An Uncharitable Truth

‘Here’s how to tell if your company is a philanthropic hypocrite,” the Guardian’s Suzanne McGee fumed in early October, following news that oil giant Baker Hughes (BH) had announced a donation of $100,000 to the Susan G. Komen Breast Cancer Foundation. Coming from a company that is heavily involved with fracking — a process that creates carcinogenic chemicals linked to breast cancer — BH’s donation was both hypocritical and rife with absurd pageantry. Komen’s founder, former CEO and Chair of Global Strategy, Nancy Brinker, accepted the check during a Steelers game, along with a promise that BH would distribute 1,000 pink drill bits to “do [its] bit for the cure.” This is not a new trend: Over the past decade, “pinkwashed” items — branded with cause-related marketing to both fundraise for breast cancer and turn a tidy profit — have come to dominate the market as a way for corporations to express slick-packaged social awareness and for consumers to feel altruistic on a trip to the grocery store. Komen’s acceptance of BH’s donation epitomizes the breast cancer awareness movement’s history of allying with questionable donors to keep momentum behind its campaign.

The breast cancer awareness movement is a complex beast. My mother’s diagnosis came in January 2009, in the United Arab Emirates; the tumor had grown into a hard knot under her skin in a matter of months. Cancer is an ugly, messy disease, and my family was unprepared for the blow. Fortunately, our community was incredibly supportive. Busloads of families went with us to the annual Safe and Sound BurJuman Breast Cancer Walk, all wearing bright pink pants in keeping with the dress code. BurJuman, a local shopping mall, decked out the highway in pink regalia for the march each year, and thousands of people showed up in T-shirts with stylized logos and pink-brimmed hats. “I’m marching for _______,” announced the pink badges we pinned to the backs of our shirts. We carried pink balloons, bought pink wristbands and streaked our faces with pink war paint. My mother squeezed my hand tightly as we walked, and she smiled. Everywhere, the ubiquitous pink ribbon stood as a symbol for our struggle and our love for those in the midst of the fight. The crowd laughed, sang and marched, and I felt nothing but intense solidarity. But as evidenced by a long string of controversies ending with the recent BH donation, the breast cancer movement has a much darker underbelly: a history of alliances that have often compromised the principles upon which the movement ostensibly stands.

Though it seems ubiquitous now, breast cancer awareness only became a consolidated movement in the early 1990s, with corporations getting involved after the government and public showed interest in the issue. For the first half of the 20th century, breast cancer was a diagnosis suffered in shame and stigma. The rapid succession of announcements in the 1970s by Shirley Temple, Betty Ford and Happy Rockefeller, however, drew a great deal of public attention to the disease and helped contribute to its destigmatization and the increased use of mammograms. By the late ’80s and early ’90s, large advocacy groups had arisen to fight the disease. In 1991, George H.W. Bush established the President’s Commission on Breast Cancer, chaired by Brinker, but Bush failed to deliver on a promise to transfer $210 million in defense spending to breast cancer research. After President Bill Clinton’s election, federal funding jumped from $155 million in 1992 to $400 million in 1993. By then the National Cancer Institute had spent more money on breast cancer than it had on research for prostate, ovarian, colorectal and liver cancers combined. This was paired with increased funding to breast cancer foundations and the first corporate activity in the breast cancer sphere: Estée Lauder makeup counters handed out 1.5 million ribbons with breast self-exam cards in 1992 and collected 200,000 pink ribbon petitions urging the White House to increase research funding further.

The pink ribbons started out peach. The original breast cancer ribbon was a peach-colored loop fashioned after the AIDS awareness ribbons and made in the living room of 68-year-old Charlotte Haley, whose grandmother, sister and daughter had all fought breast cancer. When Self Magazine and Estée Lauder came calling to offer her a national platform, Haley refused on the grounds that they were too commercial and that she feared they would cause the grassroots nature of the campaign to disappear. Estée Lauder plunged ahead with the idea anyway, but to avoid legal issues, the company changed the ribbons’ color to pink. The rest is history.

It’s unclear how close nonprofits and their corporate partners have actually come to finding a cure. The lifetime risk of breast cancer has increased from 1 in 22 in the 1940s to 1 in 8 in 2014. By the end of 2014, there will be 2.8 million women with a history of the disease living in the United States. It’s estimated that in 2014, around 232,000 women will be diagnosed with breast cancer and 40,000 will die from it. Mortality rates are a mixed bag too — while they have dropped since 1990 for white women, there are distinct racial disparities in diagnosis and survival rates. Women of color have persistently shown lower rates of screening and shorter survival periods after diagnosis. A 2013 study in the International Journal of Cancer Epidemiology, Detection and Prevention concluded: “While white women are more likely to be diagnosed with breast cancer, black women are more likely to die from it.” It’s likely that these figures result from wider racial inequalities in access to health care in the United States, but when an additional five black women die of breast cancer per day with barely an acknowledgement from the mainstream movement, it’s clear that the awareness campaign has missed some critical areas where cancer strikes the hardest.

