Enforce global tobacco treaty

Madhya Pradesh

April 24 2007

Personal Thought: Enforce global tobacco treaty

By - Bobby Ramakant

[ It is the first legal instrument designed to reduce tobacco-related deaths and disease around the world.] No More Tobacco please...... read more. thanks

Why do we need a global tobacco treaty to prevent needless diseases, disabilities and deaths attributed to tobacco use in India and national legislation wasn't enough?

India ratified the global tobacco treaty, better known as Framework Convention on Tobacco Control (FCTC), on 5 February 2004. FCTC was developed as a global response to the globalization of the tobacco epidemic. Adopted in May 2003 by the 56th World Health Assembly, FCTC quickly became one of the most widely embraced treaties in history, becoming international binding law on 27 February 2005.

Increased trade, foreign investment, global marketing and other complex international phenomena have led to the globalization of the tobacco epidemic. As the epidemic transcends national borders, its control requires international cooperation and multilateral regulation.

Tobacco is the leading preventable cause of death in the world, with an estimated 4.9 million deaths a year. If current smoking patterns continue, the toll will nearly double by 2020. A high percentage of deaths (70%) will occur in developing countries. Tobacco kills people at the height of their productivity, depriving families of breadwinners and nations of a healthy workforce.

There is no doubt that reducing the rates of uptake and consumption of tobacco will save lives and that the FCTC is the evidence-based tool with which to do it. It has been projected that with a progressive 50% reduction in uptake and consumption rates, as many as 200 million lives could be saved by the year 2050 AD and hundreds of millions more thereafter.

By becoming Parties (signing and ratifying FCTC by national parliaments) and implementing the provisions of the treaty where it counts most ¨C at country level ¨C countries are working towards a tobacco-free world and towards millions of lives saved. 146 countries have signed and ratified the treaty so far.

It is the first legal instrument designed to reduce tobacco-related deaths and disease around the world.

Among its many measures, the FCTC treaty requires countries to impose restrictions on tobacco advertising, sponsorship and promotion; establish new packaging and labelling of tobacco products; establish clean indoor air controls; and strengthen legislation to clamp down on tobacco smuggling.

Tobacco products are advertised through sports events, music events, films, fashion - in fact, any place where the tobacco industry can target potential new smokers (young people). The treaty obliges Party States to undertake a comprehensive ban on tobacco advertising, promotion and sponsorship, as far as their constitutions permit.

online available at - http://www.centralchronicle.com/20070424/2404303.htm

Asia's Cancer Rate May Pose Threat to Economic Growth (Update1)

Bloomberg.com

23 April 2007

London

News - Asia's Cancer Rate May Pose Threat to Economic Growth (Update1)

