California is on its way to becoming the first state to mandate Merck's GARDASIL vaccine for all 11 year old girls.

http://ilena-rosenthal.blogspot.com

Note from Ilena Rosenthal: May God protect our daughters from ths
fiasco in the making ... and from all the Pharma PR flacks who are
all over the internet and other medium trying to sell this potential
debacle. I highly recommend anyone who would even consider having
their young daughters injected with this widely marketed
pharmaceutical product, please read the PR Watch series.
Here's the third part.

http://www.prwatch.org/node/6232

Women in Government, Merck's Trojan Horse: Part Three in a Series on
the Politics and PR of Cervical Cancer

http://www.prwatch.org/node/6232

Women in Government, Merck's Trojan Horse: Part Three in a Series on
the Politics and PR of Cervical Cancer
Submitted by Judith Siers-Poisson on Tue, 07/10/2007 - 08:51.
Topics: corporations | ethics | lobbying | media | pharmaceuticals |
politics | public relations | U.S. government | women

In parts one and two of this four part series, "Setting the Stage",
and "Research, Develop, and Sell, Sell, Sell", we've looked at the
basic facts of Human papillomavirus (HPV) and its link to cervical
cancer, and the Merck vaccine Gardasil that is touted as the first
ever vaccine against cancer. We examined the PR and marketing push for
Gardasil that began even before FDA approval, and two non-profit
organizations that helped Merck exploit their current corner on the
HPV vaccine market.

In this article, we'll analyze the push for mandated HPV vaccination
of adolescent girls that is taking place at the state level throughout
the U.S., and the non-profit organization, Women in Government (WIG).
WIG has been Merck's non-profit front and direct channel to
state-level legislators who are the key to enacting mandates.
The Push for Mandates, and the Pushback

As reported previously, Merck laid the PR and "education" groundwork
for Gardasil well before FDA approval was granted in June 2006. But
even with FDA approval and the strong recommendation of the Advisory
Committee of Immunization Practices at the federal level, mandatory
vaccination was not a given since the power to enact such requirements
lies in the hands of state legislators. Merck was working behind the
scenes on that front as well, and moved quickly to persuade
policymakers with the authority to mandate vaccination for 11 to 12
year old girls. Within a few months of FDA approval, almost twenty
states had legislation pending that would mandate vaccination against
HPV. Merck must have felt like they had won the lottery when within a
month, the Centers for Disease Control (CDC)'s Advisory Committee of
Immunization Practices (ACIP) recommended that 11 and 12 year olds be
targeted for routine vaccination, and all women 12-26 years old be
encouraged to be vaccinated. Merck and Gardasil were on a roll, thanks
in large part to Women in Government.

According to their website, "Women in Government is a national
501(c)(3), non-profit, bi-partisan organization of women state
legislators providing leadership opportunities, networking, expert
forums, and educational resources to address and resolve complex
public policy issues." The campaigns that they feature on their home
page deal with kidney health, Medicare preventive services, higher
education policy, and the "Challenge to Eliminate Cervical Cancer,"
which was publicly launched in 2004.

Governor and Mrs. Rick Perry of Texas. Molly Ivins liked to call him
"Good Hair" Perry.Governor and Mrs. Rick Perry of Texas. Molly Ivins
liked to call him "Good Hair" Perry.On February 2, 2007, Texas
Governor Rick Perry, against the wishes of his conservative base and
to the surprise of critics, signed an executive order mandating HPV
vaccination for girls entering seventh grade. Then, unfortunately for
Perry and Merck, details of his many connections with both Merck and
Women in Government became public. Ellen Goodman of the Boston Globe
noted, "It turned out that Perry's former chief of staff is now a
lobbyist for Merck. Did that look bad? Whoa, Nellie. Did it look bad
that Merck had funded an organization of women legislators backing
similar bills? Whoa, Merck." USA Today reported that Perry's current
chief of staff's mother-in-law, Texas Republican State Representative
Dianne White Delisi, is a state director for Women in Government.
Perry's wife, Anita, a nurse by training, addressed a WIG summit on
cervical cancer in Atlanta in November 2005. Perry also received
$6,000 from Merck's political action committee during his re-election
campaign.

