TODAY -

Local actions are building blocks for #GlobalGoals

Shobha Shukla / Bobby Ramakant *

 3rd Summit of Asia Pacific Cities Alliance for Tobacco Control and NCDs prevention (AP-CAT)
3rd Summit of Asia Pacific Cities Alliance for Tobacco Control and NCDs prevention (AP-CAT)



International commitments are vital for a better tomorrow but no less important are local actions on the frontlines, for bringing in desired change. Most important and often unheard voices are of those who are striving hard to bring in a change on the frontlines. These voices from the grounds-up, need to be plugged in to those at national, regional and global levels who are driving bigger processes for a better tomorrow.

For instance, despite the World Health Organization (WHO) saying that the tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than seven million people a year, we need local actions to translate evidence-based tobacco control policies into public health impact.

Non-communicable diseases (NCDs) such as cardiovascular diseases (CVDs) like heart disease and stroke, cancers, diabetes, chronic respiratory diseases, etc cause over 70% of deaths worldwide. While there are larger policy level changes and actions warranted, there is no excuse not to scale up well-coordinated responses on the ground to prevent NCDs.

With this intent, 3rd Summit of Asia Pacific Cities Alliance for Tobacco Control and NCDs prevention (AP-CAT) brought together over 100 local leaders from 30 cities in 12 countries of Asia Pacific region. Participants included Members of Parliaments (MPs), Mayors, Vice Mayors, Governor, Vice Governor, other local government officials, public health experts, among others.

Tobacco epidemic is preventable

Barrister Shameem Haider Patwary, Member of Parliament from Bangladesh said to CNS (Citizen News Service) in video interview (youtube.com/c/citizennewsorgcns) that when he attended the World Conference on Tobacco or Health (WCTOH) in Mumbai, India (2009), the writing on the wall was clear: tobacco is the single largest preventable manmade epidemic. "Since it is preventable, then why are we not making every effort to prevent it?" he said.

"I have engaged in many litigations against tobacco companies" said Barrister Shameem Haider Patwary. He fought litigations against tobacco cultivation on the hill tracks, tobacco advertisement related issues, among others. "When I came to politics, I created my own manifesto to work against tobacco and tobacco companies as a politician. I came to know that large number of youth are getting addicted to tobacco. Youth are also the key targets of tobacco companies to make youth their future [business] and lifelong customers" said Barrister Shameem Haider Patwary.

"Bangladesh is a country of 160 million people with children and youth who will be our future tomorrow. If we can make this world tobacco-free and beat NCDs, today's youth will be tomorrow's citizens of a healthy nation" rightly said Barrister Patwary. Barrister Patwary has conducted couple of mobile courts for tobacco control and is also engaging farmers to encourage them for crop substitution. "We will give them subsidy if they abandon tobacco cultivation. Corn is very popular in Bangladesh so we are encouraging them to cultivate corn rather than tobacco" he said.

Local leaders are more in direct contact with the people. Whereas Members of Parliaments spend significant part of their time in the parliament and parliamentary processes and proceedings. For good governance it is vital that MPs work closely in tandem with local leaders who are more rooted in the community they represent.

"That is why we are working closely with Union Parishad chairman, Union Parishad members, local Sabha members, and other local leaders, as they play a key role in convincing people who elect them to lead healthier life, stop tobacco use, and reduce risk of NCDs. Without their collaboration no policy can be achieved. My ultimate aim is to declare some of the areas of my constituency as completely tobacco-free" said Barrister Patwary.

MPs can also support local leaders in amplifying their demands. "For example if local sabha member wants to promote NCDs prevention we can help promote that issue in the parliament or we can write to the ministry to help support the local leaders like Mayor who want to work on NCDs prevention, or make a park for people to do physical activity, or run awareness campaigns" said Patwary.

He shared another way to help strengthen voices of local leaders: "Parliamentary Standing Committee is a very powerful committee on health or other issues. Parliamentary committee has parliamentarians as members and it can make recommendations. Good thing is that when a parliamentary committee makes a recommendation it is reviewed every three months, and it is almost binding for the ministry to follow these recommendations."

WHO has recognized tobacco industry interference as major obstacle in implementing global tobacco treaty (formally called the WHO Framework Convention on Tobacco Control) as well as, tobacco use as a threat to sustainable development. That is why the global tobacco treaty has WHO FCTC Article 5.3 to empower governments of over 180 countries to stop tobacco industry interference in health policy.