April 23 (Bloomberg) -- Asia's cancer rate may jump by almost 60 percent to 7.1 million new cases a year by 2020, straining the region's ill-prepared health systems, said Richard Horton, editor of the British medical journal Lancet.
Aging populations, tobacco use and increasing rates of obesity are fueling the incidence of deadly tumors in Asian patients too poor to afford the most advanced treatments including Herceptin and Avastin, sold by Roche Holding AG, the drugmaker based in Basel, Switzerland, Horton said April 21 at an international cancer meeting in Singapore.
Asia's prevalence of cancer deaths may climb 45 percent to 163 per 100,000 people by 2030 from about 112 per 100,000 in 2005, according to the World Health Organization. At that rate it would overtake the Americas, where cancer-related mortalities are expected to rise to 156 per 100,000 from 136 over the same period. Europe, which has the highest prevalence at 215 per 100,000, may increase about 9 percent to 234 per 100,000.
``There really is going to be an incredible pandemic of cancer like we've not seen -- we couldn't have imagined it -- over the next 20 years,'' Horton said in an interview in Singapore, where he spoke at the Lancet Asia Medical Forum. ``We barely have the health systems to handle infectious diseases, so how on earth are we going to deal with this?''
Cancer already kills more people worldwide than AIDS, tuberculosis and malaria combined. Spending to prevent and treat chronic diseases such as cancer and diabetes may slow the expansion of China and India, the world's two fastest-growing major economies, researchers said at the meeting in Singapore.
`A Fortune'
``It is going to cost them a fortune in terms of health care expenditure,'' Horton said, adding that it will ``eliminate a huge number of people from the labor market. We think AIDS is a disaster to the world now. You have seen nothing yet.''
It costs close to $50,000 in Great Britain to treat a breast cancer patient using Herceptin, which generated $3.2 billion in sales last year for Roche and its partner South San Francisco, California-based Genentech Inc. In comparison, per capita government expenditure on health was $4 in Bangladesh, $7 in India, $11 in Indonesia and $22 in China in 2003, according to data compiled by the WHO.
Asia accounted for about half the 7 million cancer deaths worldwide in 2002, with 23 percent in China alone, D. Maxwell Parkin, a visiting research fellow at the University of Oxford's clinical trial service unit, told the two-day forum.
Health Insurance
``Historically in developing countries, people died before they could get cancer,'' said You-Lin Qiao, a professor of cancer epidemiology at the Chinese Academy of Medical Sciences in Beijing. ``Now they are living longer, we're seeing more cancer'' and degenerative diseases of the brain, he said.
The majority of China's rural dwellers don't have health insurance, Qiao said in an interview. The cost of treatment, therefore, is borne by the entire family.
Attacks on China's medical personnel almost doubled last year to 9.83 million cases, with 5,519 staff injured, causing 200 million yuan ($26 million) in costs, the official Xinhua News Agency reported last week, citing Vice Minister of Health Chen Xiaohong.
The violence reflects the growing frustration in China over a health system struggling to provide affordable medical care, said Tony Mok, professor of clinical oncology in Hong Kong's Prince of Wales Hospital, who consults in the southern Chinese city of Guangzhou.
Doctor Shortage
``The doctor treats the patient,'' Mok said. ``The family thinks it is going to work. They get all their money, sell their cow, sell their house, and then the patient dies. They get very angry.''
About 1.1 million doctors and nurses are urgently needed in Southeast Asia alone, where shortages of health-care workers exist in six of the region's 11 countries, according to the WHO's 2006 World Health Report. Developing countries make up 85 percent of the world's population, but have a third of the world's radiotherapy machines, which are used to treat cancer.
``If nothing happens, there will be a disaster,'' said Franco Cavalli, president of the Geneva-based International Union Against Cancer. ``For the time being, governments don't realize, or do not want to realize, that this is a bomb which is going to explode.''
Developing nations in Asia have little access to anti- cancer drugs now, with the U.S., Europe and Japan absorbing 95 percent of the global supply, Cavalli said.
`Westernization' of Diets
Lung cancer, Asia's biggest cancer-killer and driven by tobacco-smoking, may increase 42 percent to almost 1 million deaths a year between 2005 and 2015, the Geneva-based agency reports. Stomach cancer, the second-biggest type of the disease in Asia, may grow 25 percent to 1.2 million deaths a year over the same period, the WHO says.
Still the ``Westernization'' of Asian diets, including rising consumption of alcohol and red meat, is causing higher rates of breast, colon and rectum cancer, Oxford's Parkin said.
Pursuing sophisticated drugs and technologies for treating cancer patients ``is incredibly high-cost and probably beyond the bounds of most countries'' in Asia, the Lancet's Horton said. Instead, priority should be given to a campaign to stop smoking, increase exercise and consumption of fruit and vegetables, prevent obesity and reduce salt.
``These seem simple things, but they would eradicate a vast proportion of the potential cancer burden,'' he said

online available at - http://www.bloomberg.com/apps/news?pid=20601101&sid=ajEasGsZx8R8&refer=japan

Amit Dwivedi's JANSATTA Editorial article on STAYING ALIVE WITH HIV

अमित द्विवेदी का जनसत्ता का लेख

एचआईवी के साथ जिंदगी

ITC to meet Kerala tobacco traders

News - ITC to meet Kerala tobacco traders

The Times of India
April 21 2007
New Delhi

KOZHIKODE: Representatives of the Indian Tobacco Company and traders in Kerala, who are at loggerheads over who should pay taxes on cigarettes, will meet in Kochi on April 22 in a final bid to resolve the crisis, a leading traders body said on Thursday.

"We are meeting company representatives as a last effort and hope ITC will meet our one-point demand by agreeing to pay the 12.5 per cent Value Added Tax before fixing the maximum retail price, thereby sparing retailers from incurring the loss', Vyapari Vyavasayi Ekopana Samithi President, T Naseeruddin said. Noting that retailers, who on an average sold cigarettes worth Rs 10 lakh annually, would have to pay Rs 50,000 as tax if the company refused to pay VAT before fixing the MRP, he said that the government, which has recently included cigarettes also under VAT, had left the option to the company.

