The Susan G. Komen for the Cure foundation took another step toward rehabilitating its standing in the breast cancer community with the resignation of the executive at the center of the Planned Parenthood funding controversy.
In a largely conciliatory letter, Karen Handel, senior vice president for public policy, said Tuesday that she would step down immediately so the organization could "refocus its attention and energies on its mission."
"I am deeply disappointed by the gross mischaracterizations of the strategy, its rationale, and my involvement in it," Handel wrote, adding that she declined Komen's offer of a severance package. Handel is a self-described pro-life Christian who became the main target of Planned Parenthood supporters as the funding dispute unfolded last week.
The injection of abortion politics into the mission of fighting breast cancer has prompted thousands of Komen supporters to reevaluate the nonprofit group that encouraged them to wear pink ribbons, participate in 5K fundraising races and buy products from companies that pledged to donate some of the proceeds to the charity.
Many of them now say they are uncomfortable with the size of the foundation's executive salaries, lawsuits against smaller nonprofit groups, partnerships with companies whose products may increase breast cancer risk and lack of investment in research to prevent and treat the disease.
"The Planned Parenthood controversy is just the culmination of things that have been happening for a while," said Samantha King, a professor in the School of Kinesiology and Health Studies at Queen's University in Kingston, Canada, and author of the book "Pink Ribbons, Inc."
Komen officials did not respond to requests to discuss the matter Tuesday.
Among nonprofit organizations, the Komen foundation has long inspired admiration and a little envy, said Daniel Borochoff, president of Chicago-based CharityWatch. Other groups are "probably jealous of their success," which may come at the expense of other cancer charities' fundraising, he said.
But the Dallas-based organization has also become known for antagonizing smaller nonprofit groups, Borochoff said. As many as 80 charities have received letters from Komen attorneys over the years asking them to refrain from using the Komen-trademarked pink ribbon or the catchphrase "for the cure."
When Uniting Against Lung Cancer organized a 2010 event in which people flew kites to remember loved ones who died of the disease, it got a cease-and-desist letter from Komen because it called the event "Kites for the Cure." The New York-based charity spent more than a year tussling with Komen lawyers before resolving the issue with the right to use the name.
"It was a very big disappointment to our organization ... that we had to be distracted and spend resources on a legal action from another advocacy organization," said Executive Director Linda Wenger.
Michael N. Mercanti, managing partner for the New York law firm Lucas & Mercanti, said his firm provided free legal services to a small charity in Minnesota that organized dog sled races to raise money for breast cancer research. Aided by the big-city lawyers, "Mush for a Cure" beat back Komen's challenge.
"They shouldn't be spending money on lawyers when people give their donations to find cures for breast cancer," Mercanti said.
Groups focused on women's health have also taken issue with some of Komen's corporate partnerships.
In 2010, Komen teamed up with KFC in a promotion called "Buckets for the Cure," which raised $4.2 million for the charity through sales of pink buckets of chicken. Critics questioned the wisdom of partnering with a fast-food company known for serving fried, high-calorie food; obesity and a high-fat diet have both been linked to an increased breast cancer risk.
Komen's corporate ties prompted Breast Cancer Action, a San Francisco-based advocacy group, to launch its "Think Before You Pink" campaign 11 years ago, aimed at alerting consumers to products with pink ribbons that could raise their breast cancer risk.
"What we kind of see is an ever-increasing desire to build the money in their coffers, and then Komen starting to justify those partnerships," said Patricia Bellasalma, president of California NOW, the state chapter of the National Organization for Women.
Critics also worry that those partnerships discourage Komen from funding research on whether industrial pollutants cause breast cancer, Bellasalma said.
However, Komen paid almost $1 million to sponsor an independent review of the scientific evidence on environmental causes of breast cancer, which was released by the Institute of Medicine in December. The report said that evidence was lacking to establish clear-cut risks but that more research was needed.
Komen has been accused of paying its executives exorbitant salaries and spending too much on lavish events and too little on research.
But experts on charity finance said that some of those criticisms missed the mark.
According to Chuck McLean, vice president for research at GuideStar, a nonprofit tracker in Williamsburg, Va., Komen's tax filings indicate that it spent 77% of its income on programs in the year that ended March 31, 2011. Though some would consider this relatively low, it can be difficult to compare numbers between charities.
"The rules for classifying expenses are extremely vague," said Peter Frumkin, director of the RGK Center for Philanthropy and Community Service at the University of Texas in Austin. "One organization would see a secretary and say, 'Her job is administrative.' Another would say, 'She's critical to our program work.' "
McLean calculated that it costs Komen about 11 cents to raise a dollar, a ratio that's "very typical."
And Komen Chief Executive Nancy J. Brinker's 2010 compensation of $417,171 was in line with salaries of heads of other large philanthropies. Among charities that take in between $200 million and $500 million each year, the average chief executive salary is $430,000, according to CharityWatch.
"It's a real eye-opener for a lot of people," said Ken Berger, chief executive of Charity Navigator, which rates the efficiency and organizational stability of nonprofit groups. "But Susan G. Komen is one of the largest nonprofits in the U.S."
CharityWatch recently downgraded Komen from a B+ rating to a B in part because, according to Borochoff's estimates, its fundraising costs had climbed from 17 cents per dollar to about 25 cents per dollar in the last year.
Other breast cancer nonprofit groups have higher ratings from CharityWatch — the Breast Cancer Research Foundation earned an A+ and the National Breast Cancer Coalition Fund an A.
But, Borochoff emphasized, a B is still a very good rating and Komen's growth has remained impressive. In the last year, the group's income rose from $400 million to $440 million. "In this economy, 10% growth is pretty good," he said.
Komen's audited financial statements show that it spent $181 million on public health education and $75 million on research in the year ending March 31. In a news conference last week, Brinker said she wanted to boost the foundation's funding of research.
"One could certainly make an argument that they'd rather see more of the money go to finding a cure," Borochoff said.
Special correspondent Christie Aschwanden in Cedaredge, Colo., contributed to this report.