IAPC and WYP's The ‘last laugh' breaks taboo around death by laughing at it

In India, talking about death is taboo. So, the terminally ill and their families, or even their doctors, do not discuss death, let alone palliative care. Go break the taboo and inspire a cultural change, the campaign conceptualised by What’s The Problem for The Indian Association of Palliative Care covered multiple related objectives, reaching multiple target audiences across media:

1. Reaching both consumers and healthcare professionals
2. Initiating conversations as an event through social media and influencers but amplifying them through mass media and PR
3. Establishing media partnerships to drive opinion
4. Creating content platforms that didn’t just provide information but counselled patients and trained doctors.

Economist Intelligence Unit in 2015 ranked India's end-of-life care last among 40 countries, giving a score of 2/5 in public awareness, attributing it partly to reluctance to openly discuss death. The brand needed to drive palliative care, not just acceptance of death.

WYP met the terminally ill and their families through the IAPC network and unearthed the insight: Palliative care helps people accept death, even laugh about it. This led to the idea of the Last Laugh – A stand-up comedy show performed by the terminally ill to break the taboo. Palliative care counsellors and India’s best comedians joined hands to screen, train and support these patients. The shows with their recordings and coverage became the campaign. Using comedy to discuss death resolved several challenges. Comedy, coming from these patients, could demonstrate that palliative care helps the terminally ill get comfortable with death, even joke about it. Comedy, coming from these patients, could break the taboo – if these patients staring at death can joke about it, then why can’t it be discussed.

After IAPC’s ‘Last Words’ campaign in 2016, consumer awareness of palliative care in urban audiences in India was less than 15%, doctor awareness was 100%, doctor conviction was less than 80%, still access to palliative care is 1%.

Breaking a cultural taboo and low budgets both necessitated seeding on social media, extensive use of influencers, driving deeper conversations through user-generated content, and the use of earned media that has greater credibility.

In addition, the conversation was amplified through mass media partnerships and coverage on TV, radio, print and online. On each platform, the campaign extended the idea of using humour to start conversations on death – launching with Twitter’s first live comedy show or co-producing a half-hour comedy segment on India’s pioneering television news network.

The biggest execution challenge was working with terminally ill patients. So, palliative care counsellors and India’s best comedians screened them and spent weeks with them, converting experiences with death/dying into stand-up comedy. The show with its recordings/coverage became the brand campaign, featuring as a 30-minute comedy segment on India’s leading television news network and across India’s #1 radio network. The campaign launched on social with the first-ever live comedy show on Twitter, utilising the comedians’ fan-bases. Seed media on Facebook, search-optimising on YouTube and leveraging the influencers on WhatsApp further took it viral.

Online PR and our digital media partner drove opinion. Medical PR with partner associations and through doctor groups on Facebook/WhatsApp drove unprecedented online doctor recommendations. PR outreach in India and globally gave the campaign scale to break the taboo. The website provided counselling support and trained doctors to discuss death.

The campaign set out to break a taboo and ended up changing culture. Seeing the terminally ill laugh at death, Indians questioned our ingrained fear of discussing death, and palliative care truly entered the Indian lexicon.

The campaign trended at #1 all-India on Twitter, at #3 on YouTube, went viral on Facebook with 36,000 shares, became a viral sensation on WhatsApp (India’s #1 mobile-messaging platform), inspired India’s largest zero-cost media partnerships (other than entertainment), made it to the front pages on India’s leading newspapers, aired as a full television show, aired as a week-long radio special, and even had global impact through coverage on BBC World News. Together, they garnered over 3 million dollars of earned media, 300 million impressions, 3 million video views and reached 80% Indian doctors. All with less than $10,000 of total spends. Importantly, a country that was scared to even talk about death is now laughing at it. 

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