Barrister Patwary shared that like in Japan, Bangladesh too, significant number of shares in tobacco company are owned by the government itself. This is the biggest problem why we lag behind in implementing WHO FCTC Article 5.3, says Patwary. "This creates a serious question of bias, lobby, interference... and also government cannot decide against the interest of tobacco company when itself it is a part of tobacco company."

"We impose 1% surcharge on all tobacco products and we are advocating that this surcharge money should be used for prevention of NCDs" informed Barrister Patwary. Referring to progress made on WHO FCTC Article 19 which will empower governments of over 180 countries to hold tobacco industry liable, financially and legally, he commented that we need a far advanced legal framework if we are to hold tobacco companies liable for the damage they have caused. He said "we need some sort of funding for litigation in our country and alliance of lawyers so that lawyers get encouraged to do probono litigation against tobacco companies" to hold them to account for violations and abuses.

Catastrophic health expense derails development

There is strong evidence that catastrophic health expenditure is not only a major barrier in accessing existing healthcare services but also pushes healthcare seekers in deeper poverty. Catastrophic health expenditure is defined as out-of-pocket spending for healthcare that exceeds a certain proportion of a household's income with the consequence that households suffer the burden of disease.

"In Bangladesh also, biggest procrastination in development is the health or medical cost. If any family member gets a heart disease or stroke or cancer (all NCDs), entire lifesavings are spent over his or her treatment. Health economists have also recognized catastrophic health expenditure as biggest cause of poverty and obstruction to development" said MP Barrister Shameem Haider Patwary.

Prevention cannot take a backseat, especially when diseases that can be prevented are overburdening our health systems, and cause over two-thirds of untimely deaths. "If we take preventive measures like making safer spaces to walk or public parks for increasing physical activity we can reduce the risk of NCDs as well as save avoidable cost on healthcare. If we invest some of the funds for health promotion, so that more people are encouraged to use parks, walkways, gymnasiums, eventually we will end up making our people healthier and reducing overall health expenditure in the country" said Barrister Patwary.

"In my constituency, there is no park. Besides the river we have a big vacant land where a park is being made from the funds given by me from my allocation. In 15 Unions (governance units), my ultimate aim is to establish 15 gymnasiums, 15 sports centres and 15 public parks. Women in the village often do not have space to walk and so certain time will be allocated only for women everyday to use the park, so that they can walk, see the nature, meditate, and exercise, comfortably" shared Patwary.

Tobacco revenue is less than economic cost of epidemic

Strong evidence shows that the tobacco industry and the deadly impact of its products cost the world’s economies more than US$ 1.4 trillion annually in healthcare expenditures and lost productivity. It is not a coincidence that around 80% of the world's 1.1 billion smokers live in low- and middle-income countries, but major tobacco companies and industries are headquartered in the richer nations. No prizes for guessing that it is the low- and middle-income countries that are reeling under the severest impact of NCDs too.

Barrister Patwary agrees. "There is a mindset problem we have in top politicians that tobacco companies give high tax." More advocacy needs to be done to expose these misconceptions and recognize tobacco use as not only a threat to public health but also to nation's development and economy.

"In last parliament, Bangladesh government had passed a law, Communicable Diseases Prevention Act. When I spoke about it, I had categorically said that we not only need that law for communicable diseases but we also need a guideline, central policy, trust or dedicated statute for non-communicable diseases (NCDs). Government has taken a note of it and working on it. We also have a National Health Policy where NCDs are reflected" shared Patwary.

Uniting local leaders will translate #globalgoals into change

Nepal's Member of Parliament and former Health and Population Minister Khagaraj Adhikari said to CNS (Citizen News Service) in video interview (youtube.com/c/citizennewsorgcns) that all local lead-actors need to unite to translate these global goals into effective action towards desired change. Well-coordinated local leadership is central to effective implementation of health and development policies. Local actions are the fundamental building blocks to drive nations, regions and the world towards sustainable development. "We have to make agenda at provincial level, central level and local level leadership is key for implementation. With concerted efforts at all levels, Asia Pacific region will become tobacco-free in coming days", said Adhikari.

Nepal has demonstrated strong leadership in tobacco control. Nepal had world's biggest pictorial health warnings (90%) on all tobacco products till very recently, when Timor Leste went for even bigger pictorial warnings (92.5%) pictorial warnings on tobacco packs. Nepal's contribution to tobacco control also got acknowledged with an international award. One of the awardees for 2015 Award for Global Tobacco Control of Bloomberg, was Nepal Ministry of Health and Population.

