Hep C stigma as a pharmaceutical marketing device

A new campaign funded by Janssen-Cilag P/L under the Hepatitis Australia brand uses Hep C stigma to drive users to its product.

Update 31/7/13: Hepatitis Australia has announced they’ve removed the video. Well done all who expressed their concerns to Hep Aust and Janssen-Cilag P/L.

Update 1/8/13: And they’ve uploaded a new version!  See the video below.  Thanks to Lyn Carruthers for pointing this out.  What do you make of it?  Feel free to post your thoughts in the comments.


At first glance this looked like an anti-stigma message. Forcing people living with blood borne viruses to use their own crockery is an extremely common form of discrimination linked to HIV and viral hepatitis stigmas.

Under Australia’s national strategies for blood borne viruses, community organisations have three main goals: (1) promote prevention; (2) promote treatment; and (3) challenge stigma.

Challenging stigma is essential to achieving our prevention and treatment goals. When stigma is strong, people may feel they’d rather not know their status. People who don’t know their status can’t get treatment. People on treatment may hide their status to avoid stigma, and as a consequence, don’t receive the support they need from friends, partners and family.

So I waited for the ad to pivot to a conclusion challenging the discrimination and stigma it portrays.

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My last post was about a personal experience of discrimination linked to HIV stigma that I had on a gay chat application.

In that post I talked through some of the different theories about stigma, each one contributing a different piece of the puzzle. I argued that stigma is an inherently multi-level, complex concept.

In one influential definition by Bruce Link and Jo Phelan (2001), stigma consists of five components occurring together. We can see all of them in the hep C advertisement:

  • Labelling — the paper bag saying “I have Hep C” placed over Vladimir’s head in the ad;
  • Stereotyping — Vladimir’s co-workers believe he poses a threat of infection through casual contact;
  • Separation — his ex-partner, co-workers and football team mates see Vladimir as ‘other’ because of his Hep C status;
  • Status loss and discrimination — Vladimir is singled out and excluded in love, at work and on the footy field, and his identity as a lover, colleague and teammate in good standing is ‘spoiled’ (Goffman, 1967);
  • Power relations — these actions occur within the workplace and a sporting contest — environments where individual personality is expected to be subordinated within a hierarchical social structure; rejected as a lover as well, Vladimir is also denied entry to a caring and supportive relationship of equals.

For a short clip, it packs in some pretty heavy themes. The heavier it gets, the more important it is for viewers to see the clip pivot and challenge the stigma underlying  the discrimination Vladimir experiences.

What we see is Vladimir tearing the paper bag off his head in disgust, deciding to go visit and talk to his GP.

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In Australia, it is illegal to advertise a prescription medicine direct to consumers. ‘Talk to your GP’ is code for ‘there’s a new product on the market that can treat the condition described in this advertisement’.

The implication is that Vladimir is going to get treated and stop allowing himself to be labelled Hep C-positive. All of the other dimensions of stigma will remain completely unchallenged — they just won’t apply to Vladimir anymore, once he’s cured.

Janssen-Cilag P/L has new anti-hepatitis C drugs on the market. That’s why they’re funding this clip. The clip itself was uploaded by Hepatitis Australia in the Nonprofits & Activism category of Youtube, but the “See the Real Thing” campaign website contains the following statement:

This website is published by Janssen-Cilag Pty Limited (Janssen-Cilag), which is solely responsible for its content. It is intended for Australian residents. Last updated on 08 July 2013.

Even though the video was selected by a competition involving members of the public, the prize money was funded by a drug company and the clip directs people to a website for which a drug company is solely responsible.

From a stigma point of view it has the potential to cause the following harms:

  • By vividly portraying but not challenging stigma and discrimination, it reinforces hepatitis C stigma;
  • It places the onus on the target of stigma/discrimination to take steps to evade it;
  • It uses the stigma/discrimination portrayed to place marketing pressure on people to get treatment;
  • If it works, the funders will have a commercial interest in the stigma not being challenged.

I am surprised and disappointed in the management and Board of Hepatitis Australia lending their brand and organisational credibility to a message that is so obviously counter to the National Hepatitis C Strategy principles.

Let’s be clear: we need more people getting treatment for hepatitis C. Newer treatments are easier to take than before. Taking hepatitis C treatment can lead to people being cured of hepatitis C, reducing their risk of liver failure and liver cancer and meaning they no longer need worry about passing it on to others.

But treatment doesn’t work for everyone, and not everyone is ready for treatment. A supportive environment, free from stigma and discrimination, is essential to motivate people to get treated and to minimise the impact on people for whom treatment hasn’t worked or isn’t appropriate. This campaign is a step in the wrong direction.