Merck announced on February 20, 2007 that it would no longer lobby
directly for vaccine mandates at the state level. The New York Times
quoted Dr. Richard M. Haupt, executive director for medical affairs in
Merck's vaccine division as saying, "Our goal is to prevent cervical
cancer. Our goal is to reach as many females as possible. Right now,
school requirements and Merck's involvement in that are being viewed
as a distraction to that goal." Dr. Haupt did say, however, that Merck
would continue providing health officials and legislators with
education about the vaccine and would continue lobbying for more
financing for vaccines in general. When asked how much Merck had spent
on its Gardasil lobbying efforts, Haupt declined to name a figure.
Women in Government: Picking Up the Slack for Merck

So who is this group receiving Merck funding and pushing for vaccine
mandates across the country? As noted above, Women in Government had
identified cervical cancer as a focus of their work as early as 2004.
Available on the WIG web site is a legislative policy toolkit. It
provides legislators with sample legislation written by their
colleagues in other states, maps showing states with cervical cancer
related bills pending or laws enacted, WIG's fact sheets on HPV and
cervical cancer, and a letter from WIG President Susan Crosby. While
not focused solely on introducing and enacting HPV vaccine mandates,
they are a main component of the WIG campaign and something by which
they measure success. According to a map that WIG provides on their
site, as of June, 2007, twenty-three states and the District of
Columbia have introduced HPV vaccine mandate legislation, in addition
to Virginia, which has already enacted legislation.

WIG's non-profit and non-partisan status has given them access, status
and influence beyond the reach of Merck, the vaccine manufacturer.
Debbie Halvorson, the Democratic majority leader of the Illinois State
Senate, had a hysterectomy due to HPV infection. She told the New York
Times that, "she would continue to press for the bill, but that it was
a good idea on Merck's part to stop lobbying. 'If the people out there
are thinking that Merck is doing all this, and pushing our buttons,
they need to just step away. The fact that I'm doing what I'm doing
has nothing to do with Merck.'" Halvorson is listed as a current
member of Women in Government on the group's website. Health Policy
Monitor, the website of an international non-profit network on health
policy and reform, reports that in California in late 2006, Democratic
Assemblywoman Sally Lieber introduced a bill that would require all
girls entering sixth grade to be vaccinated against HPV beginning in
July 2008. "Assemblywoman Lieber has publicly stated that she drafted
the HPV mandate for California because of the unique opportunity it
presented to prevent cancer with a vaccine-something that has never
before been possible. … Merck representatives requested a meeting with
Lieber before she introduced the HPV bill, but Lieber declined. Lieber
did meet with Women in Government, unaware of their ties to Merck."
Straight From the President's Mouth: An Interview with Susan Crosby

WIG President Susan Crosby at a Challenge to Eliminate Cervical Cancer
Campaign press conference, January 2005.WIG President Susan Crosby at
a Challenge to Eliminate Cervical Cancer Campaign press conference,
January 2005.In March 2007, I interviewed Susan Crosby, the President
of WIG. Crosby first served on the board of WIG and then joined the
staff as Deputy Executive Director in 2002. Crosby was a Democratic
member of the Indiana House of Representatives for 12 years prior to
her tenure with WIG. In 2005 Crosby's total compensation package from
WIG was $123,925.

When asked what WIG offers its members, Crosby noted that besides the
networking opportunities, WIG itself serves as a resource in several
ways, including, "having legislators be able to call in and get
totally unbiased information … to be able to make decisions that are
the best for their state." She continued, "That's one thing that we at
Women in Government have always tried to do, is try to give them the
full picture, the balanced picture – the good, the bad, and the ugly.
Because nothing's worse than to give a legislator, a woman legislator
in particular, part of the story, and have her go back to her state,
standing up at the mike, proposing something, and all of a sudden this
question comes flying out of left field and she has no idea what it
was."

