge on these processes of assembly. We reflect on the nature of these practices and the market relationships that enable them, and we relate this reflection to debates around alternative market arrangements that would potentially mitigate the extractive tendencies of these and other digital health firms.

Market Failures and Market Framings:  Can a Market be transformed from the inside?

Geiger, Susi and Gross, Nicole (2018):   
Organization Studies v39 (10) pp 1357 – 1376.

Abstract

How do actors innovate markets in cases of perceived market failures? This paper’s aim is to examine what happens when a market is innovated or, as we call it, ‘redevised’ in situations where public and commercial interests significantly diverge. Market devices can serve an important function in such attempts to innovate markets: they are material and/or social arrangements that are put into place to shape the market in question in certain ways. But can such devices really transform a market from within? To examine this question we trace the history of the Geneva Medicines Patent Pool, a civil society initiative introduced to change pharmaceutical firms’ licensing and collaboration practices in the market for HIV/AIDS medicines. Our empirical results indicate that redevising a market in response to market failures can shift the market’s frames and contribute to altering its practices, but that this is a pragmatic and often lengthy process that is never fully predictable in advance. By attending to the intended and unintended consequences – or misfires – of redevising a market, our study raises important questions around acting in and on the market, market innovation’s’ ontological impact, zooming in and zooming out when studying redevising, and attending to the temporality of market innovation.

Concerned Markets
Economic Ordering for Multiple Values

Edited by Susi Geiger, Associate Professor of Marketing, University CollegeScreenshot 2019 03 14 at 12.02.21 197x300 - Publications Dublin, Ireland, Debbie Harrison, Associate Professor, BI Norwegian Business School, Norway, Hans Kjellberg, Associate Professor, Stockholm School of Economics, Sweden and Alexandre Mallard, Director of the Centre de Sociologie de l’Innovation, Ecole des Mines ParisTech, France

When political, social, technological and economic interests, values, and perspectives interact, market order and performance become contentious issues of debate. Such ‘hot’ situations are becoming increasingly common and make for rich sites of research. With expert empirical contributions investigating the organization of such ‘concerned’ markets, this book is positioned at the centre of the rapidly growing area of interdisciplinary market studies. Markets investigated include those for palm oil, primary health care and functional foods. The authors also examine markets and environmental concerns as well as better market design for those at the bottom of the pyramid.

 

Dr Théo Bourgeron and Prof Susi Geiger

Building the weak hand of the state: tracing the market boundaries of high pharmaceutical prices in France

Théo Bourgeron and Susi Geiger (2022)

New Political Economy

Abstract:

Prices for new medications have strongly increased over the last decades, reaching levels that could endanger healthcare insurance systems. Focusing on the French case, this article builds on the structural approach of business power and investigates how this situation results from the construction of market boundaries that created unassailable spaces for high pricing. Starting from the 1990s, it traces how high drug prices relied on the construction of a market setting first designed to increase pharmaceutical prices, in which the negotiating position of the state was deliberately weakened. But the politics of maintaining such high drug pricing quickly required reshaping the boundaries of the pharmaceutical market and concentrating the favourable negotiation framework on a small number of innovative medicines. Most recently, the spiralling of prices for these medicines have necessitated yet another revisiting of these market boundaries. High drug prices do not result from direct business power by the pharmaceutical sector; rather, the pharmaceutical sector depends on boundary-work performed in cooperation with state institutions to carve out domains for favourable market pricing. Emphasising the politics of this boundary-work thus ultimately also signals its potential reversibility.

(De-)Assetising pharmaceutical patents: Patent contestations behind a blockbuster drug.

Théo Bourgeron and Susi Geiger (2021)

Economy & Society

Abstract:

Recent debates in public health and social sciences have shown how biofinancialization has been fuelled by patents’ transformation into ‘patent-as-assets’. This paper traces the historical construction of one such patent-as-asset bundle: the multi-billion worth architecture of patents behind the hepatitis C blockbuster drug sofosbuvir. Following this process from the late 1980s to present times, we highlight the ontological entanglements of pharmaceutical patents and the scientific, legal, commercial and political contestations that result from the focal firms’ assetization projects. By shining a light on these entanglements, our paper points to the extraordinary historical conditions required for the assetization of drug patents as well as to their vulnerability to contestations. In particular, we highlight new forms of patent activism that threaten the ‘asset condition’ of high-priced pharmaceuticals.

