Professional Guinea Pigs and Big Pharma: An Interview with Roberto Abadie

Posted on by Corporations and Health Watch

Roberto Abadie is an anthropologist who has studied the experiences of people who get paid by pharmaceutical companies to take drugs in clinical trials. For the past two years, he has been a visiting scholar at the public health program at the Graduate Center of the City University of New York. His book, The Professional Guinea Pig: Big Pharma and the Risky World of Human Subjects, was published by Duke University Press last year. Monica Gagnon interviewed Abadie by email for CHW. An edited transcript follows.

CHW: What inspired you to launch an investigation into the ethics of clinical trials?

RA: In 2001, Ellen Roche, an employee at Johns Hopkins University, volunteered in a clinical trial for asthma. She suffered an adverse event (as adverse drug reactions are usually referred to) fell into a coma, and died at a local hospital a month later. She had received a few hundred dollars for her participation in the trial that resulted in her death. I realized then that while bioethicists have been debating the ethics of paying volunteers participating in the first phase of clinical trials where drug safety is assessed, no empirical studies documenting the volunteers’ experiences and motivations to volunteer had been conducted. I was especially concerned about those volunteers who earn a living by selling their bodies to test drug safety. Some professional guinea pigs (as they refer to themselves) I met have done 80 or more trials in the course of a few years. I wanted to know how much they knew about the risks they face as trial subjects but also how the prospect of monetary compensation affects their perception and disposition to volunteer.

CHW: What challenges did you face during your research into Big Pharma? Did they attempt to shield their practices (or their human trial subjects) from you?

RA: Big Pharma is not a very open industry and they try very hard to shield information about their practices. Of course, they won’t say they don’t want the public to know. Their argument is that everything related to the drug production process is proprietary information. By being secretive they are protecting their products and their shareholders. It was very hard for me to gain access to the industry side. I wanted to ask them questions about how they deal with the issue of risk during the first phase of clinical trials and what they do to ensure that research subjects are adequately protected. Unfortunately, I didn’t manage to reach them. One of the public sources of information about Big Pharma’s practices regarding Phase I trials, or any aspect of drug development for that matter, are the lawsuits that are brought against them. For example, the Vioxx case went to court and its records provided a great deal of information about how the industry thinks about risks, public health and profits. Unfortunately, few cases go to court; most are settled out of court, leaving valuable information hidden from the public view. Professional healthy research subjects I met with feared retaliation from the industry if exposed, but anonymity protected them well.

CHW: How do the participants in the trials you studied now think about the pharmaceutical industry?

RA: I studied a very particular subgroup of the ample universe of subjects that earn a living as professional guinea pigs in America. I focused on a group of white, male anarchists living in Philadelphia, a hotbed of clinical trials activity. While all professional research subjects share similar interests (make money from participating in the trials) and experiences of dehumanization and alienation, this group of anarchist guinea pigs has particular strong views against Big Pharma and also, not surprisingly, about the role of the government and the FDA (the agency in charge of overseeing the drug production process). These volunteers feel that the industry lies, not only because they enroll volunteers when they know they don’t meet all their admission criteria, but more importantly, they lie to the consumers by producing drugs that are not safe and effective, as the industry claims.

But despite their hostility towards the industry, they feel the trials they participate in are in general only moderately risky. First, they reason, they are scientific, controlled experiments where there is a lot of oversight. Second, adverse events are very rare in their experience and most of them had not experienced them. And finally, they believe that ethical regulations and the fear of lawsuits are enough to deter the industry from bad practices.

CHW: How are the health risks of clinical trials underplayed by Big Pharma?

RA: I think that the most important risk overlooked by the industry is the risk derived from the fact that trials depend on a group of professional guinea pigs, paid to test drug safety. These subjects consider their trial participation to be their job, a particular kind of trade where boredom, pain and dehumanization are exchanged for money. They do seven or eight trials a year, deriving a total estimated income of $20,000 in a good year. The problem is that the industry does not have a registry that tracks trial participation and might not be aware of the extent of the professionalization.

My concern is that continuous participation in the trial economy might expose trial subjects to unknown or unforeseen risks, some of which might show up 20, 30 or even more years later. The industry is under a lot of pressure to recruit and retain trial subjects and has no incentive to create a registry or implement any measure that would limit their ability to recruit trial subjects for the first phase of clinical trials.