These numbers have not slowed the philanthropic juggernaut that is the Komen Foundation. Komen’s 2014 Race for the Cure event was nationally sponsored by American Airlines, New Balance Athletic Shoe, Self Magazine, Walgreens, Bank of America and many other large corporations. In the 2010 fiscal year, the Komen Foundation generated $420 million in donations and revenue, and it hosted over 150 races globally in 2014. Komen has also partnered with dozens of corporations to put the pink ribbon on their products in exchange for a fraction of the proceeds they generate. Some of these partners include KFC, Ford Motor Company, the gun company Bersa and even Tito’s Vodka. Initially, the problem with these products may seem to come from the ridiculousness of advertising for a cure on products that harm people’s health. But the real problem is that this tone deafness also shows how deeply disassociated with their roots the awareness movement, and Komen itself, have become. Not only are many of these products directly tied to carcinogens that are linked to breast cancer, but their tacit approval by the Komen Foundation and its ilk is also indicative of complacency at best — and actively selling out at worst. The notion that simply buying a pink-embossed product is enough to stop cancer obscures the real needs of the movement: not money or awareness, which the cause has in spades, but demands for accountability from the government, foundations and nonprofits in terms of producing methods to cure and prevent cancer.

Komen and Brinker are undisputed champions of corporate partnership. A 2011 New York Times article quoted Brinker as saying: “America is built on consumerism. To say we shouldn’t use it to solve the social ills that confront us doesn’t make sense to me.” The term pinkwashing, which was coined by the activist group Breast Cancer Action (BCA), describes the exploitation and commercialization of breast cancer in order to boost sales. In contrast, the NYT quotes Brinker describing the decades-long marketing campaign as the “democratization of a disease” — one in which joining the fight against breast cancer is as easy as buying a pink-themed muffin. A 2002 ad run by the BCA in the NYT had a different take on Brinker’s corporate philanthropy: “Guaranteeing quality treatment for breast cancer,” the ad read, “will require real change — and not the kind you carry in your pocket.” The BCA has a good point. Many pink-themed products don’t actually move money into the hands of charities, nor does sporting tiny pink loops just in the name of “awareness.” And the money that does get channeled into nonprofits, particularly that which goes to Komen, is devoted largely to detection and mammography — noble, but comparatively less valuable than early prevention or a cure.

However, nothing seems to stop companies that are in many ways at fundamental odds with the campaign. The NFL is particularly notable for its promotion of breast cancer awareness this past October, even amidst the league’s recent domestic violence scandals — a move that not only struck many as off-key, but also made clear that a corporation’s support of breast cancer awareness does not necessarily equate to its support of women or women’s rights in other regards. It is important to recognize the adverse impact of these campaigns, regardless of intent. In her book “Pink Ribbons, Inc.,” Associate Professor of Physical and Health Education and Women’s Studies at Queen’s University Samantha King points to how marketing experts have been explicit over the past two decades that cause-related marketing is, above all else, a business strategy, and not an altruistic one. King quotes one consultant who describes it as “an innovative and socially useful way to augment the power of more traditional marketing.”

There’s nothing inherently wrong with profiting from good deeds, but there’s something questionable about Komen’s corporate spending. Much of the money earned from cause-related marketing isn’t going towards curing cancer at all. In terms of awareness, the Komen Foundation and its partners have succeeded beyond their wildest dreams; one would have had to live in a doomsday bunker for 20 years to remain unaware of breast cancer and mammography. But many question the value of this relentless education. “Screening is their thing,” sociologist Gayle Sulik, author of “Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health,” told Reuters in 2012. “Getting out the word that breast cancer exists is what they excel at — that and raising money. But if your mantra is ‘end breast cancer,’ screening isn’t going to do it.” While studies have suggested that screening has substantially increased the rate of detection for early-stage breast cancer, a three-decade study showed that screening mammography “has only marginally reduced the rate at which women present with advanced cancer…There is substantial overdiagnosis, accounting for nearly a third of all newly diagnosed cancers, and that screening is having, at best, only a small effect on the rate of death from breast cancer.”

