On a sunny June morning I put on a T-shirt emblazoned with a pink ribbon logo and joined thousands in a race through the heart of Washington, DC. A bevy of volunteers cheered us as we left the starting line, and hundreds more along the course offered water that had been specifically pink-ribbon labeled for the event. As the pink tide of runners filled the streets, big-draw performers tuned up to entertain us at the finish line. We were all winners that day; we were racking up kilometers – and pledge money – for the Race for the Cure®.

 

I completely underestimated how compelling the race would be for me. At the start line, I didn’t have particularly strong feelings about breast cancer; I was running simply because someone had asked me to. But the crowd’s exuberance was highly contagious – and I was not immune to it. Though I had never witnessed anyone’s journey through breast cancer, I felt an almost magnetic connection to runners around me who had. Thousands of individuals, thousands of unique stories, but one common theme: the color pink. The Race for the Cure did rub off on me – for that day, certainly. Though it’s been a few years since I raced, I have strong, lasting – and mostly pink – memories. And that’s exactly what the Komen Foundation banks on.

 

NANCY BRINKER AND THE KOMEN FOUNDATION

 

The Race for the Cure is the primary public event sponsored by the Susan G. Komen Breast Cancer Foundation. The race, which this year celebrates its 30^th anniversary, now takes place on a year-round schedule in upwards of 120 cities in the U.S. and abroad. The Foundation is the largest fundraiser for breast cancer research in the country. Indeed, Komen’s track record is extraordinary in the world of fundraising; in 2010, the combined individuals’ contributions, race registrations and fulfilled pledges totaled approximately $365 million. Also in 2010, the Foundation wrote off approximately $37 million in direct benefits to donors and sponsors. A minimum of 25% of the race proceeds are directed to the Foundation’s internal operating expenses. The remaining funds – up to 75% – are allocated to mammography screening programs and breast cancer research.

 

Nancy Brinker established the Komen Foundation in 1982 in memory of her sister, Susan, who died of metastatic breast cancer at the age of 36. Brinker is no stranger to success; her former husband is the retired chair of Dallas-based Brinker International, the self-proclaimed “premier casual dining restaurant company in the world.” (The corporation owns, for starters, Bennigan’s, Chili’s, Macaroni Grill, Maggiano’s, and Eatzi’s.) Nancy Brinker is well-established in Republican circles, as well; in 2000 she was a Major League Pioneer contributor, responsible for donations of at least $100,000 for George W. Bush’s campaign. FEC records show that she donated an additional $156,000 to Bush’s gubernatorial races, as GOP hard and soft money and federal PAC hard money. In 2001, Bush appointed Nancy Brinker Ambassador to Hungary, a position she held until 2003.

 

Being a staunch Texas Republican – or even a high-visibility Republican backer – does not necessarily fly in the face of Brinker’s role as an extraordinarily successful fundraiser for breast cancer research. Nancy Brinker and the Komen Foundation have other investments, however, that underscore the Foundation’s big business connections and raise significant issues about conflict-of-interest. Both Brinker and the Foundation have invested in numerous pharmaceutical companies, including AstraZeneca, a company that manufactures drugs used in breast cancer treatment – and the largest corporate sponsor of the Race for the Cure. In addition to investing in pharmaceuticals, the Foundation holds stock in General Electric, one of the world’s leading manufacturers of mammography equipment. Nancy Brinker sat on the boards of Caremark Rx, a prescription drug management enterprise that has been heavily criticized for their policies that often favor pharmaceutical corporations over plan subscribers. Brinker also sat on the board of U.S. Oncology, which owns a network of for-profit cancer treatment centers. (When she accepted the ambassadorship, Nancy Brinker vacated these posts as well as the top seat at Komen.) She remains a key figure in charting the Foundation’s course – a course that notably does not include prevention as one of its funding priorities. Brinker is, by any definition, a strongly-biased player in the major league game of breast cancer marketing.

 

The second largest player in the private sector is the Avon Products Foundation, which is the do-good arm of Avon, the self-designated “company for women.” Established in 1955 to fund programs creating economic opportunities for women, the Avon Foundation narrowed its charitable-giving goals in 1992 to just two issues: domestic violence and breast cancer research. Though Avon has a significantly larger international presence than the Komen Foundation, it is in second place when it comes to cash pots; in 2004, Avon’s Walks for Breast Cancer and sales of pink ribbon cosmetics raised just under $56 million. In 2010, the walk, alone, was expected to raise more than $26 million. Cosmetic giants Estée Lauder, Revlon, and Mary Kay all contribute portions of their pink ribbon revenues to breast cancer research, but at far lower levels than the Komen and Avon Foundations.