CHW: What are the economic forces that drive pharmaceutical companies to use risky test strategies?

RA: In particular, considering Phase I clinical trials where drugs are assessed for toxicity and not therapeutic benefit, Big Pharma depends on a group of professional subjects to run the trials smoothly. Until the 1970s, drugs were first tested on prisoners. Willing, compliant and readily available, they represented the perfect captive research subject. But ethical concerns brought the practice to a halt. The industry had to find a replacement population for an increasing number of trials and started paying prospective subjects. Some started volunteering and become dependent on the income and habituated to the trial routines.

Market recruitment of trial subjects created a new economic category: the professional guinea pig. It works well for poor, vulnerable research subjects because it provides a flexible schedule with reasonable pay, and it is great for the industry because it offers a steady supply of bodies to test drug safety quickly and effectively. The underside is that this professionalization might expose these workers to occupational risks, something that other workers in mining or agriculture have also experienced and where risks are better documented.

CHW: To what extent has the FDA addressed these problems?  What has limited their effectiveness as a regulator of testing practices?

RA: The FDA only audits one percent of Phase I trials in America. And it is a paper trail kind of process, looking for protocol inconsistencies and especially missing cases where subjects unexpectedly are dropped from the research protocol. Of course they also pay attention to the reporting of adverse events. But this monitoring has severe limitations. First, they review a very small number of trials. Second, they never do on site inspections, ­going to the trial sites, looking at the working conditions, talking to research subjects, etc. Part of the explanation for this lack of enforcement is that the FDA does not have enough resources and manpower to do this kind of job.

But the main cause is that the FDA increasingly, since the 1980s, has taken the view that what is good for the pharmaceutical industry is good for the public and that speeding the drug development process would be a good thing because first, it would bring valuable drugs to consumers, but also would help American companies compete better in a global pharmaceutical landscape.

CHW: What is the crux of the relationship between risk and monetary compensation? Do you find that volunteers typically fully understand the risks of participating in these clinical trials?

RA: The research subjects I studied are well informed about risks but this does not mean that they make good decisions about whether they should enter a trial or not. For example, they know that psychotropic drug trials are risky and they try not to volunteer for them. But this is one of the fastest growing sectors in drug development and a big producer of blockbuster drugs for the industry. Big Pharma needs to test the safety of these drugs, and knows that subjects are reluctant to mess up their mind, as they have told me, taking them. What would the industry do then? Simple, they just offer the highest pay, from $5,000 to $10,000 for a few weeks as a trial subject. Most subjects I interviewed admitted that they thought these trials presented a high risk but were tempted by the money and had done at least one.

CHW: Do professional guinea pigs often rely on money from test trials as their primary income? If so, why is this particularly problematic?

RA: They do. For most of them, trials are their main, and in many cases only, source of income. They can earn around $20,000 a year and sometimes even more. I find this practice extremely problematic because Big Pharma uses money strategically to recruit and retain research subjects who otherwise would have no interest in participating in the trial economy.  Research subjects are vulnerable because they depend on the income generated from the trial and that leads them to accept poor working conditions or risks they would not accept otherwise. Of course, the industry knows this and that’s why they use money to lure people and to keep them participating.

CHW: In what ways are the rights of human test subjects protected (or not)?

RA: Ethical regulations regarding the participation of human subjects in research have evolved a great deal since the horrors of the WWII. We have now a number of regulations that protect subjects like the requirement of informed consent before a subject enrolls in a trial. And civil law also affords protections against any wrongdoing or harm that occurs during the trial. Still, the consent form requirement is seen by professional guinea pigs as a formality, a paper to be signed among others in order to enter the trial. In most cases they make their decision about entering a trial before they get to sign the consent form. And legal recourse is expensive and might be out of reach for most subjects, unless they die or experience devastating adverse events, in which case the prospects of financial gain can lead skilled lawyers to volunteer in the case

CHW: Have you come across any particularly unique stories of people who have had negative (or positive) health effects from these trials? Please describe.

Roberto Abadie

RA: There are no positive health effects from healthy research subjects testing drug safety in the first phase of drug development. These tests are designed to assess the toxicity of a drug, not its efficacy and thus no health benefits are expected. Negative health effects or adverse events are rare. While most of the subjects I encountered had experienced some discomfort, fainting, nausea or other symptoms, they had not faced serious adverse events. In 2006, a trial sponsored by Parexel in England left research subjects with very serious injuries and opened a public debate about the professionalization of Phase I trial research in Europe and the need to create a centralized registry to track participants involvement in this trial economy.

