From Grass Roots to Pharma Partnerships: Breast Cancer Advocacy in Canada

Abstract

From Grass Roots to Pharma Partnerships examines the development, over a twenty-year span, of alliances between grass roots breast cancer groups in Canada and the pharmaceutical industry. I conclude that these alliances alter the advocacy content and style of the groups in ways that silence grass roots critique and support the policy goals of the pharmaceutical industry. I present my results in three parts. First, narrative accounts depict differing responses among breast cancer organizations to overtures from the pharmaceutical industry, from outright rejection, to a middle stance that I label “pragmatic ambivalence,” to acceptance of complete funding by pharma. Second, I describe three features of Canada’s policy landscape that have been altered by the successive adoption of neoliberal polices and which affect the character of patients’ movements.These are: 1) the failure of Canada’s healthcare system to adapt to a generation of new, expensive drugs; 2) a weakening of the system of cost controls, drug approvals, and the regulation of truth claims about drugs; and 3) policies that restrict funding to, and critical advocacy by, the civil society sector. The third section of my results describes the gradual transition of the breast cancer movement over two decades, from small, local, independent groups to a national network of organizations, many of which now rely heavily on the pharmaceutical industry for support. A series of case studies of projects carried out by groups and funded by “big pharma” illustrates subtle misrepresentations of the state of knowledge about new cancer drugs. These findings suggest that patient-centred breast cancer groups need sources of funding and information independent of the pharmaceutical industry if they are to contribute a user’s perspective to pharmaceutical policy about drugs whose effects are still largely uncharted.