Navigating the Health Care System
Direct to Consumer Advertising
Prevention First: A New Coalition of Independent Health Organizations
By Barbara Brenner, Executive Director, Breast Cancer Action. July 2001
Over the course of 2001, almost 240,000 American women will hear from their doctors the dreaded words, "You have breast cancer." While billions of dollars are being spent in search of a cure for the disease, efforts to prevent breast cancer are finally getting attention as well. Much of this attention, unfortunately, is directed toward the limited and risky approach of "pills for prevention."
While this approach may reduce an individualís chances of developing breast cancer, it ignores a primary prevention strategy that would protect us all by addressing the causes of breast cancer, particularly the environmental links to the disease. While the public is relentlessly bombarded with direct-to-consumer advertising of pills for the prevention of diseases like breast cancer, a public health approach based on the precautionary principle of public health -- keeping our air, food, and water free from pollution and healthful -- is drowned out by profit-driven pharmaceutical companies that care more about the bottom line than they do about your health.
One of the strategies we will need to shift the publicís attention away from pills for cancer prevention toward the precautionary principle (toward requiring industry and science to fully assess the impact of their activities before they impose them on the public and the environment and toward finding safe alternatives for activities that pose a threat of harm) is a counter campaign to the drug companies' current advertising campaigns. To implement that strategy, a coalition of womenís health organizations that have declared their independence from the pharmaceutical industry has come together to create a new coalition called Prevention First.
The purpose of this coalition is to promote a view of public health that stresses primary cancer prevention Ė healthy food, water, and air -- over narrowly focused risk reduction through pharmaceutical interventions that are individual precautions not available to everyone. By drawing the publicís attention to the dangers of tamoxifen for healthy women -- including the fact that the drug is a known carcinogen and the limited number of people for whom the potential benefits outweigh the potential risks -- we will educate the public about the dangers of simplistic pharmaceutical approaches to disease prevention which focus on reducing your chances of getting one disease while increasing the dangers of getting another.
We will work together to inform people about the dangers of breast cancer "prevention" pills -- particularly tamoxifen and raloxifene -- to highlight the problems associated with treating an individualís risk factors as though it were the disease, and to promote greater awareness of the precautionary principle of public health. The coalition will emphasize the difference between "prevention in a pill" and true prevention that involves finding and eradicating the causes of breast cancer; it will clarify the negative consequences of drug company consumer advertising, and how the relationships between drug companies and medical researchers can compromise research findings and reporting.
The founding members of the coalition are:
What these organizations have in common is a commitment to womenís health and the precautionary principle and independence from any financial connection to corporations that are advertising drugs directly to consumers.
Prevention First has presented testimony to the Food and Drug Administration regarding direct-to-consumer advertising and met with FDA officials to expand on our concerns and suggestions for addressing them. (For a copy of the FDA testimony, contact the Breast Cancer Action office.) We plan to continue to bring our concerns to the appropriate federal agencies, and to work with the media to get the message out to the public that it is time for a new approach to breast cancer prevention.
THE PRECAUTIONARY PRINCIPLE
Understood by doctors as "first, do no harm," the precautionary principle is sometimes abbreviated as "better safe than sorry." As explained by the Science and Environmental Health Network, the principle provides that:
|When an activity raises threats of harm to the environment or human health, precautionary measures should be taken even if some cause and effect relationships are not fully established. Implementing the principle requires exploring alternatives to possibly harmful actions; placing the burden of proof on proponents of an activity rather than on victims or potential victims of the activity; and using democratic processes to carry out and enforce the principle.|
To get involved or for more information on Prevention First, visit their website.
You can also download a .pdf file of the above ad that Prevention First ran in October 2001.
The work of Prevention First is funded by a generous grant from The Richard and Rhoda Goldman Fund.
To find out more, see The Precautionary Principle.
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