But is WIG dedicated to giving women legislators unbiased, balanced
information, or in giving WIG's corporate contributors access to the
legislators that can significantly help or harm their interests at the
state level? In 2004, more than 20 WIG funders were pharmaceutical
companies or entities heavily invested in health care issues that
could come before state legislators. A short list includes both Merck
& Co., Inc and Merck Vaccine, GlaxoSmithKline (which will soon have
the second HPV vaccine on the market), and Digene Corporation (which
manufactures an HPV test). Other drug interests listed as donors to
WIG include Novartis, Eli Lilly, AstraZeneca, Bayer Healthcare,
Pfizer, Bristol-Myers Squibb (both the company and their foundation),
and Pharmaceutical Research and Manufacturers of America, also known
as PhRMA, one of the largest and most influential lobbying
organizations in Washington representing 48 drug companies.

WIG's funding rosters for 2005 and 2006 have minor additions and
deletions, but Merck, GlaxoSmithKline, and Digene remain constant. It
appears that word has gotten around that WIG is ready, willing and
able to cooperate with those invested heavily in health care policy --
their current list of donors for 2006 includes more than 40 companies
or organizations involved in the health field.

How did HPV and cervical cancer rise to the top of the short list of
issues that WIG prioritizes? Crosby said that health has always been a
focus of WIG's work. "Four years ago we heard about HPV, and I must
tell you, at that time we didn't know the difference between HPV and
HIV. We couldn't even say 'Human Papilloma Virus' and they were saying
'Oh! This is the virus that causes cervical cancer.'" WIG created a
task force to look into it and "found out about this test that, used
along with your Pap test, could predict 99.9% whether you had this
virus and we thought, 'Oh my golly! Talk about some opportunities
here. This is unbelievable information and we need to make this
available to all women!' They need to know, when they go in to their
doctor, to say, 'I want an HPV test as well as my Pap.'"

When I raised the issue of Merck pushing for vaccine mandates when it
is currently the only vaccine provider, Crosby responded that
GlaxoSmithKline has now also presented their drug, Cervarix, for FDA
approval. When I noted that Merck, GlaxoSmithKline, and Digene, were
all WIG funders, Crosby responded "and so is Eli Lilly, Bristol Meyer
Squibb -- you could go on and on because of the health issues that we
have championed for years. Obviously, we are going to attract the
attention of that particular industry."

WIG funders also include energy concerns, casinos, alcohol, telecom
interests, Big Tobacco, and lobby firms – all of which could be either
significantly helped or harmed by state-level legislation. Does Crosby
feel such funding compromises WIG, or creates the impression that WIG
might have divided loyalties or interests? "I don't," Crosby replied.
"Because number one, I think it shows that there is not one single
industry or one corporation that is driving Women In Government. …
This is an affirmation that we are a totally unbiased, unprejudiced
group, that we are trying to gain information – the pros and the cons
– on all issues and being able to present that to our legislators for
them to be able to make informed decisions on good public policy."

Crosby emphasized that the funding provided by corporations and
industries are unrestricted grants. "To me," she explained, "I don't
see it as a conflict of interest because they're not funding a
particular legislator or a particular mission." But the funders are
getting direct access to state legislators, in part through WIG's
Legislative Business Roundtable. Crosby explained, "They are people
that come together to help the women legislators identify what the
cutting edge issues are. For instance, we might have someone from
Verizon saying, 'OK, we're looking at telephone deregulation – this
may be an issue you want to get more information on to help educate
your legislators.' Because there’s no way that we have the expertise
to know what some of the coming issues are going to be. So they float
those topics out there and we say, 'Oh, that’s something we definitely
need more information on.'" I asked whether, since Verizon is a WIG
funder, it is safe to say that funders are among the members of the
Roundtable. Crosby confirmed that they are.