CHW: How do you suggest that Big Pharma change its practices and policies regarding human subjects?

RA: Since there is no centralized record tracking the participation of research subjects in Phase I trials in America, nobody knows for example if a subject is doing two trials at the same time, or if a subject is not complying with the mandatory 30-day wash-out period in between trials. As I mentioned in the previous question, such a registry was recently implemented in Europe when it was found that trial subjects in drug safety trials were trial hopping, doing for example a trial in Ireland, then another one in England, one immediately after in Germany and a subsequent one in France. A centralized registry would prevent this from happening in the US as well. Such control would slow the recruitment rate of research subjects, delaying the completion of Phase I trials, and that’s why Big Pharma has been opposed to its implementation.

CHW: What are the broader public health implications of this practice of the pharmaceutical industry, and what can be done about it?

RA: The lack of a centralized registry tracking the participation of professional research subjects in Phase I trials endangers the research subjects because it exposes them to dangerous drug interactions. But it also challenges the validity of the trial itself because its findings become compromised if researchers cannot tell with certainty that their results are not contaminated by a different drug that is being surreptitiously taken by the research subject, enrolled simultaneously in two different trials. This is a very serious development because it compromises the quality and efficacy of drugs millions of people depend on for their health care.

The lack of a centralized registry, but also of adequate FDA control regarding the first phase of clinical trials speeds up drug production and contributes to making Big Pharma one of the most profitable industries in America. But increasingly we find new evidence that the pharmaceutical industry’s continuous search for profits and public health interests are not on the same page. We need to step up the oversight on this industry, from government, of course, but also from citizens and consumer groups. In particular, journalistic exposes have contributed to documenting outrageous cases of abuse and exploitation of research subjects in Phase I trials, like the case of undocumented Latino immigrants being recruited in a facility in Florida a few years ago, or poor, African-American homeless men with alcohol and drug related issues recruited at a site in the Midwest. Such cases, when exposed through the press, generate a public relations nightmare for these companies. When they are touched in their pocket books, these companies have shown they can do the right thing.

Image Credits:

1.     Duke University Press

2.     epSos.de via Flickr

3.     AuntieP via Flickr

4.     Roberto Abadie

5.     MedIndia

Advertisers, Tobacco Industry and Convenience Stores Charge New Cigarette Warning Labels Infringe on Free Speech

Posted on by Corporations and Health Watch

In response to the new warning labels on cigarette packs proposed last week by the US Food and Drug Administration, Dan Jaffe, the Association of National Advertisers’ exec VP for government relations, told Ad Age that the ANA thinks the proposal is unconstitutional because “the government on its own … can’t put words in the mouths of advertisers.” The second, third and fourth largest tobacco companies in the United States, Reynolds American Inc, Lorillard Inc. and Commonwealth Brands are part of a federal lawsuit that challenges the legality of the new labels. Also joining the opposition is the National Association of Convenience Stores, a group representing an industry that interacts with 160 million Americans a day. “You’re going to run into people that will not necessarily like this,” said Jeff Lenard, an NACS spokesman. “When somebody’s hungry, they get something to eat. When somebody’s thirsty, they get something to drink, and we just want to make sure that when they go in, they still want to get that.”

Jack in the Box Pulls Toys from its Kids’ Meals

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Jack in the Box has eliminated toys from children’s meals, winning the approval of consumer advocates who claim fast food corporations use the toys to attract kids to unhealthy meals. “We hope that McDonald’s, Burger King, Wendy’s, and Taco Bell are paying attention to Jack in the Box, which has decided to stop using toys to market fast-food meals to children,” the Center for Science in the Public Interest said in a statement. “It’s too bad that McDonald’s, Burger King, Wendy’s, and Taco Bell think they can’t compete on the basis of quality, value, taste, or nutrition, but instead must resort to such a discredited marketing tactic to lure families to their businesses.” However, Ad Age notes that Jack in the Box rarely markets to kids and is a fraction of the size of McDonald’s.

Will the UN High Level Meeting on Non-Communicable Diseases Stand up to Multinational Corporations?

Posted on by Corporations and Health Watch

Note: This post is a longer version of a correspondence that appeared in Lancet on August 13, 2011.