 

For a number of years, Avon farmed out the marketing and management of their three-day walks to Pallotta TeamWorks, a for-profit event producer that created the AIDS Rides of the mid-80s. PTW was notorious for exploiting good causes to make a buck, and its affiliation with Avon was no exception. Avon had its own track record of questionable allocations; for years, the Foundation has directed less than 50% of the proceeds from their fundraising activities to research. Shortly after Avon severed its connection with Pallotta, the company filed for bankruptcy. Shortly after that, the Komen Foundation launched their own three-day fundraising walks that are strikingly similar to, if not directly patterned on the Avon walks. In an ironic but hardly coincidental act, the Komen Foundation purchased Pallotta’s assets and hired a number of Pallotta-trained event planners to manage its new walk program.

 

BREAST CANCER AWARENESS MONTH

 

Breast Cancer Awareness Month (BCAM) was created in 1985 by Zeneca, now AstraZeneca, a British-based international pharmaceutical powerhouse and the third-largest pharmaceutical company in the world (their 2009 sales approached $33 billion). Each October, BCAM is heavily promoted by the Komen and Avon Foundations, dozens of big-name corporate sponsors, the National Cancer Institute, and virtually every non-profit that focuses on breast cancer detection and treatment. (Notably missing from my last sentence is the word prevention; BCAM is not about that.) BCAM heavily advocates annual mammograms – the campaign’s slogan is “Early Detection is Your Best Protection” – and designates one special day to underscore the purported necessity of regular screening. From their website: “In 2012, National Mammography Day will be celebrated on October 19.” Celebrated? Might we expect black tie and tails? No way. Single-use paper gowns, opening in front, of course.

 

When AstraZeneca – the same AstraZeneca that resides in the Brinker and Komen portfolios – created BCAM it was a subsidiary of Imperial Chemical Industries (ICI), one of the largest manufacturers of pesticides, plastics, and paper in the world. In the late 1990s, AstraZeneca’s plant in Perry, Ohio, was cited as the third-largest source of potentially carcinogenic pollution in the country; in 1996 that same plant released approximately 53,000 pounds of carcinogens into the atmosphere. As recently as 2000, AstraZeneca manufactured Acetochlor, a potent herbicide and recognized carcinogen that has been implicated as a causal factor in breast cancer (during a demerger/merger, the company sold its Acetochlor manufacturing rights to Dow Agroscience). While AstraZeneca has largely divorced itself from its carcinogenic family history, the company does not permit discussion – or even mention – of environmental carcinogens in BCAM materials, and conveniently sidesteps the Awareness factor when October rolls around each year.

 

AstraZeneca manufactures tamoxifen (brand name Nolvadex), which has long been considered the gold standard for breast cancer treatment. The FDA has also approved tamoxifen for reduction of contralateral breast cancer (cancer that occurs in the “opposite,” or second, breast,) and as preventative treatment for women at high risk of developing breast cancer. AstraZeneca also manufactures Faslodex, a drug used as hormonal treatment for postmenopausal women who have recurring, metastatic breast cancer. And more than two decades after launching National Breast Cancer Awareness Month, AstraZeneca maintained controlling interest in Salik Health Care Cancer Centers.

 

I think it is critically important to understand the complexity – and the simplicity – of AstraZeneca’s role in the big business of breast cancer. As the manufacturer of the most-prescribed breast cancer treatment drug, AstraZeneca essentially controls breast cancer treatment and chemo-prevention studies world-wide. From the corporation’s standpoint there’s certainly no profit in searching for causes, and, as we all know, there is no real cure. But every breast cancer detected is a breast cancer that will, in all likelihood, be treated.

 

THE COLOR OF MONEY IS PINK

 

Komen runners sported pink visors in the 1990 races and pink ribbons starting in 1991, but the designation of pink as the color of breast cancer fundraising was initiated on a larger and lasting scale not by Komen, but as a result of a tricky legal balancing act between a woman named Charlotte Haley and the collaborative efforts of Self magazine and Estée Lauder. Haley, whose grandmother, sister, and daughter had all battled breast cancer, had a small home business making peach-colored ribbons that she sold to raise money for breast cancer research. Though her distribution was almost entirely word-of-mouth, that word reached the corporate desks of Self and Estée Lauder, who, in early 1991, were planning to use the single-loop ribbon as the emblem of their BCAM campaign. Self approached Haley in hopes that she would turn over the rights to her ribbons, but she rejected the offer as being too commercial. Eventually, the Self/Estée Lauder partnership had no better option than to choose a different color. They launched a massive pink campaign – pink for hope, pink for renewal, pink as the ultimate color of femininity. The rest – including Charlotte Haley’s home-grown peach ribbon effort – is history.

 

Corporate America began to leverage cause-based marketing in the mid 1980s, and was in high gear by the time Self/Estée Lauder blew the roof off with their pink ribbon campaign. It is a well-documented fact that consumers will switch from their preferred brand to one of the same cost and quality that is associated with a good cause. Even more powerful: the promise of a cure. Fundraising that offers this promise is virtually guaranteed success because of one simple fact: the word “cure” is all about hope, and hope alleviates our fears.

