Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy 

By Samantha King.

Minneapolis, MN: University of Minnesota Press, 2006, 157 pp., $24.95 hardcover

Reviewed by Ellen Leopold

Twenty-one years after the launch of Breast Cancer Awareness month, October 2006 brought us pink Playtex rubber gloves, pink Goddess Hair extensions, pink Girl Uniform cards from Hooters, and pink bustiers auctioned off at the Crittenton Hospital Medical Center in Rochester, Michigan. It’s hard to imagine a list that more succinctly captures stereotypical images of female vanity and sexist body language. Yet all these items—and thousands more just like them—are sold in the name of high-minded concern for women with breast cancer, as the companies flogging them pledge to contribute some share of the income to “the cause.” Women are responding to these appeals in their millions, no questions asked, producing windfall profits for many of those on the corporate breast-cancer bandwagon.

What could explain womens’ wholesale capitulation to these regressive marketing ploys, which cast them as undiscerning shoppers and dumb down responses to a disease that kills more than 40,000 women every year? How has breast cancer advocacy of the early 1990s—including feminists’ demands for increased research funding, improved treatment and access to health care—been so effectively upstaged by corporate self-interest? Samantha King provides some thought-provoking answers to these questions. The great virtue of her book is that it interprets the success of breast cancer fund-raising not as an isolated phenomenon—a unique response to a unique disease—but rather as an expression of broader trends in contemporary philanthropy and politics. The pink-ribbon phenomenon, King says, reflects a recent marriage between new corporate giving strategies and what she calls “consumption-based citizenship.” Corporations that once made ad hoc annual gifts to an eclectic mix of charities now focus on a single cause, one that resonates with their own product—and bottom—line. In a display of enlightened self-interest, companies have found ways to make philanthropy profitable. They hope their “financially sound goodwill” will strengthen customer loyalty and enhance brand recognition.

 Meeting them halfway is a public newly awakened to the virtues of personal and corporate generosity and so-called ethical volunteerism, that stand in opposition to the welfare state’s culture of dependency. The idea is that the focused efforts of engaged citizens, set in motion by civic-minded corporations, might one day actually out-perform Big Government and its collective (read: failed) solutions to social problems.

Both trends are driven by national politics. Behind the rhetoric of “a thousand points of light” (George H. W. Bush’s characterization of the pooled power of individual philanthropy) was the drive towards broad-based privatization. George W. Bush’s “Armies of Compassion” initiative carries forward the same vision. The new mantras of civic participation are self-help and personal responsibility. Forget about the social safety net and public accountability. Citizenship, like charity, now begins at home.

King traces the impact of this political perspective on all aspects of breast cancer fund-raising. She concentrates on the best-known examples—the Komen Race for the Cure, the breast cancer stamp, and the Avon three-day walk. Throughout her narratives, she never loses sight of the larger picture, making connections between the enterprising spirit of the various “thons” (marathons, walkathons, triathlons, etc) and their reinforcement of a broader market-driven ideology.

The details are fascinating. The Komen Foundation’s 5K Race for the Cure, inspired by the rise of the fitness movement in the early 1980s, was first run in Dallas in 1983 with 700 participants. By 1999, it was held annually in 99 cities across the United States. By 2005, it attracted 1.4 million participants. All Race for the Cure events share certain features, including a survivor recognition ceremony, a “wellness” area, and a place for corporate sponsors to display their products. They all look the same, so that, as King suggests, the race itself has become “a familiar and reliable brand.” The Komen Foundation has, in fact, been able to trademark the phrase “for the cure” to protect its competitive advantage over competing cause-marketers.