Alarmed that non-communicable diseases (NCDs), the world’s number one killer, now pose a growing threat to economic development, this September the United Nations General Assembly will convene its first High Level Meeting on NCDs in New York City. World leaders and public health officials will consider how to reduce the growing threat that cardiovascular disease, cancer, chronic respiratory disease and diabetes pose to population health, economic development and health care systems.

Non-Communicable Disease Alliance Briefing Paper for UN Meeting on NCDs

These conditions cause an estimated 35 million deaths annually; 80% occur in low and middle income countries and one quarter among people younger than 60 years of age. By 2030, NCDs will cause more than three quarters of all deaths in the world.

In preparation for the UN meeting, groups as varied as the NCD Alliance, a coalition of four global voluntary health organizations, the Commonwealth Heads of Government and theMillennium Development Goal Summithave proposed important but uncontroversial actions such as improving surveillance for NCDs, integrating NCD prevention and control into national health systems, making NCD prevention an economic development issue, and allocating more international assistance for NCDs.

The NCD Alliance has also recommended more controversial steps such as ratification and full and universal implementation of the WHO’s Framework Convention on Tobacco Control and the elimination of “all forms of marketing, particularly those aimed at children, for foods high in saturated fats, trans-fats, salt and refined sugars.” The most pressing question facing the UN meeting is whether participants will be willing to tackle the corporate practices of the tobacco, food, alcohol, automobile and pharmaceutical industries that have so significantly contributed to the global spread of NCDs.

 

How Corporations Promote the Spread of NCDs

A growing body of evidence demonstrates that how corporations create, market, retail and price their products has contributed to increases in NCDs. For example, food and beverage makers market products high in fat, sugar, salt and calories; increase portion size; target children with ads and video games promoting unhealthy food; lobby for policies that make unhealthy foods cheaper than healthier ones and export their least healthy products such as sugar-sweetened beverages, fast food, cereals and snack foods to low and middle income countries. The result has been rising rates of diet-related NCDs.

The alcohol industry advertises aggressively to young and problem drinkers, contributing to liver diseases as well as injuries and violence. The industry uses its political clout to stop excise taxes that would discourage youth and problem drinking and sponsors ineffective “responsible drinking” campaigns that compete with under-funded effective approaches and emphasize individual rather than social responsibility for discouraging problem drinking. The automobile industry produces cars that fail to use available pollution control technology, opposes stricter standards for pollution control, and resists policies that favor cleaner public transportation. Increasing evidence links auto pollution with chronic respiratory disease, heart diseases and cancer.

Tobacco is predicted to contribute to one billion premature deaths in this century. The tobacco industry manipulates nicotine levels to make cigarettes more addictive and promotes its products, especially to women and young people in developing countries, their emerging markets. By increasing the rate of women’s smoking through targeted advertising, the tobacco industry has helped to shrink the longevity benefit that women have long enjoyed over men, a perverse way of reducing inequities.

Finally, while the pharmaceutical industry has developed drugs that have helped to control NCDs, it also promotes inadequately tested or dangerous drugs to treat NCDs and invests in developing minor variations of patented drugs that are profitable rather than in cheaper, safer and more effective alternatives.

While NCDs have multiple causes, a growing body of evidence shows that their burden on global health are inextricably linked to the practices of a small number of global companies in industries that are becoming increasingly concentrated. Ten multinational food companies account for 80% of the global food and beverage advertising. The three largest tobacco companies sell close to two-thirds of the world’s cigarettes and a few companies produce most of alcohol the world drinks. Thus, altering the practices and policies of a few dozen corporations could substantially improve the prospects for preventing and managing NCDs but this requires political leaders to demand changes in some of the world’s most powerful corporations.

 

Making Corporations Accountable

To date, the business world has been remarkably successful in avoiding responsibility for its role in NCDs. It does this by exploiting or manufacturing several myths about chronic disease. First, many people see NCDs as the inevitable consequence of economic development and population aging, the collateral damage of progress. But many people now develop NCDs in early and mid-adult years, so their rapid growth is not simply a function of aging populations. China, Egypt, Jamaica and Sri Lanka have NCD mortality profiles similar to the US and other developed nations, contradicting the view that NCDs are the unique curse of better off countries. Business benefits from portraying NCDs as the unavoidable corollary of aging and development because this view spares closer scrutiny of the role of corporate practices.