If the talks failed, the Samithi would then demand action against a section of the distributors, who were now `illegally engaged' in distributing cigarettes directly to the retailers bypassing wholesale traders, he said. "Anyone involved in the trade will have to necessarily possess a VAT registration and salesman permit to sell the product. We will seek stern action against the offenders in case our talks fail and if sales still continue', he said.

on line available at - http://timesofindia.indiatimes.com/NEWS/India/ITC_to_meet_Kerala_tobacco_traders/articleshow/1924843.cms

Another Death of pregnant woman with HIV is Alarming

Online at: http://www.theseoultimes.com/ST/db/read.php?idx=5099




Another Death of pregnant woman with HIV is Alarming
Saturday 7 April 2007
The Seoul Times
South Korea

It is not only shocking that alarming levels of HIV associated stigma and discrimination runs high in MP but also that despite of repeated alerts sounded on rising maternal mortality in the state, nothing much has improved.

By Bobby Ramakant

On World Health Day 7 April 2007: A 30-year-old pregnant woman who was living with HIV died outside the hospital building in Indore (Madhya Pradesh state (MP), India) after the government healthcare staff denied to provide adequate medical care and hospital admission.
It is not only shocking that alarming levels of HIV associated stigma and discrimination runs high in MP but also that despite of repeated alerts sounded on rising maternal mortality in the state, nothing much has improved.

Madhya Pradesh figures among the list of those Indian states where maternal mortality is high, particularly in rural areas, where the healthcare system is virtually non-existent and awareness on the subject among the people extremely low.

According to UNICEF, Madhya Pradesh along with Assam and Uttar Pradesh, has a high Maternal Mortality Rate (MMR) of 700 or more per 100,000 live births as against the national figure of 407 per 100,000 live births as per the 2001 Census figures. However, regional disparities in maternal mortality are wide with the death ratio being low in Kerala, Tamil Nadu and Punjab and extremely high in most northern states in India.

President of Madhya Pradesh Network of People living with HIV (MPNP+) Manoj Verma said that on 3 April 2007, a 30-year-old pregnant woman who was living with HIV, died outside MY Hospital after the government healthcare staff refused to admit the patient. She was referred from Bhuranpur, Nehru Hospital, village Gambhirpura on 31 March 2007.

After the preliminary examination, she was referred and was taken to the ward for admission. But when the doctors came to know of her HIV positive status, they intentionally discharged the patient despite of the fact that she was in labor pains. But the doctors blatantly refused to admit her. While the patient came from the fifth floor of the hospital and reached the compound, she delivered the baby girl near the water tank of the MY Hospital. The relatives again tried to approach the healthcare staff to re-admit her but the security guards refused their entry into the hospital building.

As her condition was critical on 2 April 2007 she was brought to the MY Hospital at 9.30 am and fortunately got hospital admission, but was not fortunate enough to get proper medical attention. On 3 April 2007, her condition worsened, with no doctors to attend to her and she succumbed owing to severe medical negligence during and after child birth. She belonged to 'Banjaran' backward class and had five children.

MPNP+ President Manoj called the collector of Indore who asked him to register an FIR (first Information Report) at the nearest police station. However the nearest Sayogitha Gunj police station refused to lodge an FIR.

"I am shocked to hear of the blatant discrimination against a pregnant HIV+ woman in the hospital in Indore. This is even more so because right now there is a huge campaign by UNICEF and others to work on maternal health issues in MP" said India's noted women's health rights activist Jashodhara Dasgupta of SAHAYOG (www.sahayogindia.org).

Many reports reveal the extent to which people are stigmatised and discriminated against by health care systems in India. Many studies reveal the reality of withheld treatment, non-attendance of hospital staff to patients, HIV testing without consent, lack of confidentiality and denial of hospital facilities and medicines.

Fear of discrimination often prevents people living with HIV from seeking existing healthcare services. Perhaps the most conspicuous context for HIV/AIDS-related discrimination, stigmatization, and denial is the health care sector in India, whether public or private. Many infected people trace some of their AIDS-related fear, anxiety, and denial to their traumatic experiences in health care settings.

Health activists in India stress on the dire need to frame strategies to address women's health care, including HIV vulnerabilities, in the context of rights. The issues they seek to resolve include confidentiality, partner notification, and free and informed consent — all difficult issues for women who risk violence and neglect if their HIV status is disclosed. Without increasing gender sensitivity among health planners, healthcare workers, policymakers, judiciary, and other stakeholders, the high rates of maternal mortality fuelled with HIV associated stigma are unlikely to come down.