King respects the good intentions of women participating in the race and other “thons.” She highlights the useful side effects of these events—the networking opportunities and the solidarity they create among women who have undertaken similar medical journeys. But she also laments what she calls the “tyranny of cheerfulness”: the embrace of the disease as a milestone on the road to true happiness. Endorphins whipped up in the Komen race no doubt create a heady sense of accomplishment. But as racing metaphors displace the older “war on cancer” imagery, competition inevitably creeps into the picture. Though the dead are often memorialized—with their names and images emblazoned on the chests and banners of participating “thoners”—they emerge here as losers. A whiff of personal failure hangs over them. King, citing Barbara Ehrenreich, points to “the triumphalism of survivorhood” that “denigrates the dead and the dying, a sense in which breast cancer survivors are understood to have somehow fought harder than those who have died.”

King ties this perception that survival equals success to women’s general compliance with the cancer establishment. Surviving, she argues, requires women’s “submission to mainstream scientific knowledge and reliance on doctors and scientists to protect them from death.” Rather than responding to their cancer experience with anger or despair—with questions about unequal access to quality care, the toxicity of drugs or the uncertainties of treatment—they become well-behaved patients, and, once restored to their friends and families, well-behaved survivors. Their appearance at fund-raising events is, in King’s reading, another confirmation of the wisdom of accepting the status quo. To raise difficult questions would be to break the spell that got them into the charmed circle in the first place. It would expose them once again to risk. In bowing to the prescribed protocol and spirit of the events, whether out of fear, passivity, or positive identification, women score another victory for traditional values, including those that forbid them to challenge authority.

Of course, not all American women with an interest in breast cancer have succumbed to the blandishments of cause marketing. As an example of a far different approach, King presents Breast Cancer Action (BCA), an activist organization in California that accepts no money from the pharmaceutical companies so eager to sponsor the “thons.” BCA launched an ad campaign in 2002 to raise awareness about the hypocrisy of much corporate philanthropy. The ads pointed out that for companies, the public relations value of their participation in Breast Cancer Awareness month sometimes exceeded the value of their net donations. “Will your purchase make a difference?” a BCA ad asked, “Or is the company exploiting breast cancer to boost profits?” American Express, for instance, widely publicized a “Charge for the Cure” campaign, in which it promised to donate a portion of every credit card charge during the month of October. However, the portion it donated turned out to be one penny per transaction – so it took a hundred transactions to raise one dollar for breast cancer. King explores recent corporate efforts to take their breast cancer cause-marketing global – updating previous work on the subject. Although these efforts are still in their early stages, it’s clear that companies like Avon hope their philanthropic crusades will help them establish their good-faith credentials around the world as potential partners in the development of new markets. It’s too soon to tell how American-designed “thons” and other charity events will play in other cultures, which have different experiences of disease (in, say, countries with low rates of breast cancer) or different systems of health care provision (in countries with a national health service). We will need to keep watch over this.

King focuses on the corporate response to breast cancer. As a result, she unintentionally plays down the role of the government, which is significantly more important in shaping the national response to the disease than corporations or nonprofits, despite the occasional ideological challenge. King discusses government only in relation to the breast cancer stamp, which allowed the post office, for the first time, to charge more for a stamp than its face value. The additional revenues, after costs, were donated to research. The stamp proposal won 100 percent support in Congress, while providing bipartisan opportunities galore to mine the political theme of voluntary giving as an enabler of “civic participation” and a means to “personalize the relationship between citizens and the state.” Although the net revenue from the stamp exceeded all expectations, it represents just a tiny fraction of government funding for breast cancer initiatives. The stamp, which went on sale in 1998, raised almost $3.5 million by June 2005—less than one percent of the $3.5 billion allocated to the National Cancer Institute during the same period. Like the annual shower of pink products, the stamps are part of the celebrity culture of breast cancer, the surface glitter that attracts media attention. Given the prominence of these diversions and their popularity, it’s important to understand where they come from and whose interests they serve. King’s deft and thoughtful interpretation of the pink ribbon phenomenon is an important wake-up call. Going against the grain, she takes a clear-eyed look at a trend that often seems to outshine the disease that put it on the map.

Ellen Leopold is the author, most recently, of ‘“My Soul is Among Lions’: Katharine Lee Bates’s Account of the Illness and Death of Katharine Coman,” in Legacy: A Journal of American Women Writers (2006).

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