Spending Strategy

DISEASE CAMPAIGNS are among the few battles Americans today can agree to fight together. 

Think Race for the Cure, which unifies people of all classes, races, and genders against a common, uncontroversial enemy: breast cancer.

In Common Enemies (Oxford University Press, 2019), sociologist Rachel Kahn Best ’04 digs deep into the generous well of American philanthropy to examine how and why dollars are spent the way they are. She also questions how the most successful activist campaigns affect government spending and research.

Best’s enormous trove of data establishes the first comprehensive look at disease campaigns in America. She found that they tend to target narrow categories, neglect stigmatized diseases, and avoid controversial goals. HIV/AIDS is the exception. 

The approach has successfully decreased tuberculosis, polio, sickle cell anemia, and cervical, colon, and breast cancer. However, the data also found that with this approach, important diseases are bypassed for funding, research, prevention, and awareness. Although America funds more biomedical research than any other country, resources tend to be funneled to the least controversial diseases.     

Still, Best concludes: “Disease campaigns are limited and lopsided but also big-hearted and bounteous, and they do more good than harm.”