Second, conventional wisdom posits lifestyle as the primary cause of NCDs: if only people ate better, moved more, smoked less and consumed less alcohol, the world could prevent many deaths and lower the costs imposed by NCDs. As a result, NCD prevention focuses on programs designed to change health-related behavior, often one person at a time. Of course individuals’ health behavior contributes to NCDs. However, no evidence demonstrates that the world’s population has recently become more gluttonous or susceptible to addiction. What has changed is the behavior of the organizations that shape the environments in which people make health decisions. Global expenditures for advertising increased from $50 billion in 1950 to $570 billion in 2005. In the last few years the number of corporate lobbyists working in the capitals of the United States, the United Kingdom, the European Union and wherever international trade negotiations occur has skyrocketed, giving business a disproportionate voice in the policy decisions that shape health and lifestyle.

Corporations and their political supporters insist that business has an important role in shaping NCD policies and promote a third myth that voluntary corporate codes are the most effective tool for changing their health-damaging practices. Last summer, UK Health Secretary Andrew Lansley invited Mars, Cadbury and Coca Cola to play greater roles in the national anti-obesity initiative and the development of new food regulations. Corporate health leaders at Pepsi Cola and other companies have called for more private-public partnerships to address NCDs. However, their claim that voluntary agreements for corporate social responsibility suffice to protect public health is not supported by independent assessments of such codes in the food, alcohol and tobacco industries.

Calls for public sector collaboration with businesses fail to acknowledge that many companies profit from promoting NCDs. Corporate managers are legally required to maximize profits and too often depend on business models that exploit biological vulnerabilities (e.g., a craving for high fat, sugar and salt diets), addictions, or social insecurities. Some companies may temporarily benefit from selling healthier food or promoting more responsible drinking but in the long run increasing consumption and market share usually require promoting disease rather than health.

In the final analysis, if the UN meeting is to make progress in stopping the rise in NCDs, participants  will need to find the backbone to stand up to corporate propaganda and lobbyists.  Specific policies that could put a dent in the incidence of NCDs include: tighter restrictions on advertising unhealthy products; laws and taxes that discourage companies from transferring or externalizing the health costs of their products onto consumers or tax payers; legal corporate codes of conduct that require global companies to disclose known health effects of their products and practices; and stronger restrictions corporate lobbying and campaign contributions in order to provide health advocates with a more level political playing field. Absent forceful political mobilization by social movements, local governments and health professionals and their organizations, it is unlikely that businesses will agree to such a platform but will instead argue for the incremental, ineffective approaches they have advanced so far. Stay tuned for further developments.

 

For Further Reading

Beaglehole R, Bonita R, Horton R, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011;377(9775):1438-47.

Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet 2010;376 (9754):1775-84.

Freudenberg N, Galea S. The impact of corporate practices on health: implications for health policy. J Public Health Policy. 2008;29(1):86-104.

Geneau R, Stuckler D, Stachenko S, et al. Raising the priority of preventing chronic diseases: a political process. Lancet. 2010;376(9753):1689-98.

Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr. 2011;14(1):5-13.

World Health Organization. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases, 2008.

 

Image Credits

1.     Non-Communicable Disease Alliance Briefing Paper for UN Meeting on NCDs

2.     gbaku via Flickr

3.     StephenZacharias via Flickr

4.     Corporate Accountability International

Fast Food and Soda Companies Strive to Improve Image

Posted on by Corporations and Health Watch

Fast food and soda companies are attempting to make their products seem sleeker and healthier, according to a series of articles in Advertising Age.

McDonald’s, Burger King and Subway are all building redesigned stores, aiming to look more like restaurants and cafes than fast food joints. Meanwhile, PepsiCo is planning to lauch a mid-calorie beverage called “Pepsi Next.” The new drink is likely going to be marketed as a reduced sugar beverage, and the goal is for it to taste better to some consumers than diet soda. According to John Sicher, editor and publisher of Beverage Digest, “This is an attempt by Pepsi to come up with another tool to keep consumers in their cola franchise.”

Corporations, the Public’s Health and Astroturf

Posted on by Corporations and Health Watch

Understanding the influence of corporations on the public’s health today requires increasingly sophisticated skills for decoding propaganda as deep-pocketed corporations turn to astroturfing to influence health policy. The public relations strategy known as “astroturfing,” is a form of corporate-driven, top-down advocacy that is disguised to look like bottom-up, grassroots community activism.

