The use of social marketing in international development, especially for health improvement, gets a critical look in today's Boston Globe (A handout, not a hand up).
In public health, many aid groups have embraced a strategy of stimulating demand for goods such as condoms, anti-malaria bed nets, and water-purification systems through education and advertising, and then selling them at very low prices through health clinics, kiosks, and itinerant vendors. One goal of this strategy, called "social marketing," is to create homegrown distribution networks that wouldn't exist if the products were simply given away. But another has been to persuade people to value products that are good for them, and for several decades it's been the conventional wisdom that unless people spend money on something they will be unlikely to value it - or use it. Give things away and they will be taken for granted, it's thought...
But in the last couple of years there has been a sharp backlash against this philosophy that has pushed its practitioners off-balance and led economists to take sides. Some officials with the World Health Organization have started to speak out against the practice. High-profile development scholars, including the Columbia University economist Jeffrey Sachs, have joined a chorus of criticism, and several economic studies have chipped away at the rationale behind social marketing.
The focus of the piece is on two recent studies that question the relative value of social marketing to free distribution methods. And while the balanced part of the piece does include some proponents calling for complementarity in strategies, the media advocate in me realizes that when your opponent gets the first and last word in, the reporter's mind was made up.
What puzzles me is that the reporters and commentators on this issue leave unexamined comments by the 'free distribution' advocates such as this: Kremer argues that the logic of "free = life" has been so amply
demonstrated that it should be extended to every basic health good,
including condoms. Start adding up the costs for subsidizing health-related products such as food, condoms, bednets, soap, clean cooking fuels, AZT, ACT, clean water supplies, vitamin supplements, oral rehydration salts and therapies, treatments for tuberculosis and pneumonia, reproductive health products and services, tobacco cessation programs, obesity prevention programs, treatments for mental illnesses, and ... [add your own favorites here] and I wonder where all the resources will come from, and what the trade-offs would be. Yet, while the article is framed by the idea of trying to achieve sustainability in development programs (more on social marketing approaches to sustainability) these questions remain curiously unaddressed and unexplored. We should be talking about realities, not ideologies, and seeking practical and sustainable approaches to improving the health and social conditions of poor and vulnerable peoples.
I do hope that this conversation leads to more research on which to establish an evidence base that addresses the question: Which distribution and pricing strategies, promoted for which products and services, under what conditions, work for specific groups of people? And if you like, don't call it marketing.
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