Bobby Ramakant, author is a senior health and development journalist, writing for newspapers in Asia and Africa.

Cancer Photos to Discourage Tobacco Users

The SEOUL TIMES
Seoul, South Korea
Friday 13 April 2007

Online at: http://www.theseoultimes.com/ST/db/read.php?idx=5128

Cancer Photos to Discourage Tobacco Users

By Bobby RamakantPublic Health Writer



X-Ray picture of lung cancer Health warning labels, both on cigarette packages and on all tobacco marketing materials, help create informed consent between tobacco companies and their customers and are an inexpensive and important first step in a national health education programme. On May 16, 2005, Republic of Korea had ratified the World's fist corporate accountability and public health treaty - FCTC (Framework Convention on Tobacco Control). Article 11 of the FCTC states that warning messages should cover at least 50% of the principal display areas of the package (i.e. both the front and back), but at a minimum must cover at least 30% of the principal display areas. It also requires that the messages be rotated and encourages the use of pictures and pictograms as well as the use of non-health messages ( e.g. "Quit smoking — Save money"). "We have tried everything but it has been of no use. So now we have decided to put scary photos of cancer patients on tobacco products to discourage consumers" said India's Union Health Minister Dr Ambumani Ramadoss on April 10, 2007 at the New Delhi summit of CII (Confederation of Indian Industries) and FAO (Food and Agriculture Organization of the United Nations).

Dr Ramadoss further announced that "all tobacco products would from June 1, 2007, bear photographs of patients suffering from cancer caused by tobacco consumption as further warning." Tobacco product packaging should be designed to maximize informed consent on the part of the consumer, not to maximize the appeal of the product. Strong and prominent health warning labels, limits on labels such as "slim" and "light," package inserts containing detailed health and ingredient information, and standardized packaging formats are among the ways to accomplish this goal. Unfortunately, warning labels tend to be weak in all but a few countries. More than 40 developing countries do not require any warning labels at all. Of those that do, 73% require weakly worded warnings on the side of the package and many of those are in English rather than local languages. Numerous studies have been done to determine which elements are most important in creating effective labels. Findings include:* To command attention, warning labels should occupy a minimum of 25% of the top of the front and back of the package. They should be in black and white or other sharply contrasting colors. Type style and size also must be specified to avoid industry efforts to undermine the impact of the warning.

* Messages should be unequivocal, simple, and stark. They should convey both the nature and magnitude of the risks, since studies show smokers underestimate most risks associated with tobacco use. Pictorial warnings may also be appropriate, particularly in countries with low literacy rates or where research shows that smokers are ignoring standard warning labels. Several nations have implemented strong health warning label requirements. Examples include:
- Canada, whose health minister recently proposed enlarging the labels from 30% of the package face to 60%;
- Thailand, which has added the message "SMOKING CAUSES IMPOTENCE" to its list of required warnings; and
- Australia, which was the first nation to require that "how to quit" information be printed on every pack.
- South Africa, Singapore and Poland also require strong warning labels.Tobacco companies use words such as "light," "ultralight," "slim" and "superslim" in their brand names and in their marketing materials. Research suggests that these words are intended to make implicit health claims minimizing the harmfulness of the product, and may encourage smokers motivated to quit to switch to a "light" brand. These words also appeal to smokers, primarily women, who believe they can use cigarettes to lose weight. These pictorial warnings provide smokers with helpful information on the health effects. Most smokers want this information, and certainly want their children to have this information too. The tobacco industry is continuing its decades-long strategy of trying to minimize the effectiveness of package warnings. The tobacco industry is no friend of smokers — and ironically it's true that 'the tobacco industry kills its best customers.' Also package warnings are a good public health strategy because the cost of package warnings is paid for by tobacco companies, not government. Also this should not be looked upon as an isolated initiative rather has to be supported by comprehensive healthcare, legislations and education programmes to attain long-run public health gains.

