Giving Compass' Take:

• Rachel Kahn Best explains why single-disease campaigns are popular and how they help to advance work on other causes. 

• How can funders work to ensure the success of single-disease campaigns? 

• Find out what we learned from the ALS ice bucket challenge

Common Enemies shows that disease campaigns became the battles Americans can agree to fight for three reasons. First, Americans perceive health as a particularly worthy goal, viewing infectious diseases and widespread chronic conditions as universally shared risks, and viewing patients with non-stigmatized diseases as especially deserving of public help. This means that with the exception of AIDS, diseases marked by the stigma of contagion, preventability, or mental illness see much less advocacy. Second, Americans donors respond to targeted campaigns. Reformers have repeatedly tried to launch more general campaigns to promote public health. But they’ve never been able to work up the same excitement as the single-disease campaigns. These narrower disease campaigns funnel vast sums of money and attention to a few particular diseases like AIDS, breast cancer, diabetes, and Alzheimer’s, with much less attention to others, like cancers of the colon, lung, and liver. And finally, mainstream disease campaigns have successfully pursued a politics of consensus, often emphasizing a limited set of goals and avoiding challenges to corporate interests and inequality. Many focus predominantly on awareness campaigns and research funding, paying much less attention to preventing disease and ensuring access to health care.

Fighting one disease at a time, then, means devoting vast sums to raising awareness and funding research for a few particular conditions. It’s easy to imagine more efficient ways to promote our collective well-being. But arguing that the distribution of funding is inefficient is different from arguing that these campaigns are harmful. The key question is whether the money and attention devoted to disease campaigns is being taken away from other, more important goals. Do disease campaigns crowd out responses to other problems? If we weren’t fighting diseases, would we be devoting more attention to broader health campaigns, fighting poverty, and pursuing social justice? Do diseases siphon resources form each other? If we weren’t fighting breast cancer, would we be devoting more attention to chronic obstructive pulmonary disease? And, do goals displace each other? If we weren’t busy raising awareness, would we be removing carcinogens from the environment?

By collecting data on the entire field of disease advocacy over decades, I show that rather than taking money away from other problems, disease campaigns benefited other causes. The experiences of buying Tuberculosis Seals, donating dimes for polio, wearing ribbons, and racing for the cure trained millions of Americans to be donors and volunteers. If these campaigns had never existed, we wouldn’t see the same amount of money targeting other problems—the philanthropic sector would simply be smaller. Likewise, federal investments in public health grew up around disease campaigns. If there were no campaigns securing public funding for breast cancer research, the money wouldn’t otherwise be going to study hepatitis—the National Institutes of Health budget would just be smaller. And finally, while many disease campaigns fail to promote the policies that would most improve our health, they do not crowd out campaigns for those policies. We’re less likely to prioritize prevention and treatment access when we fight one disease at a time than when we launch general public health campaigns. But fighting one disease at a time attracts more money and attention to health promotion, some of which flows to prevention and treatment access. Campaigns encouraging mammograms do not cancel out the fight against environmental carcinogens—in fact, the larger breast cancer movement helps more radical organizations gain visibility and influence, as when the environmental health group Breast Cancer Action used Breast Cancer Awareness Month to criticize corporations that use pink ribbons while marketing carcinogenic chemicals.

Read the full article about single-disease campaigns by Rachel Kahn Best at HistPhil.