So said Dr Tara Singh Bam, Regional Advisor for Tobacco Control at the International Union Against Tuberculosis and Lung Disease (The Union) on the sidelines of the 47th Union World Conference on Lung Health in Liverpool, UK.
While reflecting upon the game changing successes in the field of tobacco control, he called for broader partnerships among different public health programmes for accelerating progress in implementing effective tobacco control. He repeatedly insisted upon the importance of working together. “We can no longer work in isolation. We have to work together. We cannot achieve our desired goals if there are vertical programmes alone. People working for TB control, tobacco control, and control of non-communicable diseases (NCD) will have to work together with a holistic approach for the common good. It is the need of the hour to integrate all public health programmes to fight the menace of communicable and non-communicable diseases, which seemed to have married each other and joined hands creating a double whammy of sorts”, he said while speaking with Citizen News Service (CNS).
According to Dr Bam, community empowerment is one of the key drivers to tackle the issue of TB, tobacco control and non communicable diseases. Civil society plays an important role, not only in influencing national policy but also in mobilising the community to change their behavioural patterns. And the media plays a critical role in this. In his home country Nepal, the media took a strong stand against the pro tobacco politicians’ lobby, disclosed their engagement with the tobacco industry and fought for better public health programmes. This helped to build a strong public opinion, community support and mobilisation against the moves of the politicians. So media and community engagement is a critical element in the fight against tobacco, he said.
Translating sustainable development goals (SDGs) into action:
“At the sub national and community level, most people do not know what the SDGs are about, feels Bam. We know that SDGs are a package of actions meant to solve the problems of the common people. So we need to engage them. The first thing is to translate the targets of SDGs in simple terms such that the people at the grass root level are able to understand what they mean. Then we need to engage everyone working at the community level—whether they are faith based organisations or civil society organisations. Thirdly, we have to make judicious use of the human and financial resources, that are available aplenty, even in poor countries like Nepal. It is just a matter of mobilising the local resources effectively and engaging the local people to use them properly”, said Bam.
Bending political will in favour of public health policies:
Dr Bam has been very instrumental in making implementation of 90% pictorial health warnings on tobacco packs in Nepal and 75% pictorial health warnings on tobacco packs in Myanmar a reality. This has set an example that even small countries can make a big difference in global public health.
These are just two of the many successes of Bam in tobacco control and he attributes them to political will and commitment. His stance is—Never blame the politicians without having talked with them and without getting their point of view. Communicating with them in a proper way is very important. Most of the times we make our own impression of the politician without meeting and understanding them and try to impose our own views upon them. This is a wrong approach. We should know our issue well and be able to present it amicably to the politicians. Then only can we make our own strategy of changing their mindset, without compromising with our agenda. Just be straight forward and have a specific goal. Do not beat about the bush. Do not ask the Minister to do too many things.
Here is a personal example—“When I met first the Health Minister of Nepal, he was not aware of the complexity of tobacco control. But after I explained to him everything, he became very supportive and asked how he could help the cause. I requested him to do just one thing—increase the size of pictorial warnings on tobacco packs—as it was in his jurisdiction to do so. I told him that this would be a great achievement for Nepal and increase its credibility in the global health community. He agreed immediately”.
In Myanmar too the Health Minister was very supportive and asked Bam what was expected of him. When Bam explained to him about tobacco control and its consequences for other public health programmes, he agreed to help. He proposed to the President for 90% pictorial health warnings, but could finally get sanction for only 75%. But then, even this was no mean achievement.
Learnings to share:
From his experience of working in several countries of the Asia Pacific region, Bam says that understanding the local culture and the local political dynamics are important to change the scenario. There is no one size that fits all and policies have to be adapted to local situations/conditions.
Also personal and organisational commitment and a ‘never say die’ attitude is key to the success of any public health programme.
Even as I write this piece, all eyes are on the seventh session of the conference of the parties (COP 7) to the WHO Framework Convention on Tobacco Control (WHO FCTC) - a global anti-tobacco conference - which is currently being held in India, to review the implementation of the WHO FCTC and the Protocol to Eliminate Illicit Trade in Tobacco Products. The Health Minister of India has pointed out in his message that “India has recently implemented pictorial health warnings covering 85% of the principal display area of tobacco products packets; set up the ‘Global Knowledge Hub for Smokeless Tobacco’ which will act as a repository of knowledge related to smokeless tobacco; prohibited the manufacture, sale, distribution and transportation of packaged smokeless tobacco products and launched the National Tobacco Cessation Quitline along with mCessation services, and passed regulation for restricting display of tobacco products or their use in films and television programmes”.
We hope that the outcomes of this conference will greatly influence and galvanize the global tobacco control efforts.
(Shobha Shukla is providing thematic coverage from the 47th Union World Conference on Lung Health, Liverpool, United Kingdom, with kind support from TB Alliance (Global Alliance for TB Drug Development). Follow her on Twitter @Shobha1Shukla)