This Award citation in 2015 had put this on record: "Nepal has taken the lead among Southeast Asian nations when it comes to controlling and reducing tobacco use. Initiated by the Ministry of Health and Population in 2011, Nepal has enacted a comprehensive law comprised of large graphic health warnings, comprehensive bans on tobacco advertising and sponsorships, as well as a smoke-free law for public spaces - all while facing immense pressure from the tobacco industry. To date, the Ministry of Health has faced 16 extensive court cases brought against the measure by the tobacco industry. Unbowed, the Ministry of Health and Population has won 14 of those cases, with two appeals currently pending."

MP Khagaraj Adhikari shared that he was exposed to tobacco smoke as his father was a chain smoker. 12 years before his death, he had stopped tobacco use. So when he got the opportunity to be Nepal's Minister for Health and Population, despite odds, he made unprecedented progress to advance health promotion, in particular, tobacco control.

"121,000 people die every year due to tobacco in Nepal. Government supports patients of NCDs but this support is not enough. Moreover, prevention is better than cure" stressed Adhikari. He rightly says that "We should not have had to establish more hospitals" if health promotion was on track, because over 70% deaths are due to NCDs, a majority of which are preventable. He advocates for raising awareness to establish more stadiums and other spaces for increasing physical activity, and thereby reduce risk of NCDs.

He also emphasized on critical need to reach out to the children and young people, so that they do not choose tobacco, but choose health and life. Also young people can help convince their family members and friends to stop using tobacco for their own health and wellbeing. MP Khagaraj Adhikari said that after 20 years Nepal has local bodies elected so it is an important opportunity to engage with local leaders to advance health and development at ground level.

Local leaders unite to #beatNCDs and #endtobacco

The local leaders from 30 cities in 12 countries of Asia Pacific region adopted a strong Declaration at the 3rd Summit of Asia Pacific Cities Alliance for Tobacco Control and NCDs Prevention (AP-CAT). Dr Tara Singh Bam, Regional Director (Asia Pacific) of International Union Against Tuberculosis and Lung Disease (The Union) said that this AP-CAT Declaration commits the local leaders to implement the WHO best-buys for control and prevention of NCDs. These best-buys include:

i) reduce tobacco use;
ii) reduce harmful use of alcohol;
iii) reduce unhealthy diet;
iv) reduce physical inactivity;
v) manage cardiovascular disease and diabetes;
vi) manage cancer; and
vii) manage chronic respiratory diseases.

Hope 2019 and beyond will see these promises translate into firm public health and sustainable development outcomes.


* Shobha Shukla and Bobby Ramakant, CNS (Citizen News Service) wrote this article for e-pao.net
The writer can be reached at ramakantbobby(AT)gmail(DOT)com
This article was webcasted on January 12, 2019.



* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Khomlen Manglanda - A Play #1 : Gallery
  • Khongjom Numit: Commemoration
  • Licypriya Kangujam to address UN
  • Wu Cheng'en at Yuntai Mountain :: Review
  • Cleaning up Maram Bazar on Earth Day
  • Take action for mother earth
  • In between now and May 23
  • Challenges in Journalism
  • Shivaratri Shopping List #2 : Gallery
  • Pherzawl - a dying District! ?
  • Indo-Naga & other peace talks #2
  • Spotted Deer - Living with Natural Habitat
  • Northeast Fiesta at Jalandhar : Report
  • Environmental Sciences as career option
  • Serou: A microcosm of mosaic Manipur
  • 3 North East States to get DNA Testing
  • Protest against SC verdict on adultery
  • Mirabai misses bronze by a whisker
  • Post poll scenario in Manipur
  • Tributes to PLA killed #2 : Gallery
  • Romance of insurgency in 1970s #1
  • Earth Day 2019
  • Easter is a Day of Hope for all ...
  • Hide-and-seek in the Sky :: Poem
  • St Mary's Church: The 1st Anglican Church
  • Breaking the barrier
  • A talk with Ajit Ningthouja :: eRang
  • Realisation Day; Echoes the wake up call
  • Xavier Rutsa & Limatemsu Jamir
  • Revisiting Palm Sunday: Reflections..
  • Iceland - most safest & peaceful place
  • Easy fixes for summer hair problems
  • An evening of extreme shame !
  • Revisiting reality
  • LS : Voting for Inner : Gallery
  • Ahingbi, Chareinu :: eMing
  • Thang Ta @Sangai Festival #4: Gallery
  • The current status of Naga-Kuki relation #1
  • Traditional warfare technique of NE native #1
  • Cry Of A Dying River #72 :: Poem
  • Looking forward to May 23
  • Judgment day
  • Meekap Thokpa Numit #1 : Gallery
  • CC Meet Final: NEROCA Vs SU #2: Gallery
  • Floriculture : A booming industry in Mao
  • Positivity is the soul of life
  • Basic health competency by patients
  • Inner Line Permit (ILP) Demand :: Timeline
  • 7th Woodpecker International Film Festival
  • Cracking the repoll whip in Outer
  • Dirty game is a threat to Democracy
  • Ibendhou Kounu Haraoba #2: Gallery
  • Indo-Naga & other peace talks #1
  • Civil Society Forum Manifesto for Election
  • Life and Me :: Poem
  • The Killing Fields 2013-18 : News Timeline
  • Election jamboree & voters bonanza
  • Suspension Order for 7 MLAs : NPF
  • Chin Woman Dies after Tatmadaw Bomb
  • A reference to the party in power
  • An idea without fear
  • Sajibu Cheiraoba at Mysore #2: Gallery
  • Artillery Regiment in Battle of Imphal
  • Appraisal on LS election (Outer) #2
  • Minimum Income Guarantee is a promise
  • Northeast Fiesta 2019 at Jalandhar
  • Cyber Security - the need of the hour
  • Sunset Unplugged, Agartala: Event Report
  • Reality of casting vote in Outer PC
  • Real face of Indian election
  • Tributes to PLA killed #1 : Gallery
  • Khomlen Manglanda : Play synopsis
  • Download: Meetei Mayek Keyboard
  • Voting (PC) @ Kangpokpi #3: Gallery
  • Letter from a river most polluted
  • Truth commission in Manipur needed..
  • Vacancy at Makok Tech, Bishnupur
  • Cheirao Chingkaba #2 : Gallery
  • The sky is the SIYOM of the stars
  • An introspection of roots of AFSPA
  • A note on Cheiraoba ..
  • A well-known paradox :: Poem
  • The saga of EVMs
  • Festival of Democracy hypes
  • 14 girls sold to persons in Saudi Arabia
  • Took up boxing after watching Ali- Mary
  • Sajibu Cheiraoba at Mysore #1: Gallery
  • Mittong Khunou: The Battle Honour of INA
  • A Lifeline for the Assamese
  • Multiple posts at PiCaSoid, Imphal
  • NE Annual day of CNESPR , JMI
  • Essential summer travel tips
  • Discussion : Myanmar's Democratization
  • Violating election model code of conduct
  • Catapulting AFSPA in the limelight
  • Revisiting CAB issue
  • Voting (PC) @ Kangpokpi #2: Gallery
  • Voting (PC) @ Kangpokpi #1: Gallery
  • Bloody Phanek at Paris Film Festival
  • Homoeopathy, a revolutionary science
  • The goodness of good fate does not smile..
  • Outer Constituency has voted
  • Helpless indignation
  • CC Meet Final: NEROCA Vs SU #1: Gallery
  • Yengkhom Roma : Lifetime Award
  • Appraisal on Lok Sabha election (Outer) #1
  • Cyber Crimes - Crimes by finger tips
  • Research Support Officer @ Amethyst
  • Condemns militarization of NEHU Campus
  • Shadow of CAB on Lok Sabha elections
  • "CAB" Factor Faded
  • Thabal Chongba @Khurai : Gallery
  • Military Sociology: Present, Past & Future
  • Know your MP - Election 2019
  • Dirty Dancing :: Poem
