Health in the circuit of capital: Vaccine economies and the geographies of accumulation

Abstract

This article develops the concept of the circuit of health capital to analyze India's COVID-19 vaccine crisis, foregrounding the structural dynamics of capital accumulation over event-driven or geopolitical explanations. Drawing on Marx's theory of the circuit of capital, it examines how financialization, intellectual property regimes, institutional procurement arrangements, and segmented production networks collectively structured the flow and obstruction of vaccines during the pandemic. Using the Serum Institute of India as a central case, the article demonstrates how scarcity was not an aberration or failure of distribution, but a systemic outcome of circuits designed to prioritize surplus realization over public health needs. By conceptualizing health commodities as moving through interlinked financial, productive, and commercial nodes, the circuit framework offers a materialist lens for understanding contemporary global health governance and its inequalities. The paper proposes this model as a foundation for future research and political critique beyond state-centric or purely epidemiological accounts, as well as accounts based on national sovereignty.