In the U.S., the energy in public health is focused around regulating food and beverages with high-fructose corn syrup. In case this controversy has passed you by, high-fructose corn syrup is an extremely common additive to foods and beverages that damages health in a variety of ways.

Manufacturers are keen to leave it in products because for palates accustomed to it, it can be tasty and addictive, so it increases purchases and profits for food companies. Borrowing from effective strategies in the fight against tobacco, some public health advocates want to discourage the consumption of high-fructose corn syrup by making it cost more. This effort is sometimes referred to by the shorthand “soda tax.” Several initiatives have been proposed to establish a soda tax to alleviate budget shortfalls and to help pay for health care reform. Not surprisingly, food and beverage manufacturers see this as an attack on their bottom-line and are lobbying hard against any and all soda tax initiatives.

In the Internet era of easily disguised URL’s and no gatekeepers to vet what gets published, this kind of disinformation is harder to detect than ever. I’ve written here before about “cloaked websites” – websites that intentionally disguise authorship in order to put forward a political agenda – and these are a central tool of corporate propaganda in the digital era, including the battle around the soda tax. For example, the URL “www.nofoodtaxes.com” will take you to this site:

At first glance, it looks like a grassroots movement of everyday people concerned about “big government” and the “difficulty of feeding a family in today’s economy.”  The link in the middle (“watch our tv ad!”) takes you to a slickly produced television commercial that aired in heavy rotation on stations in New York State where a soda tax was proposed. In the ad, a “concerned mother” posing as just a concerned citizen, talks directly to the camera and engages her assumed audience in a shared sense of outrage at the intrusion of big government imposing more taxes on hard-working families.

In fact, “Americans Against Food Taxes” is a cloaked site and is part of a front group funded and organized by the American Beverage Association, to protect industry interests. However, it can be very difficult to tell what’s a front group. The text on this website says that Americans Against Food Taxes is a “coalition of concerned citizens – responsible individuals, financially strapped families, small and large businesses in communities across the country” who opposed a government-proposed tax on food and beverages, including soda, juice drinks, and flavored milks. However, the real membership is the world’s largest food and soft drink manufacturers and distributors, including the Coca-Cola Company, Dr. Pepper-Royal Crown Bottling Co., PepsiCo, Canada Dry Bottling Co. of New York, the Can Manufacturers Institute, 7-Eleven Convenience Stores, and Yum! Brands.

Corporations that have a negative impact on the public’s health are especially adept at this sort of strategy.

In some ways, these sorts of propaganda efforts are not new. Going back to 1995, the tobacco giant Philip Morris hired PR Firm Burson-Martsteller to create “The National Smokers Alliance,” an early astroturf group. The purpose of the group was to stop Federal legislation intended to curb smoking by young people, a policy change that would have improved the public’s health by reducing tobacco-related deaths, and it would have hurt Philip Morris’ bottom line by reducing the number of future smokers. In this pre-Internet astroturf campaign, Burson-Martseller organized mailings and ran a phone-bank urging people to call or write to politicians expressing their opposition to the federal law.

The National Smokers Alliance continued its efforts against any legislation that would prevent new teen smokers through the late 1990s. In 1998, the group added television ads with a 1-800 number to call to its arsenal of techniques, along with phone-banking and mailing. According to The New York Times, “Those smokers who are reached by phone banks sponsored by cigarette makers, or who call the 800 number shown in television ads, are patched through to the senator of their choice.” Since then, public health advocates have managed to win major victories over big tobacco in the realm of popular opinion in the United States, yet many of these stealth marketing tactics continue unabated in other countries.

So, how do people concerned about the public’s health – or, even their own personal health – make sense of all this? How do we parse top-down, corporate propaganda from actual bottom-up, community-led efforts at activism?

On the one hand, it can be a difficult task. Some argue that astroturf is just another form of organizing. As one strategist accused of astroturfing against health care reform writes in a 2009 New York Times op-ed, “Organizing isn’t cheating. Doing everything in your power to get your people to show up is basic politics. If they believe what they’re saying, no matter who helped organize them, they’re citizens and activists.” This kind of sophistry, “it’s not astroturf, it’s just organizing,” is a common argument made by those trying to defend such tactics.

On the other hand, it’s not all that difficult to parse propaganda from facts if you ask two questions about the information we encounter online (or anywhere, really): 1) where is this information coming from? and 2) who stands to benefit from this information?

