Modern movements prove change is possible—biocapitalism sows the seeds of its own destruction—we illuminate cracks in the edifice key to the system’s crumbling

In one of the earliest uses of the portmanteau biocapital, Sarah Franklin (2003) described the emergence of “ethical biocapital.” Thinking in the context of reproductive technologies and the fraught terrain of stem cell research, Franklin described ethical biocapital as a commodity form, a type of innovation, and a market strategy in which “concerns about public opinion are literally being built into biological life forms” (2003:98). Since Franklin’s writing, theorizations of biocapital—succinctly defined as the shift toward the commodification and marketization of the life sciences since about 1980 (see Sunder Rajan 2006)—have proliferated in the social sciences (see Helmreich 2008). Theorists of biocapital call attention to the ways in which life itself is increasingly subject to the demands of profit-seeking enterprise. Franklin’s early contribution was to identify how the complex ethics and values surrounding the stuff of life are also subject to commodification. Widespread objections to certain ways of handling biological materials—for example, human embryos or seed crops (see Schurman and Kelso 2003)—had constituted cultural obstacles to biological commodification. The response, Franklin suggested, was to anticipate and incorporate ethics into the biotechnological materials themselves, such as by engineering ways around the use of embryonic stem cells. In this and other theorizations, the transition to biocapital appears as progressive, inevitable, and overdetermined (Sunder 31 Rajan 2006), capable of leveraging increasingly sophisticated biological control to transform would-be obstacles into new opportunities for accumulation. These obstacles could be ethical or cultural, as in Franklin’s example, or they could arise from the nature of biomaterials themselves (see Boyd, Prudham, and Schurman 2001). While biology was not inherently suited to commodification, an increasingly sophisticated array of engineering techniques capitalized on biology by reshaping biomatter itself. In one sense, Open Insulin fell in line with Franklin’s characterization of ethical biocapital: the Project’s members built ethics into bioengineering. In another important sense, however, Open Insulin was different. Rather than ethical concerns about playing god, Open Insulin members objected to capitalism itself, and especially to biocapitalism,8 positioning themselves as a movement of resistance to the commodification of a life-saving medication. They objected to what they described as an “oligopoly,” a “cartel,” or simply, “Big Pharma.” Their approach was not to anticipate and insulate themselves against consumer backlash. Rather, their bioengineering efforts were backlash made manifest as the materialized objections of an empowered biotechnological citizenry. Open Insulin was less “ethical biocapital” than 8 This is my reading of Open Insulin Project members’ politics, as they did not engage the social science literature on biocapital themselves. Most members of Open Insulin did, however, identify the Project as more broadly anticapitalist. This chapter tells the story, from the vantage of a participant-observer, of the conditions and possibility for the emergence of such a project. This account tends toward the hope and optimism that Open Insulin members, associates, and supporters held for their project and for the future of biotechnology and medicine. It does so in the service of understanding what a project like Open Insulin represents, why it emerged when and where it did, and whether the stage might be set for the emergence of similar efforts. The next few chapters will put this optimism to the test and examine what happened when the Open Insulin Project moved from concept to concrete practice. This trajectory roughly mirrors both the history of Open Insulin as it grew and developed and the course of a new member’s induction into the Project, like the one I went through as I first learned about the Open Insulin Project and began to regularly attend and participate in its meetings. Crucially, biocapitalism itself created the conditions of possibility for Open Insulin. These conditions were characterized by several different developments at the intersections of biology and capital, especially as they converged in areas of biotechnological concentration like the San Francisco Bay Area. These convergent developments included: the development of a biotechnological industry characterized by hope and promise, speculative investment, volatility, and a focus on intellectual property (Thompson 2005; 33 Sunder Rajan 2006; Fortun 2008; Birch 2017); the emergence of synthetic biology at the nexus of biology, engineering, and informatics (Roosth 2017); and the selective empowerment of patient-consumers within the stratified patchwork systems of 21st-century biomedicine (Clarke et al. 2010; Rose 2007). These developments interacted with one another, and they were evident in the story of the Project as well as in the stories of the individual volunteers that it comprised. Because Open Insulin was the product of the same conditions that produced the very expensive and inaccessible medicines it opposed, I characterize the Project as the product of an internal contradiction of biocapitalism. Marx identified the most fundamental contradiction of capitalism as its tendency to generate crises of overproduction: periods in which depressed wages and increased production capacities become incompatible, failing to generate a consumer base capable of sustaining profitability (1990 [1894]; Marx and Engels 2002 [1848]). In short, capitalism renders labor ever more productive while simultaneously deepening the exploitation of those who perform it. According to Marx, the effects of crises of overproduction, though usually managed by expansion in search of new markets, eventually threaten capitalism itself as they grow in severity and expose the contradiction at the heart of capital accumulation. Scholars working in the Marxian tradition have identified many more contradictions of capital, including the cultural (Bell 1972), the ecological (O’Connor 1988; 34 Foster 2000), the financial, and the geographical (Harvey 1982), complicating the relationship between capitalism’s forces, relations, and conditions of production. Notably, David Harvey (2014) argues not only that capital is rife with contradictions, but that these contradictions are central to the reproduction of capital. These contradictions rarely resolve but are instead reconfigured and moved around as capital reinvents itself. The state of affairs that produced the Open Insulin Project revealed a contradiction in biocapital: insulin was produced in new, more user-friendly, and more profitable forms, while at the same time, the cost to patients continued to increase steadily, resulting in approximately half of those who needed insulin lacking reliable access (Gotham, Barber, and Hill 2018; Biniek and Johnson 2019). Amid growing upset about the unaffordability of healthcare, insulin, a nearly hundred-year-old essential medicine, served as a powerful synecdoche. In the United States, this upset drove support for socialized medicine, calls for accountability from public representatives, and demonstrations against the pharmaceutical companies that many members of the concerned public—as well as members of Open Insulin—held accountable (Sable-Smith 2018; WBUR 2019; Caffrey 2019; Rowland 2019). Among some biotechnologically inclined residents of the Bay Area with access to the region’s excess biotechnological resources, it drove efforts to put these means of production to work and actually make medicine. These efforts addressed 35 the insulin affordability crisis by challenging the entanglement of biology and capital. Biology, Capital, Medicine As a self-identified radical, anticapitalist project, Open Insulin serves as a counterexample to the ways in which biology is increasingly “enterprisedup” (Strathern 1992) and converted into forms of capital. As an empirical case, it helps demonstrate that biology and its values are neither fully subsumed by capital, nor are developments in the biosciences readily explained by economic developments independent of the biosciences. Rather, Open Insulin both emerges as a response to the entanglement of the biological, the medical, and the commercial and is uniquely empowered by the features of this entanglement. Scholars of science and technology studies studying diverse areas of biology—including molecular biology and genomics, plant and animal breeding, assisted reproduction technologies, tissue engineering, regenerative medicine, and pharmaceuticals—have identified a shift since roughly 1980 toward the mutual entanglement of biology and capital. Sunder Rajan (2006) explains this transition as the dawn of the biocapital era. For Sunder Rajan the transition is neither total nor complete, but rather piecemeal and tendential: “the relationship between ‘capitalism’ (itself not a unitary category) and… biocapital is one where the latter is, simultaneously, a 36 continuation of, an evolution of, a subset of, and form distinct from, the former. Further, biocapital itself takes shape in incongruent fashion across the multiple sites of its global emergence” (2006:10). Sunder Rajan (2006) ethnographically explores this emergence in the contexts of American and Indian pharmaceutical development. He leaves us with the sense that biotechnology does indeed represent a new phase of capitalism. This phase varies across contexts, including the contexts Sunder Rajan explicates, but he nonetheless identifies trends. Many of these trends stem from changes in the American life sciences that have subsequently become models for emerging life sciences industries like India’s. In the American context, policy changes at the dawn of the 1980s—most notably, the Supreme Court Case Diamond v. Chakrabarty and the Bayh-Dole Act— subjected biological life and matter to intellectual property protections and rendered the boundary between academic and industrial life sciences progressively porous. As a result, the life sciences have increasingly adopted a speculative, future-oriented grammar, focused on hope, hype, and salvation. Biocapital does not merely describe the influence of capital on the biosciences and biotechnology; it also describes the ways in which contemporary capital is increasingly biological and biopolitical (Sunder Rajan 2006). In other words, our ways of thinking about value are also increasingly informed by our ways of thinking about life. While in some ways Sunder Rajan takes pains to illustrate the symmetry of this mutual transformation of 37 biology and capital, he does argue that “the life sciences are overdetermined by the capitalist political economic structures in which they emerge” (2006:6). He makes the case that political-economic formations, while they may not determine the course of the life sciences in any straightforward sense, nonetheless “disproportionately set the stage” (2006:6) for their developments. Other scholars who have explored dimensions of the phenomenon that Sunder Rajan calls biocapital have identified similar features. Stefan Helmreich (2008) taxonomized the work in this area when he catalogued the “species of biocapital.” The theories in this vein call attention to how biology, biotechnology, and biomedicine increasingly subject life itself at the molecular level to the speculation and financialization; collectivized risk and individualized risk management; flexibility and de-standardization; and commercialization in pursuit of added surplus value. Melinda Cooper argues that these processes have brought biology, and specifically biotechnology, into line with the advance of neoliberal capitalism: “the biotech revolution… is the result of a whole series of legislative and regulatory measures designed to relocate economic production at the genetic, microbial, and cellular level, so that life becomes, literally, annexed within capitalist processes of accumulation” (2011:19). 