This document discusses tobacco control interventions as cost-effective "best buys" for preventing noncommunicable diseases. It outlines the tobacco epidemic and impact on health and economies. The WHO Framework Convention on Tobacco Control and MPOWER strategies are presented as evidence-based mechanisms for implementing demand reduction measures like tax increases and protection from smoke, as well as supply measures. Case studies show progress in implementing strong warning labels, advertising bans, and tax increases in countries like Iran, Jordan, and Egypt. Tobacco control is estimated to avert over 5 million deaths at relatively low cost.
Universal health coverage as a concept was born in 1883 when Germany introduced health coverage for achieving health status of its young population.India, is still attempting to find a way for providing appropriate, affordable and accessible health care to its population.
Universal health coverage was established in the WHO constitution of 1948 declaring health a fundamental human right.The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
Universal health coverage as a concept was born in 1883 when Germany introduced health coverage for achieving health status of its young population.India, is still attempting to find a way for providing appropriate, affordable and accessible health care to its population.
Universal health coverage was established in the WHO constitution of 1948 declaring health a fundamental human right.The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
The course offers an opportunity to develop a holistic understanding of Primary Health Care, its functions, and scope. The course attendants will learn the principles of Primary Health Care, the course is expected to help the students to understand and internalize international health and public health transition facilitating the integration of health sector with other sectors.
Innovation in Surveillance of Communicable and Non-Communicable DiseasesDr. Nirmal Kandel
Innovation in Surveillance of Communicable and Non-communicable Diseases
http://nirmalkandel.com/wp-content/uploads/2014/03/Innovation-in-Surveillance.pdf
Non-communicable Diseases And Interventions to minimize itGaaJeen Parmal
Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Epidemiology of Non Communicable Diseases (NCDs)Prabesh Ghimire
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all the sources although references have not been explicitly cited for all the contents in this document.
Health System Management Field Program 4th yearAbiral Wagle
On a two month long field program from 17th Falgun 2077 to 15th Baisakh 2078 , we Group D2 had Placements in different settings- Primary Hospital Class B (Highway Community Hospital), Primary Hospital Class A (Dhading District Hospital), Secondary Hospital (Hetauda Regional Hospital), Rural Municipality (Benighat Rorang) and Municipality (Neelakantha)
The findings from the field program are summarized as:
-Overall municipal profile and municipal health profile of Benighat Rorang Rural Municipality
-Hospital Profile of Highway Community Hospital
-Epidemiological trend analysis of AGE cases in Hetauda Hospital
-Five-year plan on strengthening TB program in Neelakantha Municipality
The emergence of the concept of "International Health." Traces back to the pre/post world war period and how it impacted the formation of various international health organization for various strata of the society.
Presentation delivered by Dr Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean
The course offers an opportunity to develop a holistic understanding of Primary Health Care, its functions, and scope. The course attendants will learn the principles of Primary Health Care, the course is expected to help the students to understand and internalize international health and public health transition facilitating the integration of health sector with other sectors.
Innovation in Surveillance of Communicable and Non-Communicable DiseasesDr. Nirmal Kandel
Innovation in Surveillance of Communicable and Non-communicable Diseases
http://nirmalkandel.com/wp-content/uploads/2014/03/Innovation-in-Surveillance.pdf
Non-communicable Diseases And Interventions to minimize itGaaJeen Parmal
Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Epidemiology of Non Communicable Diseases (NCDs)Prabesh Ghimire
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all the sources although references have not been explicitly cited for all the contents in this document.
Health System Management Field Program 4th yearAbiral Wagle
On a two month long field program from 17th Falgun 2077 to 15th Baisakh 2078 , we Group D2 had Placements in different settings- Primary Hospital Class B (Highway Community Hospital), Primary Hospital Class A (Dhading District Hospital), Secondary Hospital (Hetauda Regional Hospital), Rural Municipality (Benighat Rorang) and Municipality (Neelakantha)
The findings from the field program are summarized as:
-Overall municipal profile and municipal health profile of Benighat Rorang Rural Municipality
-Hospital Profile of Highway Community Hospital
-Epidemiological trend analysis of AGE cases in Hetauda Hospital
-Five-year plan on strengthening TB program in Neelakantha Municipality
The emergence of the concept of "International Health." Traces back to the pre/post world war period and how it impacted the formation of various international health organization for various strata of the society.
Presentation delivered by Dr Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean
Non-Communicable Diseases: Malaysia in Global Public HealthFeisul Mustapha
Paper presented at a CME Session, held in conjunction with the NIH Research Week 2014, 26 November 2014 at the Institute for Health Management, Bangsar
Non-communicalbe diseases and its preventionShoaib Kashem
Non communicable disease account for a large and increasing burden of disease worldwide. It is currently estimated that non communicable disease accounts for approximately 60% of global deaths and 43% of global disease burden. This is projected to increase to 73% of deaths and 60% of disease burden by 2020.
Health effects of Smoking and tobacco use.pptxidris977926
Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis
E-Cigarettes a Disruptive Public Health Phenomenon - Professor Antoine FlahaultLindsay Fox
E-Cigarettes a disruptive public health phenomenon: Ethics, risk and the precautionary principle
Slides from Professor Antoine Flahault's presentation at the E-Cigarette Summit, London November 12, 2013.