Dr Théo Bourgeron – Post Doctoral Research Fellow

‘Let the virus spread’.
A doctrine of pandemic management for the libertarian-authoritarian capital accumulation regime

Bourgeron, Théo (2021)

DOI 10.1177/1350508421995741

Abstract:

Debates have grown around the initial COVID-19 response of radical right-wing governments such as those of the UK, the US and Brazil. These governments initially let the virus spread among the population and delayed the enforcement of strong social distancing measures such as a lockdown. Focusing on the UK’s early response to COVID-19, this article builds on Nicos Poulantzas’ Marxist theory of the state to highlight how this pandemic management doctrine stemmed from changes in the UK’s capitalist class. It traces the ideological grounding of this doctrine, relating it to the rise of libertarian think tanks in British conservative circles and shifts in the policy committees in charge of pandemic preparedness. It suggests that this pandemic response is an episode of the ongoing replacement of the dominant neoliberal accumulation regime with a new libertarian-authoritarian one and examines how this latter materialises the interests of an emerging group of ‘disaster capitalists’. Therefore, it takes the COVID-19 crisis as an example of how the reconfiguration of capitalist accumulation regimes articulates a new doctrine of catastrophe management, radical right-wing ideologies, libertarian-authoritarian institutions and the growing power of capitalist actors able to profit from extreme events.

Constructing the Double Circulation of Capital & “Social Impact.”

An Ethnographic Study of a French Impact Investment Fund.

Bourgeron, Théo (2020)
Historical Social Research 45 (3): 117-139.
doi: 10.12759/hsr.45.2020.3.117-139.

Abstract:

»Die Konstruktion der doppelten Zirkulation von Kapital und ,sozialem Impact‘. Eine ethnographische Studie über einen französischen Impact- Investitionsfond«.

Elaborating on a three-month ethnography of an impact investing fund called Impact Equity, this article aims to understand the mechanisms at work in the emergence of the impact investing sector. After presenting the case of Impact Equity (section 1), the article details the norms and devices through which impact investing is constructed in everyday financial work (sections 2 and 3) and investigates how impact investors mobilise moral beliefs and strategic motivations to navigate competing definitions of “social impact” (section 4). In doing so, this article outlines how the construction of the sector has involved the creation of channels enabling capital and “social impact” to circulate between institutional investors, impact investment funds, and “impactful businesses,” and it highlights the historical tensions that this process has involved.


Dr Ilaria Galasso – Post Doctoral Research Fellow

The second pandemic: Examining structural inequality through reverberations of COVID-19 in Europe

Amelia Fiske, Ilaria Galasso, Johanna Eichinger, Stuart McLennan, Isabella Radhuber, Bettina Zimmermann, Barbara Prainsack (2022)

Social Science and Medicine

Abstract

While everyone has been impacted directly or indirectly by the COVID-19 pandemic and the measures to contain it, not everyone has been impacted in the same way and certainly not to the same degree. Media coverage in early 2020 emphasized the “unprecedented” nature of the pandemic, and some even predicted that the virus could be a global “equalizer.” Ensuing debates over how the pandemic should be handled have often hinged on oppositions between protecting health and healthcare systems versus saving livelihoods and the economy, a dichotomy that we argue is false. Drawing on 482 interviews conducted in Germany, Italy, Ireland, Austria, German-speaking Switzerland and the UK over two points in a 6-month period as part of the ‘Solidarity in times of Pandemics Research Consortium’ (SolPan), we illustrate the ways that oppositions posed between saving lives or saving livelihoods fail to capture the entangled, long-standing nature of structural inequalities that have been revealed through the pandemic. Health- and wealth-related inequalities intersect to produce the “second pandemic,” a term used by a research participant to explain the other forms of devastation that run in parallel with virus. Our findings thus complicate such dichotomies through a qualitative understanding of the pandemic as a lived experience. The pandemic emerges as a critical juncture which, in exacerbating these existing structural inequalities, also poses an opportunity to work to better resolve them.