Just because WIG is concerned about health doesn't mean they would
refuse funding from Big Tobacco.Just because WIG is concerned about
health doesn't mean they would refuse funding from Big Tobacco.WIG is
also taking funding from the likes of Altria (formerly Philip Morris)
and beer maker Anheuser-Busch. Not exactly stars in the health
promotion pantheon. Referring back to her assertion that WIG wants to
provide women legislators with the good and the bad, the pro and the
con, of each issue, I asked if there is really a pro side to Big
Tobacco, pointing out that on an archived web page listing previous
WIG funders, they listed Altria Group just across from a box that read
"November is Lung Cancer Awareness Month." Crosby replied, "We're
putting the message out there, and it's up to Altria. They know that
we are going to continue to give both the pros and the cons on that
particular topic and they're not going to dictate to Women in
Government, just like no business dictates to Women in Government. …
It's up to Altria if they still want to come to the table and they
do."

"Perceived" conflicts of interest are not enough for WIG to refuse
corporate funding. "I'm sorry that it has happened," Crosby said, "but
I would say that if you know our women legislators, ... you know that
no one particular person or industry is going to tell them or dictate
to them what they're going to do. It's just so sad that they've lost
the focus that this might be the medical breakthrough of the century –
a vaccine against cancer."

Crosby predicts that, when years in the future people look back at
this debate, "All this hoopla will be moot." But some former WIG
supporters disagree. In early January 2007 WIG held their annual state
directors conference on San Marco Island, Florida. Two of those
attending were Marilyn Canavan and Andrea Boland, both Democratic
state legislators from Maine. Both were surprised by the tone of the
sessions devoted to HPV, cervical cancer and mandatory vaccination.
Canavan later told Terry J. Allen, who was writing for CorpWatch, 'The
tenor of presentations - they were not discussions ... (they) seemed
one-sided to me ... I remember thinking as I was leaving the meeting,
'I just don't want to do this ... we need to have public dialogue.'

"Boland also reported a 'pull to get on board [promoting
vaccination]... and when I raised questions, the response was 'Do you
want your daughter to die of cancer?'" As a first-time attendee,
Boland was struck by the role that corporations played in determining
the policy priorities for WIG. "'When discussing what the agenda for
next year would be,' participants were told to 'wait to see who's
funding things.' Similarly before fixing the program for next year,
they 'had to see what the sponsors want.'"

Canavan, a four-term legislator and a WIG state director, resigned
from WIG on March 2, 2007. "An organization that stands to profit,
like a pharmaceutical company, shouldn't be driving the health agenda
in the public realm. You see so many front organizations, I'm not
going to say Women in Government is one, but it matters who's funding
them." She concluded, "When we lose trust in companies like
pharmaceuticals or a group like Women in Government, we start to
become suspicious about everything. We need to have public dialogue.
The point is not that the vaccine is bad, but that the public agenda
has all been company-driven."
How It Plays Out in the States: Wisconsin as a Case Study

Wisconsin State Senator Lena TaylorWisconsin State Senator Lena
TaylorIn Wisconsin, State Senator Lena Taylor, a Democrat representing
Milwaukee, plans to introduce legislation that would ensure HPV
education and would lay the groundwork for an eventual HPV vaccination
mandate. Taylor is a long-time member of Women in Government.

One concern regarding Gardasil and mandating its use is the creation
of a false sense of security for girls and their parents. For example,
on Senator Taylor's website (see below) until June 2007 was a
statement boasting of the the introduction of legislation "that would
add the vaccination for HPV, which is linked to 99.7% of cervical
cancer cases, to the list of required vaccines for Wisconsin girls
entering sixth grade. This legislation can end cervical cancer, which
kills 3,700 women each year, in the next generation of Wisconsin
women." Asked about the clear overstatement of the vaccine's benefit
Taylor's Legislative Assistant Jeff Pertl conceded that the original
posting was in error. "We've changed the language on that, to be
candid. … The initial number we were given by the medical community
was that 99.7% figure. The general number we've been seeing in the
press is 70%, which I think is a more conservative number, and that's
number we've been using now. I would argue that I think it's higher
than that, but in general we've moved to the more conservative
number."