Full summary of the E-Cigarette Summit: http://ecigarettereviewed.com/e-cigarette-summit-london-summary
Respiratory medicine still faces many challenges that are brought on by modern lifestyles. The population is aging, many individuals are still unable to quit smoking, and environmental factors, like air pollution, remain largely unsolved. With these, the global burden of respiratory disease has been predicted to continue increasing in the years to come.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Preventive Interventions: The cost-effective “Best-Buys”
1. Preventive Interventions:
The cost-effective “Best-Buys”
- Global advances in Tobacco Control -
Riyadh, 10 -12 September 2012
Douglas Bettcher, MD, PhD, MPH
Director, Tobacco Free Initiative
Director Ad Interim, Chronic Diseases and Health Promotion
2. WHY TOBACCO
CONTROL
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
3. Tobacco and the NCD action plan:
4 risk factors, 4 noncommunicable diseases, 2 conditions
Cancer Chronic
respiratory
Diabetes diseases
Noncommunicable Cardiovascular Mental disorders
Diseases and disease
Injuries
Conditions
Physical
Risk factors inactivity Harmful use
of alcohol
Unhealthy
Tobacco
diets
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
4. 86% of people who die from NCDs between the ages of 30 and 70
live in a developing country
Low-income High-income
countries countries
1.5 million 2.0 million
(11%) (14%)
Upper middle-
income countries
2.3 million
(16%)
Lower middle-
income countries
8.3 million
(59%)
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
5. Huge disparities exist across countries in relation to the probability of death from
an NCD between the ages of 30-70
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
6. The Tobacco Epidemic - Today
Source: WHO 2008
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
7. Tobacco kills… Tobacco kills ...
About 90% of all
22% of global deaths from
…nearly cancer chronic
6 million deaths, 71% obstructive lung
of all lung diseases and 42%
people cancer
of all chronic
respiratory
each deaths. disease are
attributable to
year. • 10% of cardiovascular
disease deaths cigarette
smoking.
Source: WHO Global status report on noncommunicable
diseases, 2010, http://www.who.int/nmh/publications/ncd_report2010
/en/
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
8. Exposure to second-hand smoke also kills
Distribution of
One third of adults are regularly total deaths
attributable to
exposed to second-hand tobacco SHS, 2004
smoke.
About 600 000 people die each year
as a result of exposure to second-
hand smoke.
• 430 000 are adults, of whom 64% are women
• 28% of the second-hand smoke deaths are
among children
Source: Global estimate of the burden of disease Mattias Oberg … [et al], WHO 2010,
http://www.who.int/tobacco/publications/second_hand/global_estimate_burden_disease/en/index.html
.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
9. The Tobacco Epidemic is About to Get Much
Worse…
Tobacco could kill
up to
If current 1 Billion
smoking patterns persons in the
Tobacco continue, the 21st Century
currently kills death toll from unless urgent
nearly 6 tobacco use will action is taken
Million/year but be:
this will increase • 2000–2025~150M
to over 8 • 2025 – 2050 ~ 300 M
• 2050 – 2100 > 500 M
Million/year in a
few decades.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
10. THE SOCIO-ECONOMIC
IMPACT
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
11. New perspectives
The poorest people in developing countries are affected the most:
Example: Poorest people smoke the most
45 Smoking prevalence (2004)
Lowest household
40 income quintiles
35
30
(percentage)
25 Highest household
income quintiles
20
15
10
5
0
Low-income Lower-middle Upper-middle- High-income
countries Income income
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
12. OPPORTUNITIES
AND GLOBAL RESPONSE
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
13. Mechanisms for Tobacco Control
WHO Framework Convention on
Tobacco Control (WHO FCTC)
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
14. WHO Framework Convention on Tobacco Control:
An evidence-based tool to save lives
Objective:
“To protect present and future
generations
from the devastating health, social,
environmental and economic
consequences
of tobacco consumption and exposure
to tobacco smoke …
to reduce continually and substantially
the prevalence of tobacco use and
World No Tobacco Day Poster 2011
exposure to tobacco smoke.”
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
15. What is the WHO FCTC?
First global health treaty negotiated
176
under the auspices of WHO
176 Establishes tobacco control as a
priority on the public health agenda
Provides a political and legal platform
Parties for adoption of sound, evidence based
tobacco control measures
Introduces a mechanism for firm
country commitment and accountability
Entry into force 27 Feb 2005
176 parties covering about 87% of the world’s population
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
16. Demand reduction Supply reduction
provisions provisions
Price and tax measures (Art.6) Elimination of illicit trade (Art.15)
Protection from secondhand smoke Prohibition of sales to and by minors
(Art.8) (Art.16)
Contents regulation (Art.9) Support for viable crops for growers
Disclosure of contents (Art.10) (Art.17)
Packaging and labelling (Art.11)
Education and awareness-raising
(Art.12)
Advertising, promotion and
sponsorship (Art.13)
Cessation programmes (Art.14)
