Molecular sovereignties: patients, genomes, and the enduring biocoloniality of intellectual property

Monoclonal antibodies are revolutionizing cancer treatments, but come at an increasingly problematic price for health services worldwide. This leads to pressing demands for access, as in the case of Kadcyla. In 2015, patients in the United Kingdom invoked the sovereign rights of the Crown in order to demand access to this expensive yet potentially life-saving medicine that had prior been de-listed due to price. This article interprets this campaign as an act of sovereign reassertion against a fundamental exclusion, which, however, ultimately fails to challenge the concrete mechanism enabling this exclusion—intellectual property (IP). By connecting this example to other declarations of molecular sovereignty, the article argues that the use of sovereignty can perpetuate further exclusion. Drawing on the notion of biocoloniality (Schwartz-Marín and Restrepo 2013) it points out that the intellectual property regime contains a deeply embedded fiction of the world as terra nullius, a blank uninhabited canvas ripe for discovery and appropriation. This decontextualised vision of life as property works to exclude populations and patients from playing a significant role in determining the use of technologies and treatments. Instead of countering this fundamental exclusion, the concept of sovereignty further entrenches this assumption and merely contests the assignation of this property.