# Misleading Advertising of Health-Related Products in Ecuador during the COVID-19 Pandemic
## 1 Introduction  
Media coverage of the COVID-19 pandemic is unprecedented; the media significantly increased their tuning ratings (the number of people watching a television program) during this time [1, 2]. The COVID-19 pandemic also saw the parallel development of what has been called an \"infodemic\", or a massive dissemination of information related to the disease through all media [3]. A substantial portion of this information concerning drugs or products with no demonstrated activity, then its use could instead increase the risk of getting infection or its progression with an unfavorable prognosis [4]; this information was often communicated in an inadequate, sensational, or distorted manner and was often supported by weak scientific evidence and may have influenced the behavior of many people in several countries, particularly frequent users of social media, with associated potential risks related to the hazardous use of these products [5].  
The media is a public service that plays a key role in informing society and promoting debate [6]. While newscasts attempt to echo governmental provisions and relevant information from the local context, commercial announcements (propaganda or advertising) attempt to position in the audience a message that can influence decision-making at the individual and collective levels [2]. Journalism has a great responsibility in our society since it plays a role that no other profession does: to report regularly and create opinions on significant issues. Abdicating from this responsibility, putting economic interests or benefits before the interests of the public, is unacceptable and unethical. In the case of newscasts, during the transmission of \"official news,\" advertising content is also disseminated. These spots, to a greater or lesser extent, usually fund the programming. While journalistic content (informative, entertainment, etc.) may take the format that its producers considermost appropriate, it should never disguise the presence of advertising. Citizens have the right to recognize when they are presented with a journalistic message or an advertising message to make an appropriate assessment [7, 8]. To mitigate these wrong messages or misinformation, for more than two decades, the World Health Organization (WHO) has promoted several initiatives to incorporate ethical criteria for drug promotion and advertising by content regulators; however, it is seen daily that the claims made about drugs and health-related products in the media are not based on scientific evidence [9, 10]. In Ecuador, the consumer protection law defines \"misleading\" advertising as: \"Any form of information or communication of a commercial nature, the content of which is totally or partially contrary to the real conditions or of acquisition of the goods and services offered or that uses texts, dialogues, sounds, images or descriptions that directly or indirectly, and even by the omission of essential product data, induces deception, error or confusion to the consumer\" [11] (Supplementary Material). When the media hosts erroneous content, the right to be truthfully informed is compromised and the consumer is therefore misled. Although in several countries from Latin America, there are regulations for the promotion and advertising of health-related products, in practice they are not always met [12]. False and misleading advertising of drugs can lead to serious impacts on the health of the population [13]. In the case of Ecuador, all media advertising related to food, medicines and health-related products are regulated by the Agency for Regulation and Health Control (known as ARCSA in Spanish, which stands for Agencia de Regulacion y Control Sanitario). Thus, by law, it is prohibited to advertise prescription drugs in the mass media [14]. With this background, the objective of this study was to identify misleading (either abusive or inappropriate) advertising of health-related products on Ecuadorian television during the COVID-19 pandemic.