Ongolly Fernandos – PhD Student

The social meanings of artefacts: Face masks in the COVID-19 pandemic

Franziska B. Schönweitz, Johanna Eichinger, Janneke M.L. Kuiper, Fernandos Ongolly, Wanda Spahl, Barbara Prainsack, Bettina M. Zimmermann

Frontiers in Public Health, section Public Health Policy

Abstract

Since the beginning of the COVID-19 pandemic, research has explored various aspects of face mask use. While most of the research explores their effectiveness to prevent the spread of the virus, a growing body of literature has found that using face masks also has social meaning. But what social meaning does it have, and how does this meaning express itself in people’s practice? Based on 413 qualitative interviews with residents in five European countries (Austria, Belgium, Germany, Ireland, and Switzerland), we found that the meanings of face masks have changed drastically during the first months of the pandemic. While in spring 2020 people wearing them had to fear stigmatization, in autumn of 2020 not wearing masks was more likely to be stigmatized. Throughout the first year of the pandemic, we found that mask wearing had multiple and partly seemingly contradictory meanings for people. They were perceived as obstacles for non-verbal communication, but also a way to affirm friendships and maintain social contacts. They also signaled specific moral or political stances on the side of face mask wearers and non-wearers alike, expressed their belonging to certain communities, or articulated concern. In sum, our findings show how face masks serve as scripts for people to navigate their lives during the COVID-19 pandemic. We conclude that public and political discussions concerning face masks should include not only evidence on the epidemiological and infectiological effects of face masks, but also on their social meanings and their social effects.

MISFIRES’ TEAM

Normative positions towards COVID-19 contact-tracing apps: findings from a large-scale qualitative study in nine European countries

Federica Lucivero, …Ilaria Galasso,Fernandos Ongolly, … Emma Stendahl & Ine Van Hoyweghen (2021)

Critical Public Health

Abstract

Mobile applications for digital contact tracing have been developed and introduced around the world in response to the COVID-19 pandemic. Proposed as a tool to support ‘traditional’ forms of contact-tracing carried out to monitor contagion, these apps have triggered an intense debate with respect to their legal and ethical permissibility, social desirability and general feasibility. Based on a large-scale study including qualitative data from 349 interviews conducted in nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, the Netherlands, German-speaking Switzerland, the United Kingdom), this paper shows that the binary framing often found in surveys and polls, which contrasts privacy concerns with the usefulness of these interventions for public health, does not capture the depth, breadth, and nuances of people’s positions towards COVID-19 contact-tracing apps. The paper provides a detailed account of how people arrive at certain normative positions by analysing the argumentative patterns, tropes and (moral) repertoires underpinning people’s perspectives on digital contact-tracing. Specifically, we identified a spectrum comprising five normative positions towards the use of COVID-19 contact-tracing apps: opposition, scepticism of feasibility, pondered deliberation, resignation, and support. We describe these stances and analyse the diversity of assumptions and values that underlie the normative orientations of our interviewees. We conclude by arguing that policy attempts to develop and implement these and other digital responses to the pandemic should move beyond the reiteration of binary framings, and instead cater to the variety of values, concerns and expectations that citizens voice in discussions about these types of public health interventions.

Ethical Reasoning During a Pandemic: Results of a Five Country European Study

S. B. Johnson….. E. Stendahl……& N. Hangel (2022)

AJOB Empirical Bioethics

Abstract

Introduction: There has been no work that identifies the hidden or implicit normative assumptions on which participants base their views during the COVID-19 pandemic, and their reasoning and how they reach moral or ethical judgements. Our analysis focused on participants’ moral values, ethical reasoning and normative positions around the transmission of SARS-CoV-2.Methods: We analyzed data from 177 semi-structured interviews across five European countries (Germany, Ireland, Italy, Switzerland and the United Kingdom) conducted in April 2020.Results: Findings are structured in four themes: ethical contention in the context of normative uncertainty; patterns of ethical deliberation when contemplating restrictions and measures to reduce viral transmission; moral judgements regarding “good” and “bad” people; using existing structures of meaning for moral reasoning and ethical judgement.Discussion: Moral tools are an integral part of people’s reaction to and experience of a pandemic. ‘Moral preparedness’ for the next phases of this pandemic and for future pandemics will require an understanding of the moral values and normative concepts citizens use in their own decision-making. Three important elements of this preparedness are: conceptual clarity over what responsibility or respect mean in practice; better understanding of collective mindsets and how to encourage them; and a situated, rather than universalist, approach to the development of normative standards.