On the issue of negative publicity caused by Merck's heavy-handed
lobbying efforts, Pertl said, "We've consciously tried to keep some
distance from Merck, you know they got some national attention, but
they haven't really been involved here in Wisconsin. … We're trying to
make this about the public health issue. Our bill's bi-partisan and
we're trying to stay out of the quagmire wherever we can."

Regarding the links between the drug companies and Women in
Government, of which Senator Taylor is a long-time member. Pertl
dismissed a correlation between her membership and her work on this
legislation. He said that "while Women in Government did push this
issue in a lot of areas," Taylor's office had gotten more information
and model legislation from the National Conference on State
Legislatures (NCSL) than from WIG. "We didn't get a lot of contact
from Women In Government, and it certainly wasn't like a lobbying
effort, at least not that we were aware of. Again, I can't speak for
the whole country, but I suspect it's a bit overblown, but it's hard
to say." Like WIG, NCSL is also funded by corporations, including
Merck and GlaxoSmithKline.

Did Senator Taylor disclose to her colleagues that she is a member of
a group that receives financial support from those corporations? Pertl
replied, "We didn't actually know that Women in Government receives
funding from Merck until the news story broke, much like everybody
else. We just didn't pay that much attention to the finances, quite
frankly." Addressing the question of revealing WIG's funding to
prevent any perceived conflict of interest, Pertl continued, "When we
found out, we had a conversation with others – there are a lot of
members of the legislature here that are members of Women in
Government … it really wasn't a major concern here."

Pertl concluded with this point. "I think there are two things that
are spiking concern right now, if I can be candid. One is that HPV is
a sexually transmitted disease. If this were transmitted in any other
way, we probably wouldn't be having this conversation. … The second
problem is that if you pass the law today, the news story is today,
even if the implementation is two years from now. … And I think that's
why we might do an education bill first. … Because here's the most
important thing – the public has to have faith."
Meaningful Analysis: Missing In Action

Legislative Aide Jeff Pertl touched on an important, and unfortunate,
aspect of the HPV vaccine issue. Within a polarized political and
religious climate, some conservative organizations and leaders are
against the mandating of HPV vaccines due at least in part to a
concern about encouraging promiscuity, and this has produced a
knee-jerk reaction. Instead of carefully examining the issue, the
response from some has been to endorse the vaccine simply on the
grounds that if the Right is against it, they should be for it.

For example, in the Spring 2007 issue of Ms. magazine, this response,
and the rampant oversimplification and misinterpretation of the HPV
vaccines use and efficacy, is apparent. The author, Cindy Wright,
discussed the overturning of Texas Governor Rick Perry's executive
order mandating vaccination. But she credits the "firestorm" to social
conservatives, not to the controversial ties between Perry, his wife,
Women in Government, and Merck outlined above. In response to the $400
price tag quoted for the three shot regimen (and it might cost even
more), she opines, "Even if I had to pay full price, how could I say
no to the first-ever cancer vaccine? How could anyone? Who would
consider not giving our daughters the best chance of avoiding a deadly
disease?" In fact, regular Pap tests are still the best way to detect
pre-cancerous conditions and to treat them well before they become
cervical cancer. Wright's tone is reminiscent of George W. Bush
claiming, "You're either with us, or with the terrorists." The
implication is that if you're not running to get your daughter
vaccinated, someone should call Child Protective Services.

