Governing Life Through Attrition: Biopolitics, Structural Violence, and Health in Rural India

This paper examines biopolitics as an embodied and unevenly lived condition, drawing on ethnographic research on health, illness, and care among rural and tribal communities in Jharkhand, India. Building on Foucauldian insights into the governance of life, the paper argues that biopolitical power in postcolonial health systems operates not primarily through optimisation or enhancement of life, but through differentiated neglect, exposure, and managed precarity. Health governance emerges here as a key site where life is stratified, rendered governable, and selectively sustained. Empirically, the paper is based on long-term fieldwork using ethnographic methods and Participatory Rural Appraisal (PRA), documenting how bodies become the interface through which state rationalities, market logics, and institutional absences are experienced. Public health programmes, insurance schemes, and primary care infrastructures frame populations as administrable targets, yet their uneven implementation produces zones of abandonment where illness is normalised and suffering rendered politically unremarkable. In this sense, the paper advances a reading of biopolitics attentive to what is left undone missed diagnoses, delayed care, bureaucratic deferrals, and forced mobility in search of treatment. Conceptually, the paper brings biopolitical theory into dialogue with the concepts of structural violence and postcolonial political economy. While classical biopolitics emphasises the productive management of life, the Jharkhand case illustrates how governance also works through attrition: by allowing life to deteriorate within acceptable thresholds. This mode of power is neither purely sovereign nor disciplinary, but operates through dispersed institutions, policy silences, and fiscal rationalities that quietly decide which lives are worth sustaining. Such an analysis complicates the distinction between neoliberal and illiberal biopolitics by demonstrating how market-oriented reforms and welfare commitments coexist, resulting in hybrid regimes of care and control. The paper aligns most closely with the panel Nature, Science, and Health, while also contributing to debates on Neoliberal and Illiberal Biopolitics. It demonstrates how health policies translate scientific categories such as risk, vulnerability, population, and coverage into administrative practices that reshape relations between citizens, bodies, and the state. At the same time, it foregrounds subaltern experiences that challenge abstract accounts of biopolitical rationality, revealing how people interpret, endure, and sometimes contest being governed as biological subjects. By grounding biopolitical theory in ethnographic evidence from rural Jharkhand, the paper extends the biopolitical canon beyond Eurocentric settings and policy-centric analyses. It argues for a conception of biopolitics that takes seriously the politics of slow harm, everyday suffering, and the moral economies through which life is differentially valued, governed, and allowed to persist.