Seminar 3: Global health and big tobacco

On 10 September 2010, Dr Tom Glynn of the American Cancer Society gave the third of C3’s International Breakfast Seminars, on ‘The rocky road to a global health agenda – why Big Tobacco may be smiling’. It dealt with the growing prominence of non-communicable diseases in the global health agenda, and why tobacco control must continue to merit particular attention. The seminar was held at the House of St Barnabas, Soho, London.

• Slides from the event are available here >> (warning: large pdf file: 5MB).
• A full precis of the event is available here >>

Dr Glynn spoke as preparations are under way for the 2011 UN summit on non-communicable diseases (NCDs). His concern is that NCDs should be at the top of the global health agenda, but that ‘battle lines’ should not be drawn between potentially competing campaigns seeking funding, whether for tobacco control, HIV, diabetes or heart disease. This competition was labelled the ‘risk-factor hierarchy’ or ‘caste system’ by Dr Glynn, as groups compete for limited funds for research, prevention and treatment of NCDs.

Dr Glynn challenged the notion that tobacco control had already been achieved. Whilst take-up of smoking has slowed in high-income countries,  there is an escalation in (for example) deaths from cancer in developing countries, which now account for 56% of all cancer cases and 63% of all deaths. Recent figures on the economic burden of cancer revealed an annual global cost of $895 billion in lost family incomes, not including the cost of care.

As with other NCDs, cancer is in transition from being regarded as a ‘disease of the west’ to becoming a major issue for developing countries. Dr Glynn said that Africa was the only continent in which NCDs had not overtaken infectious diseases as the primary cause of death.

There are, however, positive signs, with alliances forming to represent all NCDs. What is crucial was to have a limited number of specific actions agreed by all before the 2011 UN summit.

A wide-ranging discussion followed, covering points including:

• campaign groups need to refine their message, with no more than three demands to take to the 2011 summit;
• reaching out to young people on campaign issues must use new approaches, including social media;
• the importance of retaining all three risk factors when lobbying on NCDs: a single focus could be destructive;
• lessons should be learned from the Copenhagen Climate Change summit, where infighting helped lead to its failure;
• is the UN the most important forum? Real achievements will come from social justice and people’s desire for change. It is essential to tap into this through avenues such as social media;
• although in the United States it appears that obesity issues are marginalising tobacco control there is surely a way for both issues to link together;
• tobacco control has to remain the core issue in the run-up to the 2011 Summit, as all the evidence points to its success, perhaps along with other clear wins such as access to insulin and morphine.