The Ms. article ends with exactly the attitude that the Gardasil PR
has encouraged, and Merck has been loath to correct. Wright concludes,
"Meanwhile, my daughter has gotten her second booster. That's one less
life-threatening illness to worry about." Is it any coincidence that
Merck's crowning PR push was built around the phrase "One Less"? Let's
hope that Wright's daughter does her homework more thoroughly than her
mother and doesn't assume that she is now fully protected against
cervical cancer. That misperception is what is truly life-threatening.

It is possible to be supportive of the vaccine and widespread access
to it without favoring mandated vaccinations. And it is certainly not
just the Religious Right that opposes HPV vaccine mandates being put
in place at the state level. In February 2007, the American Academy of
Family Physicians cautioned that it was "premature to consider school
entry mandates" for Gardasil "until such time as the long term safety
with widespread use, stability of supply, and economic issues have
been clarified. USA Today quoted Joseph Bocchini, chairman of the
American Academy of Pediatrics' Committee on Infectious Diseases, as
affirming Merck's February 2007 announcement to discontinue its direct
lobbying efforts in favor of vaccine mandates. "At this point,"
Bocchini said, "we really don't know whether we even need to consider
a mandate. We need to get some data over time."

Even though middle school girls were not the focus of the research and
development stages, they have become the target for vaccine
mandates.Even though middle school girls were not the focus of the
research and development stages, they have become the target for
vaccine mandates.Dr. Diane Harper, whom I quoted at length previously
in this series, has serious concerns about mandating the HPV vaccine
for middle-school aged girls. Dr. Harper was involved in designing and
implementing clinical trials for both Merck's Gardasil vaccine and
GlaxoSmithKline's Cervarix. According to Dr. Harper, eleven- and
twelve-year olds have had safety testing, but not efficacy testing.
This means that there is no way to tell how long Gardasil will provide
protection, or when a booster shot might be needed.

So why focus on that age group? "That age range was targeted because
the manufacturer has this vaccine, and they need to recoup their R&D
(research and development) costs. ... But how do you administer this
vaccine? How do you package it and put it out there so that it makes
sense to the public and so that the right public health programs and
different sub section of the medical community 'own' the vaccine?"

Part of the answer is that mid-adolescence is a good age because
vaccinations given in early childhood are coming due for a booster,
and there is a growing realization that many risky behaviors and
conditions, like smoking, depression, and obesity, are emerging at the
that age as well. The manufacturers and the CDC decided to add the HPV
vaccine to a platform of vaccines to give at that age, including
meningitis, pertussis and tetanus updates, pneumococcal vaccine." Dr.
Harper continued, "I think that's a very noble thought, and that it's
a thoughtful way of thinking of where to place the vaccine. The
problem is that in so doing, you lose the concept of what the vaccine
was for, the actual power of the vaccine. It gets folded into the
bigger purpose of helping adolescents have a better health life. But
you lose the fact that women continue to get HPV infections throughout
their lives -- there is no one age when cervical cancer stops. It
pigeon-holes the vaccine into something for twelve-year olds, it also
pigeon-holes it into a wedge to start talking about sexuality."

I asked Dr. Harper to explain her opposition to mandating the vaccine
when she was prominently featured on the agenda of a Women in
Government summit on cervical cancer held in Bay Harbor, MI in July
2005. She replied, "My talks and discussions at that meeting were
identifying the benefits (not the limitations) of the HPV vaccines as
they were being developed. My talks served as an educational platform
so that the benefits scientists were seeing from the clinical trials
could be explained to the legislators in a way they could take back to
their legislative bodies." She continued, "At the time I was working
with WIG, the concept of mandates was either not discussed or very
embryonic in form. ... There was not consensus on the age at which to
vaccinate women with the HPV vaccine, this would not come from the
ACIP until November 2006 with the wording that 11-12 year olds would
be targeted for routine vaccination, and all women 12-26 years old
would also be encouraged to be vaccinated. The Merck representative to
WIG was strongly supporting the concept of mandates later in the WIG
meetings and providing verbiage on which the legislators could base
their proposals."

