Pharmaceutical Ethics and Grassroots Activism in the United States: A Social History Perspective

J Bioeth Inq. 2020 Mar;17(1):49-60. doi: 10.1007/s11673-019-09956-8. Epub 2020 Jan 17.


Women's health activists laid the groundwork for passage of the law that created the U.S. Food and Drug Administration in 1906. The pharmaceutical and food industries fought regulatory reforms then and continue to do so now. We examine public health activism in the Progressive Era, the postwar era and the present day. The women's health movement began in the 1960s, and criticized both the pharmaceutical industry and the medical establishment. In the 1990s, patient advocacy groups began accepting industry funds; thousands of commercially-funded groups now dominate the advocacy landscape. As pharma funding became normalized, concerns arose regarding a) the lack of transparency and public accountability regarding funding, b) the distortion of groups' agendas, and c) the ability of pharma-funded groups to dominate the discourse and override less well-resourced patient and health advocacy groups. Although industry-funded groups argue that funding allows them to provide useful services, the trade-off in health risks, exorbitant prices and distorted information is far too high. Sincerity is beside the point; patients and the industry have differing interests when it comes to drug safety and efficacy, drug information and drug prices. A growing resistance movement is asserting the values of its activist predecessors and opposing the prevailing culture of pharma-funded advocacy.

Keywords: Advocacy; FDA; Marketing; Patient groups; Pharmaceutical industry; Public health history; Regulation.

Publication types

  • Historical Article

MeSH terms

  • Drug Industry / ethics*
  • Female
  • Financial Support / ethics*
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Male
  • Political Activism*
  • Public Health / history*
  • Public Health / legislation & jurisprudence
  • Public Policy / history*
  • Public Policy / legislation & jurisprudence
  • Social Change / history*
  • United States
  • United States Food and Drug Administration / history
  • United States Food and Drug Administration / legislation & jurisprudence
  • Women / history