Bobby Ramakant, who serves as The Seoul Times columnist, is a member of NATT, Network for Accountability of Tobacco Transnationals, and edits Weekly MONiTOR series, reporting violations of tobacco control policies as a senior public health and development journalist. He writes for newspapers in 11 countries and can be reached at bobbyramakant@yahoo.com)
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Keep-The-Promise Campaign is a 120 days (7 April – 4 August 2007) media advocacy and communications campaign dedicated to raise awareness about existing tobacco control legislations (including FCTC) in countries in Asia and Africa, bring out challenges in their enforcement and increase media coverage of the same. The campaign shall also remind of promises made on tobacco control by policy makers of different countries in Asia and Africa and strengthen advocacy to Keep The Promises! More details about the KTP Campaign are available online at:
http://mycitizennews.blogspot.com/2007/04/keep-promise-campaign.html

Is Tobacco Company Seriously Concerned About People's Lungs In Pakistan ?

Online at: http://www.scoop.co.nz/stories/HL0704/S00265.htm

New Zealand
Scoop Independent News
17 April 2007

TIME-TO-PONDER: Is Tobacco Company Seriously Concerned About People's Lungs In Pakistan ?


By Bobby Ramakant

Will Pakistan Tobacco Company protect people's lungs by building environment parks alone? Nine out of ten lung cancers are attributed to tobacco use, says Pakistan's noted expert Prof Javaid Khan. Time to seriously ponder and act on to make effective tobacco control a reality.
A colour newspaper advertisement (see below) was published in Pakistan 's newspapers to announce the foundation stone-laying ceremony of Ghourghushti Environment Park in Attock district by collaborative efforts of Pakistan Tobacco Company and Government of Pakistan on 8 April 2007 . Prime Minister Mr Shaukat Aziz laid the stone.
Pakistan is one of the 146 countries that have ratified the global tobacco treaty and in doing so has taken a great step forward in protecting the health and lives of its citizens from the tobacco epidemic. Formally known as the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the treaty aims to reverse the tobacco epidemic by changing the way tobacco corporations operate around the world.

"On one hand the government of Pakistan ratified FCTC and committed itself to comprehensive tobacco control, yet they are accepting money from the tobacco industry to create a public park at Attock District (NWFP)" said Senior Chest Physician and noted tobacco control advocate Prof (Dr) Javaid Khan from Aga Khan University. He further said that "By such collaboration, tobacco industry is trying to tell the public that they are doing public welfare for the country. Previously they also claimed that they have made mobile dispensaries for poor patient and planted million of trees in the country to help the environment. Our government should not accept money from the tobacco industry as this money is tainted with the blood of those who have died from tobacco related diseases".

If tobacco industry is seriously interested in public welfare, the first step it can take on its own is to reduce the mountainous burden of diseases, disabilities and deaths attributed to tobacco use. By building environment parks for people's lungs and hoping people will believe that they are concerned about their lungs, tobacco industry must be kidding! People of Pakistan are smart enough to understand that the single largest preventable cause of lung cancer is tobacco.
"Unfortunately, tobacco corporations like British American Tobacco, Philip Morris/Altria and their subsidiaries (Pakistan Tobacco Company is the subsidiary of BAT) have attempted to interfere with the implementation and enforcement of the global tobacco treaty in countries around the world. These corporations use their tremendous political influence to weaken, delay and defeat tobacco control legislation around the world." said Kathryn Mulvey, Executive Director of Corporate Accountability International (www.stopcorporateabuse.org ).

Corporate Accountability International has been urging governments to be attentive to tobacco industry interference in public health policy, said Kathryn Mulvey. BAT and Philip Morris/Altria spend millions annually in an attempt to brand themselves as "socially responsible" corporations. This allows them to hide behind glossy image make-overs while continuing to promote tobacco addiction to children and adults around the world.

"Pakistan Tobacco Company sought to curry public favor through a public-private partnership to build the Ghourgushti Environment Park in Pakistan's Attock district. Pakistan's Prime Minister Mr. Shaukat Aziz accepted the tobacco corporation's invitation to lay the foundation stone at the Park's ground-breaking. This behavior is one clear example of tobacco corporations seeking to buy favor with the public and with elected officials" said Mulvey.

All around the world, people are rejecting Big Tobacco's attempts to interfere with health policy. And people of Pakistan are no exception. Let us hope that Government of Pakistan will dissociate itself from this 'environment park' venture with Pakistan Tobacco Company to begin with and further strengthen its commitment to global tobacco treaty.
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(The author is a senior health and development journalist writing for newspapers in Asia and Africa. He is a member of Network for Accountability of Tobacco Transnationals (NATT) and can be reached at: bobbyramakant@yahoo.com