11 countries, including Bhutan signed and adopted the Dili Declaration to control the use of tobacco in the region

WHO:  Health ministers of 11 countries yesterday pledged tough actions on tobacco use as the 68th session of the World Health Organisation (WHO) Regional Committee meeting opened yesterday in Timor- Leste’s capital, Dili.

Host Timor-Leste has one of the highest tobacco consumption rates in the world.

The Dili Declaration on tobacco, which was adopted yesterday focuses on four aspects of the Framework Convention on Tobacco Control (FCTC) that SEAR countries would implement – imposing equal taxes on all tobacco products, enforcing ban on tobacco advertisements, enforce pictorial warnings on cigarette packs and implement 100 percent ban on public smoking.

Tobacco control is one of the three health issues on the agenda of the round table ministerial meetings. Human resources for health and sustainable development goals will be discussed in the other two ministerial meetings.

Regional Director for WHO SEAR, Dr Poonam Khetrapal Singh said that besides others, the region also faces socio cultural challenges in controlling tobacco use.

Tobacco use, she said, kills nearly six million people globally every year, with over 1.3M deaths occurring in the region.

Lauding Timor Leste’s efforts in tobacco control and for showing the real meaning of ‘governance for health’ Dr Poonam Khetrapal Singh said that the region is one of the largest producers and users of tobacco products in the world.

“Tobacco use in South-East Asia is alarmingly high, triggering major health and economic consequences,” she said. “Tougher actions are needed for tobacco control and prevention.”

Health minister Tandin Wangchuk said that while Bhutan enacted its legislation on tobacco control in 2010, the Act had to be amended twice. Lyonpo shared that, although ahead in it’s tobacco control efforts, Bhutan still needs to educate inspectors in monitoring and put in place cessation programme in health centres.

Director for the Department of NCDs and Environmental Health, Dr Thaksaphon Thamarangsi said that the Global Status Report on NCD, 2014, found tobacco use among males ranged from around 34 percent in Bhutan to 74 percent in Myanmar.

The Global Youth Tobacco Survey, 2014, found that current tobacco use was high in Timor-Leste at 42 percent followed by Bhutan at 30 percent and 20 percent each in Nepal and Indonesia.  “It’s the use of smokeless tobacco that is high in Bhutan, although its one of the earliest countries in the region to have anti-tobacco measures in place,” Dr Thaksaphon Thamarangsi said.

Timor Leste’s Prime Minister, Dr Rui Maria de Araijo who joined the WHO community at the inaugural shared that over 70 percent of Timorese men use tobacco.

“This is a tragic and unacceptable figure for the type of prosperous nation we strive to become,” he said.

He said the decree law that will allow authorities to take concrete legal and policy measures to control tobacco consumption and sales in Timor Leste has been circulated for comments before its tabled at the Council of Ministers for approval.

“I will make sure this will happen shortly so that we can put a halt to Timor-Leste being exploited through weak legislation,” he said.

Tobacco use is culturally accepted in Timor Leste, just as alcohol is in Bhutan. Even with a legislation, Timor-Leste’s health minister Dr Maria do Ceu Sarmento Pina da Costa said that this cultural acceptance would be their main challenge in their tobacco control efforts.

Accelerating the implementation of WHO FCTC is vital to achieving the post-2015 Sustainable Development Goals, which aim to reduce tobacco use by 30 percent by 2025.

The Regional Committee meeting from September 7-11 will discuss the health agenda for the Region. It will deliberate on key issues such as preparing to respond to health emergencies, the growing anti-microbial resistance which threatens to undo the advances made with the use of anti-biotics, prevention and control of cancer, expanding universal health coverage and elimination of neglected tropical diseases

Lyonpo Tandin Wangchuk said universal health coverage would be the future of Bhutan’s health care system. “Through universal health coverage, our public health care will be strengthened to combat the menace of NCDs,” he said.

Sonam Pelden, Timor-Leste