Health is a fast-growing trillion dollar industry – but the way in which it is being reported is not healthy, according to Professor Harry Dugmore, who explains why and what has been done to remedy this in The Media magazine.
Health journalism in South Africa is both flourishing and failing. It is flourishing because a few motivated and brave journalists have toiled to do it well. But it is also failing, because there is so little coverage of important health issues and because, to be useful, health journalism has to grasp and explain complex topics in medicine and public policy. It doesn’t do this well enough, often enough.
To explain the developing National Health Insurance plans, or indeed much of how health systems and health economics works, is to engage with genuinely complex material and to try to make sense of it for non-experts. To make sense of this month’s ‘big story’ – that a daily low-dose aspirin and a glass of milk might can cut a person’s chances of dying from cancer by about 10% (and apparently reduce lifetime mortality risks of some cancers by 50%) – and get the actual science, maths and stats right, requires vigilant journalism.
This is true for all journalism, of course. Journalists – from feature mavens to five-stories-a-day reporters – have to be mini-experts in a wide variety of fields; wanting to get it right, and being obsessed with accuracy.
What might be different in health journalism is that there are additional scientific and technical challenges. And, beyond these, there are also all sorts of biases and beliefs (both of journalist and audiences) that have to be unpacked and often confronted. Our existential duel with our own mortality; our views on what makes us ill and what gets us better, are ingrained in cultural practice, power relations, and ideological positioning.
Nothing is uncontested.
Trillions of dollars are at stake too. By many measures, health is the fastest-growing industry in the world. The technology changes incessantly, costs only seem to escalate and profit margins are usually stunning. In the 21st century, the lines between big pharmaceutical companies, food companies and ‘alternative’ medicine suppliers are blurring into multinational behemoths.
Hospital companies, health insurers and state medical all have a story to tell. They employ and deploy mini-armies of public relations experts to tell those stories.
The media, by contrast, are often able to devote only a single reporter to a story, say for example a new drug launch, who are then faced with an army of seasoned public relations people giving out telephone directory-sized press packs and running ‘fact’-laden audiovisual presentations.
Take, for example, a media hullabaloo late last year that followed the release of a ‘national health survey’ conducted for a leading multinational pharmaceutical company. Dozens of headlines such as ‘Fat South Africans in denial’, ‘SA’s fattest city’ (reputably Cape Town) and ‘South Africa’s the third fattest country in the world’ screamed out from, in particular, online news sites.
While the headlines highlighted a real and growing epidemic of obesity in South Africa, there was little comment on the survey’s methodology or the fact that the survey results were released by GlaxoSmithKline as part of the South African launch of Orlistat, now released in South Africa as an over-the-counter weight-loss medication.
This ‘national survey’ found that “61% of South Africans are overweight”, as measured by the yardstick of having a body mass index in excess of 25kg/m2.
How did they know? The stories were based on asking people to estimate their weight (do you know your weight right now?) that sampled just 500 South Africans and was commissioned by GlaxoSmithKline.
The opinion-seeking methodology of the survey and the linking of such ‘research’ to a launch of a contentious (and potentially dangerous) weight-loss drug by the world’s third-largest pharmaceutical company by revenue was never questioned by journalists.
Part of the challenge for journalists is that the ‘research’ conducted does pick up on the right trends, so that seems to be fine… and who’s got time to really press on something clearly on the right track?
But even a quick glance at the methodology of the survey would indicate that it is neither scientific, nor academic, nor rigorous. It’s a public relations stunt. And it worked – the launch generated a lot of column inches about ‘fat South Africa’. Indeed, many of the news stories paint a pretty hopeless situation. It seems that nothing can be done.
But, wait… there’s a newish drug, once only available by doctors’ prescription, but now available to you over the counter. A drug made available by the same company that commissioned the ‘national survey’ that produced seemingly hard numbers with their own ‘confidence levels’ that try very hard to sound like they come from some kind of ‘scientific’ exercise.
What’s scary is that no journalist at all looked at the now freely available weight-loss drug, its purported efficacy, its side effects and real dangers, and the international controversy over its shift from prescription to non-prescription status. Arguably, that is neither GlaxoSmithKline’s nor its public relations company Magna Carta’s fault. They were, after all, just doing their jobs.
This is a fairly random example of why we need more health journalists and better education of both health journalists and the general population. We’re hoping that the newly established Discovery Health-sponsored Centre for Health Journalism at Rhodes University will be able to play a role in providing such training.
The new Media Studies Honours degree with a specialisation in health journalism, starting this year, as well as a host of other initiatives – including short courses for working journalists and online resources – aims to equip journalists better to cover more health issues, in better ways.
Of course, Discovery Health is a big player in the health industry in South Africa and has vested interests and strong positions, as do all players. In starting a Centre for Health Journalism with its substantial sponsorship, we had to be sure we could create training for journalists that does what this article suggests is desperately needed: much more fair, wide-ranging and fearless health journalism.
At the launch of the centre, Dr Jonathan Broomberg, CEO of Discovery Health, said he hoped the centre “will make a significant contribution to the overall quality and quantity of health journalism in South Africa. By promoting excellence in health journalism, we hope to raise the level of national debate on healthcare systems and improve the public’s understanding of health issues.”
That doesn’t mean going soft on medical insurers, including our sponsors. It means committing to helping journalists do the best job they can in a field where poor journalism can have life and death consequences.
This story was first published in The Media magazine in March 2011.
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