National Nurses United

SEIU:2 4/24/08 12:35 AM Page 16 SEIU planned to use these types of elections as a cornerstone to much of its future organizing. SEIU is extremely angry the CNA/NNOC foiled the first test of its strategy, so in the past month has dispatched hundreds of out-ofstate staff to California to disrupt CNA/NNOC facilities and members' work, even going so far as to confront, harass, and videotape board of director members at their homes. At one point, CNA/NNOC even obtained a temporary restraining order against SEIU. And on Saturday, April 12, several hundred SEIU members literally crashed a labor conference banquet in Michigan, punching, shoving, and trampling attendees who blocked their way as they tried to rush the stage. Since SEIU will be distorting facts and trying to discredit CNA/NNOC in order to fracture RN unity, let's take a moment to review CNA/NNOC's track record. CNA/NNOC is the nation's fastest-growing staff nurse union and counts 80,000 members in all 50 states, with bargaining units in California, Illinois, Nevada, Maine, Pennsylvania, and Texas. The California Nurses Association established the National Nurses Organizing Committee, its national wing, in 2004 in response to multiple requests from RNs for a serious national RN movement that achieves results. Some of what CNA/NNOC has been able to accomplish with member activism and resources include passing California's landmark staffing ratios, winning contract provisions such as pensions, which are now a statewide industry standard, and growing a national nurses' movement. In 2005, the nurses shot down Gov. Arnold Schwarzenegger's attempt to weaken ratios, eliminate public-sector pensions, and replace the Board of Registered Nursing with a nonnursing agency. Also that year, CNA/NNOC mobilized over 300 RNs across the country to perform disaster relief work after Hurricane Katrina, subsequently founding the RN Relief Network to coordinate future volunteer efforts. In just this year, RNs fought off phony healthcare reforms in California, defeated backroom deals brokered between SEIU and hospital management, and organized the first union hospital in Texas. Arguably one of the most important reforms accomplished by the RN movement, RN-to-patient ratios perfectly illustrate the difficult put his name to the letter. A half dozen phone calls to IAEP, leaving messages for Levy, IAEP President David Holway, IAEP's legal department and IAEP's national communications director, Stephanie Zaiser, yielded only a response from Zaiser. According to Zaiser, IAEP's national president, Holway, had not known that Levy was sending out such a letter, and that IAEP has since made a policy that the organization does not endorse specific drugs. When I pointed out that letters were sent out as recently as a few days ago and asked when the new policy was put in place, she said she didn't know. When I asked if IAEP had any financial relationship with Pfizer, or had ever taken a contribution from Pfizer, she said she didn't know. When I asked whether Levy's signing of such a letter, stating that the "union leadership" backed Lipitor, without the knowledge of the rest of the union leadership, had had any repercussions for Levy, she said she didn't know. When I asked if she could go back and ask Holway those questions, she said "no." When I asked for Holway's phone number (which I subsequently found) she said she didn't have it. When Holway's assistant contacted him on his cell phone and told him that I was on the line, he said that the communications director had already answered my questions. I concluded that IAEP really doesn't want to talk about the Lipitor letter. What is particularly disturbing, says Dr. Fernandez, is that this is not the first time she has seen a drug maker use a progressive organization for cover. Fernandez, who specializes in disparities in the medical care that people of different races receive, then told me a story about BiDil, a heart failure drug approved by the Food and Drug Administration for the treatment of African-American patients. In this case, the manufacturer persuaded the New England branch of the NAACP to back the drug. "BiDil is not designed to target heart failure in African Americans. It is not even a new medication. Actually, it's a combination of two older, generic medications that have long been approved for use among all patients with heart failure, regardless of race," Fernandez explained. "NitroMed, the maker of BiDil, initially sought patent protection for this 'new' combo pill to market to all patients with heart failure. The FDA denied that request." "NitroMed then opted for the next-best strategy," says Fernandez, "applying for patent protection for treating African-American patients with heart failure. The company argued its case both on the basis of science (the drug's efficacy had clearly been demonstrated in a study that included only African-American heart failure patients) and on the basis of combating racial disparities in health. The FDA agreed to approve the pill, but rather than issuing a broad-based approval (as it routinely does with studies that include only white patients), the agency made the unfortunate, and controversial, choice of limiting the drug's approval to the treatment of heart failure in African Americans." In 2007, Fernandez wrote an article about BiDil for the Annals of Internal Medicine. The FDA published a rebuttal. Meanwhile, Medicare refused the cover BiDil and the NAACP's New England branch accused the agency of racism. Sadly, "the venerable civil rights organization has fallen for the same marketing ploy that the FDA did in approving BiDil in the first place, and that could set a dangerous precedent in the struggle to end racial disparities in health," Fernandez observes. She also notes that the Wall Street Journal reported that NitroMed had made a whopping $1.5 million grant donation to the NAACP. Fernandez then wrote an op-ed piece for the San Francisco Chronicle, describing how "NitroMed's strategy has paid off. Its combo pill now has patent protection, allowing the company to increase the price of the 'new' medication far above the cost of its two generic components [BiDil costs about $3,000 a year more than its generic components]. What's worse, though, is that the FDA's approval created the misperception of a race-specific drug effect and paved the way for more race-based marketing of pharmaceutical products. "Marketing to particular groups is a lucrative strategy for many products, from soft drinks to cars," she continued. "Harnessing the political rhetoric of the moment is not new. Virginia Slims successfully used the rhetoric of feminism to sell cigarettes with the iconic 'You've come a long way, baby' ad campaign, while ignoring the harmful effects of tobacco. "That's what the FDA's approval has done for BiDil. Claiming a race-specific effect not only helped NitroMed gain patent protection, it defined a market niche. The use of civil rights rhetoric for BiDil masks the NitroMed's real goal: selling an expensive 'new' pill made from two cheap old ones." 16 REGISTERED NURSE W W W. C A L N U R S E S . O R G APRIL 2008

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