  • Democracy needs time for good admin
  • Travel at U-Factor
  • Shadow of NSCN (IM) in Outer PC
  • The great escape
  • Arambai Exhibition Show : Gallery
  • View of Premier State College Senior Assn
  • Distant One :: Poem
  • The hysteria of a first time voter
  • Course in Folkloristics & Semiotics
  • NDPP is 'Entertainment Govt' : Zeliang
  • On issue of "Letters signed by Neiphiu Rio"
  • The visit of PM Modi
  • If BJP win, people of Manipur support CAB
  • Cheirao Chingkaba #1 : Gallery
  • sekeN heN :: Seireng
  • Yangnu Golmei : Sangeetbhusan 2018
  • Victimizing only the Women & Children
  • Lest The North-East Fall Asleep
  • Naga Peace Process :: News Timeline
  • Driving a dangerous feat on Indian roads
  • Need to be democratic in a democracy
  • Cheiraoba Chak Katpa #1 : Gallery
  • Selfie da track :: e-pao Radio
  • Demand for ILP :: Articles/Photos...
  • The legend of the Laiyyars : Election tale
  • Sports for peace & development
  • What is peace ?
  • Rongali : Celebration of Assam & NE
  • Manipuris celebrate New Year
  • Imphal security beefed for Modi's visit
  • Sajibu Nongma Panba Shopping: Gallery
  • Sajibu Cheiraoba: Ritual festival of Meiteis
  • Sajibu Cheiraoba Meitei New Year Day
  • Stop War with Nature :: Artwork
  • Cry of a Dying River - 71 :: Poem
  • Pulmonary Valve Balloon dilatation
  • Supping with an ally of the foe
  • Deflected focus: The dress debacle
  • Nipalsuba Mapok #2 : Gallery
  • Running for LS polls: The candidate
  • Gift :: Poem
  • Architect/Architectural Designer @R-Square
  • Little things that help to enhance beauty
  • Congress Manifesto for Repeal AFSPA
  • Social Media - a boon or a curse?
  • Anti-CAB stand: Interesting take from PRISM
  • AFSPA on Congress Manifesto
  • Bamboo Cooking Competition #1 : Gallery
  • April Calendar for Year 2019 :: Tools
  • Yaoshang Sports @Keishampat #2 : Gallery
  • First Wave Feminism
  • JRF wanted at NERIST, Arunachal [Upd]
  • Cheiraoba Thabal 2019 at Bangalore
  • NPF to support Congress on issue based
  • Jyotishmita to represent Assam in Miss India
  • Paothang : Newsletter from Pune
  • Eyeing votes with promise on AFSPA
  • Together let's save the future
  • Shirarakhong Village, Ukhrul :: 360 View
  • Journey into Nature of Human Culture #4
  • Candidate accommodation at Aligarh
  • The globe is in your fist
  • Heartless :: Poem
  • Condemn Killing of Manjur Ahmed
  • Indifference bordering on arrogance
  • Modi's visit: Will it restored BJP image?
  • Yaoshang Halankar #1 : Gallery
  • No Budget at International Mime Festival
  • In defence of the "Meira Paibis"
  • Post-Doctoral fellow @ NEIST, Jorhat
  • Attributes for vibrant career #2
  • Against Custodian Killing of Manjur Ahmed
  • Revamp Sajiwa Jail : The great JN escape
  • LS Poll : CAB factor and Manipur
  • Dont trust anyone: Pune police to NE
  • Muhammad Abdur Rahman Khutheibam
  • Yaoshang Fancy Dress : Gallery
  • Urmila Chanam on menstruation myths
  • Meetei Tribe Bears More Tribal Characters
  • Dear Happiness :: Poem
  • MP election issues & non-issues
  • Augment credit flow to farm sector
  • Fresh approach of Sangma
  • Phayeng Koubru Haraoba #3: Gallery
  • TabLlE :: Seireng
  • The Naliya Queen
  • Distress Relief at various districts
  • Bedtime Blues :: Poem
  • Babies who are born deaf
  • The approaching day of redemption
  • Yaoshang Marathon Race: Gallery
  • Abok :: Artwork & an Essay
  • Eyek Tamba :: Learn Manipuri script
  • Yaoshang Pichakari #2: Gallery
  • Utlou incident & of Nupi Khongoinaba
  • Understanding failure & how to face it
  • Responsibilities of voters : 5 years stake
  • Nando escaped from custody is a threat..
  • A New Dawn Awaits Tusom & Somra
  • Yaoshang Cooking competition: Gallery
  • MSAC Literary Meet @Chandigarh : Gallery
  • Lamtagee Thabal @ Pune : Gallery
  • Yaoshang Sports @Keishampat #1 : Gallery
  • Abdur Rahaman : Gopal Sharma Award
  • Thokchom Sanatombi : Sangeetratna
  • AEgi puNsi :: Seireng
  • Nipalsuba Mapok : Shumang Leela
  • Mukna Kangjei #2 : Gallery
  • Sory Wahengbam : eRang Actress Profile
  • Saroi Khangba @Imphal : Gallery
  • Featured Front Page Photo 2019 #1: Gallery
  • Maharaj Kumar Priyabarta Singh : Profile
  • Manipuri Calendar for 2019 : Download
  • List of Restricted Holidays for 2019
  • List of Public Holidays for 2019
  • List of General Holidays for 2019
  • SPONSORED ADS