http://www.nytimes.com/2001/08/05/weekinreview/05BLAI.html
|
August 5, 2001 Healthy Skepticism and the Marketing of AIDS
By JAYSON BLAIR
GOING the Distance" reads the advertisement, which shows four
mountain climbers bursting with health, and promotes an anti- AIDS drug
manufactured by Merck What's wrong with that? Plenty, according to the Food and Drug Administration, which recently
ordered that the Merck ad, as well as those of other companies featuring
robust young men heaving javelins, riding bikes and crewing on sailboats, be
pulled. Such portrayals, said the F.D.A., were "not generally
representative of H.I.V. patients and do not adequately convey that these drugs
neither cure H.I.V. infection nor reduce its transmission." For their part, Merck officials originally defended their ads, saying they
were part of a larger effort to get patients to talk to their doctors about
treatment and to show that people were living longer lives on the drugs, but
the company has since complied with the order. Truth in advertising has long been considered an oxymoron. From political
campaign spots to the perfect grill marks on hamburgers in Burger King
television ads, advertisers have always improved upon reality. But the
practice is much more contentious when it comes to medical advertising. After
all, the risks associated with embellishing the appearance of fast food are
appreciably lower than those having to do with creating misconceptions about
a mortal disease. "The standard for a false or misleading advertisement is whether the
ad makes a material statement that is likely to mislead the consumer,"
said Kent R. Middleton, an advertising professor at the University of
Georgia. "That's why when you get into the health field more statements
are considered material, with greater consequences for consumers than candy
advertisements or Coke ads." In addition, Ronald Valdiserri, deputy director for the AIDS center at the
Centers for Disease Control and Prevention, said that AIDS is different from
most diseases in that almost everyone involved in fighting it — prevention
advocates, drug companies, politicians and even the United Nations — has from
the first crafted images of the illness to suit a specific set of needs. In 1987, for example, the federal government decided to blitz the American
people with a frightening message: anyone could get AIDS. "If I can get AIDS, anyone can," said the son of a Baptist
minister in one of the government's public service announcements. The award-winning campaign, called America Responds to AIDS, helped
catapult the disease into the public consciousness and convince public and
private funders to underwrite the fight against it. But while the message of the
campaign was technically correct, it was also somewhat misleading. Yes, everyone faces some measure of risk. But 14 years ago, AIDS in the
United States was overwhelmingly a disease of gay men and intravenous drug users,
and their children. Yet references to drug use and sexual orientation in the
America Responds to AIDS ads were removed under pressure from conservatives
in Congress. The minister's son, for example, was gay, but that information
was kept out of the script. To be sure, prevention experts say that targeting the widest possible
audience is not necessarily a bad thing when it comes to a disease like AIDS,
particularly when one of the goals is to build not only awareness, but broad
support for research and prevention measures. But the decision to make descriptions of the new illness as
unobjectionable as possible entailed real costs. For years, prevention
advocates contend, the ad campaign — because of what had been left out — made
it impossible for them to get federal health officials to set aside money
specifically to educate drug users and gays. Much of the government's $600
million AIDS- prevention budget was used instead to combat the disease among
college students, heterosexual women and others who faced a relatively low
risk of contracting the disease. THE United Nations may soon pay a similar price, said Patricia Siplon, an
AIDS prevention advocate and political science professor at St. Michael's
College in Colchester, Vt. By 2003, the world body hopes to begin spending $7
billion to $10 billion a year battling AIDS and other diseases with a
campaign that will reach almost every nation on earth. But the United Nations
has bowed to pressure from conservative states like Egypt, Sudan and
Malaysia, as well as from the Vatican, which insist that no mention be made
of prostitutes or gays, even in nations like South Africa, Thailand and
Poland, where those groups constitute a large portion of the infected. "What is so tragic this time is that the proportion of the problem is
20 times bigger, and there are many more people who are going to suffer
because we are slow learners," Professor Siplon said. Similar disinformation has been spread by the advertising used to promote
anti-AIDS drugs, said Natasha Jenkins, an infectious disease market analyst
in London for Datamonitor Healthcare, which does research for drug company
advertising campaigns. Since 1997, when the F.D.A. first allowed drug companies to market
directly to consumers, "They have made it seem like there is a cure and
a lot of people have stopped taking the same precautions because they feel
that AIDS is being controlled by drugs," said Ms. Jenkins. Her view is borne out in recent surveys, including one this year by the
San Francisco Public Health Department that showed that gay men who said they
rarely or never saw the AIDS drug ads were more likely to say they practiced
safe sex. "There is obviously a tradeoff in wanting and letting people know
that there are treatments for H.I.V. infection," Dr. Validiserri, of the
C.D.C., added. "But we also don't want to go so far that we minimize
what is still a lifelong, incurable disease." Christine G. Sinnock, a social worker at St. Jude Children's Research
Hospital in Memphis, who works with children and young adults with AIDS,
points to polls showing that although 75 percent of Americans thought AIDS
was the country's most pressing health problem in 1987, that number had
dropped to 45 percent in 1995 and to 26 percent by last year. "The numbers make it seem as if we had found a cure, but it is really
just that the drug companies are winning the image game," Ms. Sinnock
said. "Whether it is the America Responds to AIDS campaign or the more
recent ads by the drug companies, we have a history of creating misconceptions
that have made this disease more difficult to fight on the ground
level." |
|||||||
|
|
ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.