Komen has countered these accusations by claiming to put an emphasis on the people who are suffering in the present. Though this is a worthy goal, the question of motive has long surrounded the awareness movement. King notes that National Breast Cancer Awareness Month (NBCAM) was actually founded in 1985 by Zeneca, now AstraZeneca, a pharmaceutical corporation that manufactures tamoxifen, a top breast cancer drug. Until 2000, AstraZeneca was also the leading producer of chemicals and petrol-based products that have been linked to breast cancer. NBCAM promotes mammography as the most effective tool in fighting breast cancer, and AstraZeneca continues to reserve the right to approve or veto every piece of marketing material for the month’s activities. The link between a pharmaceutical corporation that makes its billions from cancer drugs and its campaign to promote detection — not prevention or a cure — hardly needs explanation, but unfortunately the issue has rarely drawn overt criticism. This is probably due to the increased celebration over the past two decades of cause-related marketing. King argues that corporate influence has framed the fight against breast cancer as most productive when it utilizes the “personal optimism” of breast cancer survivors and research money generated by the pharmaceutical industry.

Moreover, while Komen touts itself as searching for the cure, the proportion of money it spends on research has decreased in recent years from 29 percent in 2008 to 15 percent in 2011. Meanwhile, 18 percent of its revenue was spent on fundraising and administrative costs. Komen has also used a large amount of money to sue lesser known charities and events with the words “for the cure” in their name, even if they were fundraising for entirely different causes. As of 2010, Komen has filed trademark opposition against more than 100 smaller charities. These legal ventures cost almost one million dollars per year. Komen’s executive salaries are also extremely high: Brinker was paid $684,000 in 2012. This isn’t the only questionable allocation of Komen’s cash. The foundation suffered a scandal in 2012 after the instatement of a new, anti-abortion vice president led to Komen pulling almost $700,000 in grants from Planned Parenthood — money that had been apportioned to help low-income women secure breast-cancer exams. Though Komen quickly reestablished the grants, the damage was done: The vice president resigned almost immediately, and Brinker stepped down as CEO soon after. Just one year later, Brinker was voted one of the 100 Most Trusted People in America by Reader’s Digest — surprisingly, public support had remained high throughout the controversy.

Finances aside, there’s also the question of what effect the pink ribbon campaign has on individuals. In the midst of my mother’s struggle with breast cancer, our family drew a great deal of support, solidarity and comfort from the corporate-sponsored marches that have such problematic undertones. One need only watch the high production value videos taken at these marches, with beaming faces and an upbeat, “can-do” attitude displayed by almost everyone in the march, to see the genuinely positive effect that this corporatized activism can have. But this relentless focus on positivity — and the clean, sanitized image of the campaign, highlighting smiling white women in the midst of recovery instead of the realities of a body ravaged by cancer — has been strongly criticized for trivializing the disease. Following the controversial BH donation, the Pittsburgh Tribune Review quoted University of Michigan Professor Shobita Parthasarathy as saying that pinkwashing is a way to avoid the fact that “[breast cancer] is hard and ugly and devastating and women are dying of the disease.”

Positivity isn’t the only problem with the awareness movement; there’s also a distinctly sexual undertone. When faced with the movement’s wristbands that say “I <3 boobies” and sweatshirts emblazoned with “Save the Tatas!” — retailing, of course, at $45 — it’s hard to deny that the focus shifts from illness to gendered objectification. It is distinctly concerning that a movement ostensibly based on women’s health has such a preoccupation with sexualizing an illness and implying that the reason someone should care about it is the prospect of losing her breasts. Sex might sell, but that doesn’t make it an appropriate marketing technique for such a serious issue. On the ground, cancer is about watching your mother’s fingernails softening and turning purple and falling out from the chemo; it’s about a whole lot of needles and red-rimmed eyes and tooth-and-nail fights with insurance companies. The long and short of it is that cancer leaves scars on everything in its wake, and wading through  its reality can never hope to live up to the cheeky, pretty-pink image of the awareness campaign.

While the pink ribbon is an incredible symbol of how a once-stigmatized women’s health issue was brought to the forefront of the American consciousness, it is also an indicator of what capitalizing on capitalism itself can achieve. The breast cancer awareness movement provides patients with a strong sense of community and support in their deepest times of trouble. But this does not excuse the movement’s numerous flaws. The unwavering confidence of the Komen Foundation and its corporate partners, in spite of mounting evidence that the problems they face are not going away, indicates not just arrogance, but also entrenchment in the practices that cause health disparities and needless deaths in the first place. Though the breast cancer awareness movement took a great leap forward in the 1990s, that doesn’t mean it should now be reduced to drill bits. Increased consumer knowledge about charitable practices, demands for greater accountability from large institutions and increased funding for preventative measures and treatments will go a long way towards getting back to the roots of the campaign: the fight to stop a disease that has caused innumerable families so much pain.

Art by Kwang Choi.