 

Pink ribbon marketing is a form of “awareness” fundraising. A hallmark of awareness fundraising is that it is notoriously vague about where the money goes. Ads stoke consumers to “fight breast cancer” – a battle that sounds noble, but is intentionally nonspecific. Consumers lured in by the advertising feel like they’re supporting a good cause – and they may well be – but to what extent? Sales of pink-ribboned merchandise rake in big, big bucks – many hundreds of millions annually – much of which ends up in advertising machinery and corporate pockets. The actual revenues directed to breast cancer research from the sales of pink-ribboned products can be as meager as two cents on the dollar. Two cents on the dollar.

 

There is additional hypocrisy packaged with the pink-ribboned cosmetics and body care products marketed by such corporate powerhouses as Estée Lauder, Avon, Revlon, and Mary Kay. These “do good” cosmetic companies conduct self-promoting campaigns and donate funds to breast cancer research while simultaneously pushing products that incorporate parabens (estrogen-mimicking chemicals that have been shown to increase the risk of breast cancer) and phthalates (also identified as hormone-mimicking chemicals, and known to cause a broad range of birth defects in animal tests). Cosmetics are not subject to FDA regulations; neither is the color pink.

 

The issues I’m presenting are complex and intricately interwoven. We have an enormously successful foundation maintaining strategic alliances with corporations that thrive because of the very disease that foundation crusades against. We have a mega-giant pharmaceutical corporation that profits wildly from sales of its breast cancer treatment drug, and also sponsors the nations’ pre-eminent breast cancer detection effort. We have another highly successful foundation crusading for the same cause while marketing cosmetic and body care products imbued with chemicals that may advance the incidence of the disease. We have an astonishing array of pink-ribboned goods for sale, though most of these sales produce mere pennies on the dollar to support the cause. And we have the very real problem of sweatshop labor producing many of these pink products, which, in my view, vastly overrides any positive value inherent in the products, or in the sale or purchase of them. We have thousands of businesses aligning with the foundations by jumping on the pink ribbon band wagon, businesses that also then benefit from the “glow” of the cause. (As I was researching this article, I received three catalogs from companies marketing to women; tucked into each was a card announcing that corporation’s sponsorship of the Race for the Cure.) The glow is contagious.

 

ONE SIMPLE STEP: GO SEMI-POSTAL

 

In contrast to non-transparent “awareness” fundraising tactics, the United States Postal Service has, for eight years, conducted one of the better direct fundraising projects related to breast cancer research. The USPS “semipostal” breast cancer research stamp – the first of its kind – was introduced in 1995. For a premium (now, of ten cents) you can buy stamps and simultaneously donate to breast cancer research. Over the first 7 years of the project, the USPS incrementally withheld only $1.1 million for administrative costs, including printing; this low level of overhead has been maintained, even as the USPS is increasingly challenged by alternative avenues of communications and package delivery. The balance of the revenues from premiums is directed in a 70/30 split to the National Institutes of Health (NIH) and the Department of Defenses’ Peer Reviewed Breast Cancer Research Project. Since its inception and through November, 2011, the program has raised $72 million for breast cancer research. NIH directs most of their share to the National Cancer Institute (NCI). While NCI has not demonstrated a transparent and full commitment to investigating the possible role of environmental contaminants in cancer, the Institute continues to do groundbreaking work in the areas of genetics and the molecular biology of cancer. If you are ready to take one simple step towards funding breast cancer research, buy these designated stamps.

 

If it is important to you to show pink ribbon support, you can make a simple loop to wear on your lapel; all it takes is some inexpensive ribbon and a safety pin. If it is important to you to show your support by joining the Race for the Cure, do so. I encourage you to consider joining unofficially, though. You won’t get the Komen T-shirt, but you also won’t get the Foundation’s massive amounts of publicity materials, nor will your name be sold to Komen’s partner corporations. On race day, you can join the runners and wear your own pink T-shirt; have your friends pledge dollar amounts to support you. You can gain the satisfaction of racing and bask in the communal glow, and then send your pledge proceeds to an organization that will spend your money wisely. A list of organizations that we support is below.

 

MAKING YOUR MONEY COUNT

 

Each of these organizations accepts donations on line or by mail; none are pink ribboned.

 

Breast Cancer Action (http://bcaction.org/) is a highly vocal non-profit that has a strong track record of taking corporate pink ribbon campaigners to task. Their web site provides, in stripped-down, precise language, a huge amount of information about fund raising for breast cancer research. BCA’s “Think Before You Pink” (http://thinkbeforeyoupink.org/) project promotes consumer awareness and corporate transparency.

National Breast Cancer Coalition  (http://www.breastcancerdeadline2020.org/) is a strong political voice in the large pool of cancer lobbyists. NBCC’s focus is on increased federal funding to support breast cancer research.

 

The Breast Cancer Fund (http://www.breastcancerfund.org/) focuses on preventable causes of breast cancer and is dedicated to eradicating the disease; strong focus on environmental risk factors.

 

The National Women’s Health Network (http://nwhn.org/), “a voice for women, a network for change,” is also a clearinghouse for information and links to dozens of vetted organizations involved in breast cancer prevention, education, detection, and treatment.

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Nancy Welch retains copyright of this article and can be contacted at nwelch7@gmail.com