If the answers to both those questions are “a giant corporation,” chances are it’s astroturf. The chances are also good that it’s bad for the public’s health.

First Lady Recommends Limiting Screen Time for Children

Posted on by Corporations and Health Watch

Cross-posted from Appetite for Profit.

It seems some thought I was a tad too harsh in my critique of the new MyPlate, the federal government’s latest attempt to teach Americans how to eat right. So in the spirit of recognizing positive moves coming from Washington D.C., here is some good news.

Last week, First Lady Michelle Obama announced the latest addition to her effort to reduce childhood obesity: Let’s Move Child Care, which includes a checklist for child day care providers to follow. The most impressive recommendation is to limit screen time. Specifically, to “none under age 2″ and for 2 and up, limit to 30 minutes/week during child care and no more than 1-2 hours/day of quality screen time at home.

First Lady Mrs. Obama unveiled the effort while visiting children at Centro Nia, a bilingual child care center in Washington, DC.

This is a very strong recommendation (backed by the American Academy of Pediatrics) and cannot have made the television industry or its advertisers very happy. And it could help reduce the negative impact of marketing because the earlier children form emotional bonds with cartoon characters, the sooner junk food pushers can exploit those connections. Remember that scene in the film Super Size Me when Morgan Spurlock showed how easily young toddlers recognized images of icons such as Ronald McDonald?

Kudos to the Campaign for a Commercial-Free Childhood(CCFC) for its leadership on this issue. (Full disclosure, I am on their steering committee.) In recent years, CCFC has been fighting Disney over its controversial videos, Baby Einstein. The upshot of that battle was Disney changed its advertising claims.

We have certainly come a long way. Here’s what Let’s Move has to say on videos for babies:

Not too long ago, moms and child care providers all over the country were buying and showing videos and DVDs galore geared entirely toward the infant audience. But now we know that babies and even toddlers (ages 0 to 2 years old) shouldn’t get any screen time at all — zero, not even a few minutes here and there.

Take that Disney! (Here is CCFC’s statement applauding the first lady’s campaign.)

Other positive recommendations for day care centers include serving fruits or vegetables at every meal, avoiding fried foods, saying “so long to sugary drinks” and my favorite: just give kids water, imagine!

When it comes to keeping kids hydrated, it doesn’t get much better than plain old water. And it’s wise to serve toddlers and preschoolers only water at meals — so that they don’t get filled up with milk or juice, making it less likely they’ll have room to eat.

Did you hear that American Beverage Association and National Dairy Council?

Why is this a big deal? In addition to providing leadership and supporting parents, the Let’s Move campaign says it has already received commitments from the Department of Defense, General Services Administration, and the nation’s second largest childcare provider, Bright Horizons, to implement the checklist, which will impact the lives of more than 280,000 children.

And that, is a very good start.

You can watch the first lady’s video announcement here.

 

 

 

Image Credits:

1.     Let’s Move

2.     Campaign for a Commercial-Free Childhood

What Makes a Corporation Socially Responsible?

Posted on by Corporations and Health Watch

Jantzi-Sustainalytics, a Canadian-based company that rates companies on social responsibility recently identified Canada’s top 50 socially responsible corporations.

Winners were selected on the basis of their performance across a range of environmental, social, and governance areas on such outcomes as environmental initiatives, impact on local communities, treatment of employees, sustainability and supply-chain management. Notably absent, however, was any assessment of companies contribution to the rise of non-communicable diseases. (See this week’s Commentary on NCDs). Among the winners were McDonalds, Campbell’s Soup, Ford Motor Company, HJ Heinz, Kellogg’s, PepsiCo, and Starbucks, companies whose practices and products are leading contributors to diabetes, cancer, heart disease, hypertension and stroke.

The Smoke-Filled Revolving Door

Posted on by Corporations and Health Watch

Last week, Lorillard, the third largest tobacco company in the United States, named Neil Wilcox, a former Food and Drug Administration science policy analyst, as senior vice president and chief compliance officer. Prior to his 13 years at the FDA, Wilcox was director of global regulatory affairs at The Gillette Company and vice president of global regulatory and scientific affairs at the Kimberly Clark Corporation. At Lorillard, Wilcox will oversee compliance with the federal Family Smoking Prevention and Tobacco Control Act. Lorillard is market leader in menthol cigarettes with an estimated 35 percent market share. FDA is expected to rule soon on how to regulate menthol.