38 By arguing both that biology has been capitalized and that capital has been biologized—even if, as Sunder Rajan (2006) argues, the former overdetermines the latter in the last instance—theorists of biocapital emphasize biology’s unique features. Those who apply a “Marxist-feminist” lens (Helmreich 2008), place special emphasis on biological materiality, specifically biomatter’s generative and reproductive capacities. Reproduction—as opposed to production—has historically been taken for granted within capitalist economies, but the development of new forms of control over these capacities (see Franklin 2007; Landecker 2007) has helped to generate surplus value from them. The separation between production and reproduction breaks down under biocapitalism, and “life itself” becomes the objective (Rose 2007; Cooper and Waldby 2014). And a powerful objective it is; in medicine, a focus on the pursuit and optimization of health has enabled the growth of massive technoscientific industries of surveillance and intervention (Clarke et al. 2010). In these industries, patients become active consumers of technoscientific information and products, empowered agents in their ongoing pursuits of the horizon of healthfulness. The power of “life itself” and the economies of hope that they inspire further speak to the unique cultural power of the biosciences, which profoundly shape what it means to live and die in the 21st century. In contrast to these suggestions of biology’s distinctiveness, Kean Birch (Birch and Tyfield 2013; Birch 2017a, 2017b) notably criticizes the concept of 39 biocapital and, even more widely, the tendency in science and technology studies to append “bio-” onto existing theoretical concepts. Birch and Tyfield characterize this tendency as a “fetishization of everything ‘bio’” (2013:299). Birch’s most significant concerns with the proliferation of bio-concepts stem from the biological overshadowing and overwhelming the concepts to which it becomes attached (2017b). Birch and Tyfield fear that in the process, a tendency to attribute too much power to biological matter and technoscience displaces sophisticated analytical work, sacrificing attention to how economic and financial processes of modern capitalism are changing independently (2013). A key example of the latter is the shift Birch observes toward assetization and rent-seeking in the life sciences, as opposed to the Marx-influenced analyses of the commodity form that tend to dominate the STS biocapital literature. For Birch, the end result is analyses that are unable to grasp the complex, evolving relationships between biology, economies, knowledges, and societies (2017b). Against these tendencies, Birch argues for the need to examine the practices, political-economic actors, and knowledges involved in the creation and management of value in bio-economies.10 The Open Insulin Project could not exist if not for the developments characterized in the biocapital literature, developments it relies on for knowledge, resources, and intelligibility. While my analysis of the Open Insulin Project draws heavily on the existing biocapital literature, I aim to 10 Birch and Tyfield (2013) do refer to the bioeconomy, acknowledging that in so doing, they fall into the same “bio-everything” trap. 40 avoid Sunder Rajan’s, Cooper’s, and Marx’s (over)deterministic interpretations and to find, through the example of Open Insulin, more room for alternative formations. Employing ethnography and empiricism as advocated by both Sunder Rajan and Birch, I strive to stay grounded among the actors and practices that produce the value of the Open Insulin Project, looking at how they craft and characterize their approach. This approach emerges specifically from the bioengineering and biomedical landscapes of the Bay Area, enabled by a persistent desire for increasing control over biomatter and from strong ethical objections to the capitalization of health and medicine in particular. My study of Open Insulin suggests that if the entanglement of biology, biotechnology, and capital is indeed an overdetermination of the life sciences by capitalist political economy (Sunder Rajan 2006) or their annexation within capitalist forms of accumulation (Cooper 2011), it is incomplete, contestable, and perhaps, extricable. Making Open Insulin The Open Insulin Project is a volunteer team comprising—among others—self-proclaimed “biohackers” and “mad scientists”; community activists; computer hardware and software engineers; students, retirees, PhDs, and professionals; and the gainfully, self-, un-, and under-employed. These folks took different paths to get involved with the project, but there are some clear running themes among its founders and most consistent members. These themes reflect the conditions that make the Project possible, providing the materials, the labor, and the will that Open Insulin needs to operate; they also carry within them some of the tensions that made Open Insulin challenging. Members were generally well educated, often in computer and information sciences, indicative of the way biology is increasingly tied not only to engineering, but to computer engineering specifically. This has allowed open-source and hacker activists to identify biotechnological interventions. Several of the Project’s volunteer members were between jobs or splitting their time between Open Insulin and other commitments in the Bay Area’s tech-oriented economy. These members felt qualified and compelled to intervene in healthcare economies by becoming producers of biomedicine, and they did so as a vehicle for their moral objections to the capitalization of healthcare. These individual stories of involvement—“community bios”—are woven into the history of the Project itself, from its foundation to approximately four years into its existence. This “community bio” illustrates how Open Insulin was conceived, how its home, Counter Culture Labs, was built in the shadow of Bay Area’s biotech industry. It also illustrates how the Project drew on synthetic biology and its particular fusion of biology and engineering. Finally, it demonstrates how Open Insulin engaged the existing biomedical system using a calculated strategy of circumvention based largely on precedents in software. While this strategy provided an empowering sort of roadmap for the 42 Project, it also implicitly accepted many of the features of biocapitalist order (see Chapter 2). Overall, the collective story of the Project further demonstrates how biocapital underwrote Open Insulin’s antibiocapitalism. This “community bio” shows how Open Insulin developed from its inception and the factors that enabled its progress while also gesturing toward some of the difficulties and hurdles it encountered along the way.