Face it all together: threat of pandemics and responsibility to deliver on health for all

Shobha Shukla *

COVID-19 pandemic has proven how global economy depends on health security. Another key lesson hard learnt is how important are integrated health responses and strong local actions for preventing diseases and averting untimely deaths. Global level thrust on health policy, scientific research and programming was of course very important in pandemic response but so were local responses, that were no less important and lifesaving.

Indonesia's Secretary General of Ministry of Health Dr Oscar Primadi opened the 5th Asia Pacific Summit of Mayors (APCAT) which recognizes how the COVID-19 pandemic has not only thrust a public health emergency but also triggered cascading humanitarian crises.

Dr Guy Marks, President of the International Union Against Tuberculosis and Lung Disease (The Union), said that this APCAT Summit’s importance is unlike any other ones in the previous years. Over 72 million cases of COVID-19 worldwide have occurred and over 1.6 million people have died. Millions more lives, families, and livelihoods upended. This is the heart-wrenching heavy price the world has had to pay for weak health systems, poor tobacco control, ineffective prevention of non-communicable diseases (NCDs), and not stronger action on communicable diseases and other social and commercial determinants of health.

Dr Guy Marks added that evidence has emerged that those most at risk of dying or becoming extremely ill from COVID-19 are those with pre-existing NCDs. Tobacco is a leading common risk factor for major NCDs that account for over 70% of untimely deaths globally, and it also increases the risk of communicable diseases like world’s biggest killer infectious disease, tuberculosis (TB). The tobacco pandemic is entirely preventable and avoidable. COVID-19 has clearly shown the urgency of having integrated responses with improved health system.

Dr Tara Singh Bam, Deputy Regional Director of The Union Asia Pacific, who is also a part of the World Health Organization (WHO) Civil Society Working Group on NCDs, said that "the global health crisis has become even more acute with COVID-19. Along with the coronavirus pandemic, several other epidemics are looming large, threatening our fragile health systems, like those of TB, NCDs, and tobacco. Despite being preventable and curable, TB continues to be the world’s deadliest infectious disease, with 1.4 million deaths in 2019.

NCDs account for over 41 million untimely deaths globally. The tobacco pandemic, which is entirely preventable, remains among the biggest public health threats the world has ever faced. Tobacco kills more than 8 million people every year around the world, with over 7 million of these deaths due to direct tobacco use while additional 1.2 million deaths because of non-smokers being exposed to second-hand smoke."

5th APCAT Declaration launched

Co-Chairs of Asia Pacific Cities Alliance for Tobacco Control and NCDs prevention (APCAT) are Dr Bima Arya Sugiarto, Mayor of Bogor City of Indonesia and Francis Anthony Garcia, Mayor of Balanga City of Philippines. Mayor Francis Garcia launched the 5th APCAT Declaration committing to accelerate progress towards eventually ending tobacco, as well as preventing the avoidable burden of COVID-19, NCDs and communicable diseases and thereby avert untimely deaths, by:

- Sustaining effective implementation of tobacco control programs that include smokefree environments; complete ban of tobacco advertising, promotion and sponsorship; promotion of larger graphic health warning on tobacco packs and smoking cessation programs; and ban electronic cigarettes, heated tobacco products, shisha and similar products,

- Ensuring NCDs prevention and treatment services are sustained with inclusion of NCDs in COVID-19 responses as part of health security, acknowledging the links between COVID-19 complications and underlying chronic conditions,

- Continuing delivery of routine care, supplies of essential medicines and technologies, screening and diagnosis, access to resources, and supportive services for ongoing management of tuberculosis and other lung diseases,

- Rejecting funding, logistics, donations or grants from, and partnerships with, any entity related to any unhealthy commodity industries (such as tobacco, alcohol, sugary and sweetened beverages) and pseudo-science funded by these industries and their front groups,

- Working with national government and policy makers to raise taxes and prices on unhealthy commodities, tobacco products, alcohol, sugary and sweetened beverages,

- Adhering to public health and scientific expertise for prevention and management of COVID-19 effectively, and by rebuilding our cities in a way that improves public health system.

"We commit for doing everything in our power and the power of our city governments to ensure that COVID-19, tobacco control, NCDs prevention and TB control programs are effectively implemented and measured, and the recovery from COVID-19 is healthy, equitable and sustainable" said Francis Garcia.

we face a shared threat but also a shared responsibility

The Union President Guy Marks summed it up best: "at this juncture we stand united in solidarity – as we not only face a shared threat but also have a shared responsibility. All these deaths from these four pandemics (of COVID-19, NCDs, TB and tobacco) are preventable. This is where political leadership is so critical."