Dr. Harper reiterated her position to "fully support the use of the
HPV vaccine for women of all ages, and support health insurance, third
party payers to cover this for preventive women's health care. I do
not support the concept of mandates for 12 year olds that keep
children from school if there is insufficient access to the vaccine."
She also indicated that she feels strongly that individual women
legislators have a genuine concern for women's health.
WIG Isn't Alone: Other Ways to Buy Access to State Legislators

Women in Government is not alone in providing its corporate funders
with direct access to the state legislators that can help or harm
their corporate interests through state-level legislation. The
National Foundation for Women Legislators, which works with women in
all levels of elected offices, unabashedly outlines the access to
legislators that Corporate Membership levels, ranging from $5,000 to
$50,000, will buy. At the $50,000 President level, corporate members
can "host (a) conference call with key legislative members on policy
issue" and can also mail to the NFWL membership list four times during
the year. President and Senator ($35,000) level corporate members can
also participate in NFWL leadership activities. NFWL stopped listing
its corporate funders on its website in 2002, but at that time, they
included Merck, Pfizer, SmithKline (pre-merger with Glaxo), PhRMA and
other pharmaceutical interests, not to mention Philip Morris, Enron,
the Chlorine Chemistry Council, the National Rifle Association, and
Exxon. In a 1999 fundraising mailer sent to tobacco company Philip
Morris, now Altria, NFWL promises that "by joining the Corporate
Leadership Circle of the National Foundation for Women Legislators,
you will have the opportunity to lend your expertise and point-of-view
to lawmakers at a number of high-profile, yearly events."

The NCSL Foundation, which is the 501 (C) 3 non-profit that raises
funds to support the programs of the National Conference of State
Legislatures, outlines the benefits on becoming a gold ($10,000) or
silver ($5,000) sponsor of NCSL. Benefits include varying levels of
access to the NCSL leadership and to the member legislators, including
being able to serve on one of the Conference's sub-committees. The
NCSL Foundation lists its funders as including the usual suspects of
pharmaceutical firms (Merck, GlaxoSmithKline, Pfizer and others,
including the lobby group PhRMA), in addition to energy, telecom, and
other deep-pocketed interests. NCSL has a briefing page on HPV and
what is happening at the state level, but does not appear to have yet
taken a pro-mandate stance.

The American Legislative Exchange Council, a network of conservative
legislators that pushes legislation that favors big business and
rollbacks of environmental regulations, also provides direct access
and influence to its corporate funders. ALEC's Health and Human
Services task Force lists individuals from GlaxoSmithKline, Bayer
Health Care, and PhRMA as private sector representatives. At their
April 2007, Task Force Summit meeting, the co-chairs announced the
formation of a one-time Health and Human Service Working Group on HPV
vaccination mandates. This working group will present on the mandate
issue at the ALEC annual meeting at the end of July in Philadelphia.
What Have We Learned?

These first three articles on the Politics and PR of Cervical Cancer
have attempted to untangle the issues surrounding an important health
care topic as it has played out in the U.S. We started with a basic
analysis of the facts around cervical cancer, and what Merck has to
gain by having the first vaccine on the market. We've looked at the
award-winning PR campaign that Edelman produced for Merck and the
non-profits, Cancer Research and Prevention Foundation and Step Up
Women's Network, that helped create a culture of fear couched in the
empowerment of women and girls. We've looked at the lobbying efforts
to push for state mandates of HPV vaccination which has been channeled
through industry-funded non-profits like Women in Government. And
we've outlined the concerns that all the hype and spin are a grave
disservice to women's health. Merck's greed, and the willingness of
its partners to go along with an industry driven campaign, have
compromised the actual promise of the vaccine.

In the fourth and final article, "Profit Knows No Borders, Selling
Gardasil to the Rest of the World," we'll examine developments in
other countries around the issue of HPV vaccination.