Sandra Bärnreuther

This paper examines a digital platform used in the primary health sector in a state in Eastern India. Within a 'regime of tactility,' it is supposed to redefine the state's presence in rural areas, not only by attending to patients but also by screening the population and establishing health databases. While the health workers who operate the digital platform represent the state in 'the peripheries,' the state itself exhibits mistrust towards them and monitors their performance through the platform. Based on long-term ethnographic research, the manuscript analyses the use of digital health technologies as technologies of accountability. The competitive nature of monitoring techniques leads to an ever-higher number of digital consultations, which projects the image of a caring and efficient state. However, the paper also explores the unintended consequences of this politics by display on the provision of healthcare. Even though digital technologies and the managerial form of governance they engender promise to touch people's lives, they lead to intangible forms of care while leaving untouched pressing structural issues that India's health sector has been facing for decades.

Scholarly analyses of transactions of biological material are often focused on either the moral economy of exchange or the political economy of production. In this paper, I highlight the ambiguities that characterize commercial gamete donations in daily clinical life in In Vitro Fertilization (IVF) hospitals in Delhi through agents’ practices of valuation. In Delhi’s IVF economy, agents occupy a pivotal role in mediating gamete transactions: not only as traders of biological substances but also as brokers of values. Aligning various regimes of value, they let transactions appear as morally meaningful as well as economically profitable to donors. Agents also make use of polyvalences and frame transactions in distinct lights in negotiations with different participants. It is their mediations and practices of valuation, I argue, that make commercial gamete donations viable and sustain Delhi’s intimate IVF economy.