Fear is power: The link between public health concerns and corporate profit

The 2023 dengue outbreak should still be fresh in memories. 

About 1,700 people died – more than the combined deaths between 2000 to 2022 - and 3,00,000 were affected. Among the deaths, a significant portion was of children.

It caused unfathomable panic, mental trauma, grief and financial strain among many. And if the predictions of scientists come true – this year's outbreak is surpassing 2023. 

While major national crises like dengue wreak havoc through the communities, for consumer product industries, like mosquito repellants, any such public emergency means monsoons for record profits.

The same was observed during the peak of the Covid pandemic – which took about 29,000 lives between February 2020 and February 2022 in Bangladesh, and a massive economic scuffle. 

Sales of plastic-bottled hand sanitisers skyrocketed, alongside other products that managed to draw direct and indirect links to individual and collective efforts to fight the infection.  

While consumer products such as repellents and sanitisers can certainly play a role in improving public health, their actual ability to directly fight public health emergencies can often be tenuous. 

For example, according to research, repellants have little ability to kill aedes mosquitoes, which is responsible for spreading dengue; while by the second year of the pandemic, the effectiveness of sanitisers in controlling the spread of Covid-19 came under serious scrutiny.  

It turns out the fear of disease and sale of protective equipment are strongly correlated, and clearly, manufacturers have not been hesitant to exploit the grey area between.

'Brandwashing'

Martin Lindstrom, a Danish author and former Time magazine Influential 100 Honouree, in his 2011 book "Brandwashed" discussed how corporations and advertisers conspire to allure the customers in buying their products. 

One of his key focuses was selling fear. 

In 2007, UCLA neurobiologist Michael Fanselow said that fear is "far, far more powerful than reason" and "it evolved as a mechanism to protect us from life-threatening situations, and from an evolutionary standpoint there's nothing more important than that."

This is where advertisers and companies take advantage for selling products, as Lindstrom goes, "Advertisers prey on our fears of our worst selves by activating insecurities that we didn't even know we had ………."

Lindstrom detailed the story of how antiviral toiletries became household commonplace, in the Western hemisphere, during the SARS and H1N1 swine flu outbreaks – more than a decade before the Covid.

As a marketing strategy, for instance, Lysol would first sell to the audience how the flu was deadly, and that while "it is not clear how the virus spreads", which was clearly misleading, maintaining proper hygiene using their products would keep one safe. 

Lindstrom would also mention another antiviral tissue commercial claiming that it was "99.9%" effective against flu viruses - never clarifying the scientific validity.    

You may wonder how many of exactly similar commercials you saw during the pandemic.

This is not to say that commercial hand-sanitisers are of no significant use in reducing pathogens, for example the novel coronavirus - especially from surfaces. 

In the early months of the Covid pandemic, sale of hand gels was at its peak. However, in late 2020, a Lancet article by Emmanuel Goldman suggested that the risk of Covid transmission from surfaces was "exaggerated".

Later studies would suggest that the efficacy of hand hygiene toiletries in preventing Covid-19 was unclear. However, it did not stop corporations from making loads of money.

From 2019 to 2020, the global hand-sanitiser market alone grew from $1.1 billion to $6.3 billion.

How it works: 'Cue, Routine, and Reward'

To anyone's surprise, the exploit mechanism is incredibly simple. It involves a cycle of three steps: cue (craving), routine (craving responses), and reward (craving outcome). 

As Claude C. Hopkins, the American advertiser pioneering global branding of Pepsodent in the early 1900s, suggested - the most important aspect is making people crave for consumption. 

This is where advertising usually steps into the murky area between fact and fable. 

The most used tactic involves taking cut-and-dry hard facts, such as data and conclusions from science studies, and phrasing texts in a manner that the consumers, who often have less access to facts, would be driven to try the products.

Once the craving has been set, the next task is to make sure that the consumers turn their urges into habits (routines) – because only then positive outcomes (rewards) would be apparent. 

And repeat the cycle. 

To apply the three-way model, let us take a 20 second long commercial by one of the most well-known personal-care giants of Bangladesh.

The commercial is an awareness campaign on novel coronavirus. 

It starts with a disclaimer that "This is not an advertisement" and describes easy steps to fight the coronavirus.

But then the commercial shows a hand holding a company-logoed hand gel, and recommends "Instant germ-kill with sanitizer/hand wash when out of home," all in block letters.

Only after that does the commercial urge people to stay home, cover their face while coughing or sneezing, and visiting doctors. 

This was posted on YouTube in early January 2020 – at that time Covid 19 had merely spread in China, and understanding of the virus was at its infancy. 

One may question how the people involved with the commercial knew that early that handgels would be a major cure – whereas measures such as vaccination, physical distancing, and covering faces in public would later be proven as, by far, more effective.

Nevertheless, here was the cue that a deadly disease was looming and consumers must use hand gels whenever they are out of home (routine) which will keep them safe (reward). 

During the 2019 dengue outbreak, another commercial was broadcast in Bangladeshi cable channels, sponsored by a major South Asian mosquito repellent manufacturer.      

 Their mosquito repellents can be seen in every local- and superstores of the country. 

Here, a medical practitioner from a renowned private medical college discusses steps to follow for dengue prevention. 

As he speaks - specifically when he discusses necessities of mosquito repellants at schools, offices, and even households with "nets on the windows" - teasers of a certain mosquito aerosol brand flash at the bottom.  

These teasers claim that the particular brand "means not a single mosquito carrying the dengue virus survives", and "move forward in preventing dengue" while images of a labelled aerosol bottle appear.

The campaign stays subtle in throwing the cue (an already public emergency when the video was posted), suggesting the routine (use their mosquito repellent), and discussing rewards (stay safe from dengue). 

How authentic are commercials' claims?

Worldwide, whenever there has been a public health crisis – manufacturers, retailers and advertisers act promptly in profiting. 

During the peak of the 2023 dengue outbreak in the country, around July to September, the price of aerosols increased by Tk35 to Tk50 per can, when that of mosquito nets hiked by Tk50 to Tk200. 

In 2022, the money spent on purchasing anti-mosquito electric rackets was worth Tk45 crore.

Prior to that, in 2019, the mosquito repellant market was worth in total Tk1,579 crore, which was 48% more compared to two years earlier.

However, a 2023 collaboration between Bangladeshi, Australian and American entomologists revealed that the common Bangladeshi aerosol brands are unable to kill almost 74% of the resting Aedes aegypti variant.

The researchers discovered metabolic functions in the Aedes mosquitoes of Dhaka that made them resistant to pyrethroids – a class of chemicals ubiquitous in common Bangladeshi mosquito sprays. 

What does this mean in the long run?

This means two things. 

First, the bombastic claims that advertisers and companies make about the efficiency of these products are clearly misleading. In the end, it is the profit that is ensured, while the public are often deprived of the reward – i.e., health and well-being. 

Lindstrom described it simply but beautifully, "whether it's germs or disease ………… marketeers are amazingly adept at identifying a fear out of the zeitgeist …………… and preying on it in ways that hit us at the deepest subconscious level." 

This brings to the second – that from an ethical standpoint, it is essential that companies rather consider scientific results, and plan for improved formulation. 

Given it would be impractical to bar such marketing entirely, education about the processes, as Lindstrom suggests, is vital for helping people make smarter and selective consumption decisions.

This helps the public not fall victim to fearmongering, and more importantly, ensures the focus on government bodies that are responsible for protecting public health has not been deflected.