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
17. BEST BUYS
AND
GOOD BUYS
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
18. Rationale – Why "best buys" for NCDs?
Consequent need to
develop:
NCD "best buy"
interventions that are cost-
effective, feasible, low-cost
Public health and Cost-effectiveness –
and appropriate to
economic burden – show indicates solutions but not implement within the
the size of the problem, but their constraints of the local
not how to address and feasibility, affordability and health system
reduce it acceptability Financial planning tool for
identifying resource needs
Price tag analysis to inform
global resource
mobilisation
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
19. The cost of action vs inaction
(in developing countries over the next fifteen years)
Cost of action: Cost of inaction:
US$ 170B US$ 7T
is the overall cost for
all developing countries is the cumulative
to scale up action lost output in
by implementing a set of developing countries
"best buy" interventions associated with NCDs
between 2011 and 2025, between 2011-2025
identified as priority
action by WHO
Reports are available at www.who.int/ncd
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
20. MPOWER: Six policies which
build on the WHO FCTC
and are an integral part of the
NCD Global Strategy Action Plan
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about the dangers of tobacco
Enforce bans on tobacco advertising, promotion
and sponsorship
Raise taxes on tobacco
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
21. Tobacco control is cost-effective
US$0.6 billion for all low- and middle-income
countries (US$0.11 per capita)
Monitor tobacco use and prevention
BEST BUYS Protect people from tobacco smoke
& Offer help to quit tobacco use
Warn about the dangers of tobacco
GOOD BUYS Enforce bans on tobacco advertising
Raise taxes on tobacco
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
22. Tobacco control is cost-effective
5·5 million deaths could be
averted over 10 years if these
elements of the WHO FCTC were
implemented in countries:
• increased taxes on tobacco products;
• enforcement of smoke-free workplaces;
• WHO FCTC-compliant packaging and labelling, with
public awareness campaigns about health risks;
• comprehensive ban on tobacco
advertising, promotion, and sponsorship.
at a cost of less than US$ 0.40 per person
in low income and lower-middle income countries
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
23. Estimates for the average annual cost of tobacco control best buy
interventions in all low- and middle-income countries (US$ 2008)
P
R
W
E
W
A study that modelled P, W, E, R for 23 countries
5.5 million deaths could be averted at less than US$ 0.40/person /year in low- and lower-middle-
income countries, and US$ 0.5–1.00 in upper-middle-income countries.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
24. Status of MPOWER measures
Number of highest achieving countries in 2010
59
23
M 31 19 19
P 19 27
O
W
E
R
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
25. Progress is being made
3.8 billion people
(55% of the world’s
population)
are covered by at least one
MPOWER measure at the
highest level of achievement,
including
1.1 billion people
M
covered by a new policy
P
since 2008
O
W
E
R
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
26. MPOWER measures
bring smoking rates down rapidly
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
27. EMRO – countries with MPOWER measures
at the highest level of achievement
M Djibouti, Iran, Jordan, Lebanon, Morocco
P Iran, Libya, Pakistan
O Bahrain, Iran, Saudi Arabia, United Arab Emirates
W – labels: Djibouti, Egypt, Iran
W – campaigns: Egypt, Lebanon, Morocco
E Djibouti, Iran, Jordan, Kuwait, Qatar, Sudan, Syria, UAE
R West Bank and Gaza Strip
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
28. Iran implements strong pack warning labels
The Islamic Republic of Iran enacted a comprehensive
tobacco control law in 2006.
In 2008, the law was strengthened to require pictorial
warnings on all cigarette packages.
Warning labels cover 50% of the pack and include
graphic images of diseases caused by smoking.
Use of misleading terms, such as “mild” and “light” are
also banned.
As a result, Iran’s requirements fully meet the WHO
FCTC Article 11 guidelines and thus effectively warn
smokers about the risks to their health.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
29. Jordan strengthens prohibitions on tobacco
advertising, promotion and sponsorship
Tobacco advertising and marketing had in theory been banned in Jordan since 1977,
but the enforcement was weak.
The 2008 legislation clarified and strengthened the law and added new provisions to
limit point-of-sale tobacco marketing, including bans on the sale of individual
cigarettes and sales through vending machines.
To strengthen enforcement, the Ministry of Health trained 35 health promotion
coordinators on practical and suitable methods for enforcing and implementing the
law and on procedures for inspections.
This successful model for enforcing advertising and marketing bans is ready to be
expanded to the rest of the region.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
30. Egypt restructures and increases tobacco excise taxes and
earmarks additional revenues to fund health programmes
In 2010, Egypt replaced its tiered tax system with a uniformly applied 40% ad valorem excise
tax as well as a single specific tax rate of Egyptian £ 1.25 (USD 0.20) per pack of cigarettes.
Total taxes per pack by an average of 87%, which increased the average retail price by an
estimated 44%. This increase on cigarettes could reduce cigarette consumption by 21% and
smoking prevalence by more than 10%, and hence reduce the number of adult smokers by
about 893 000 and prevent about 208 000 premature deaths.
Egypt’s approach to reaching the dual
goals of reduced tobacco consumption
and increased resources to spend on
health can provide invaluable lessons
for other countries.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
31. Plain packaging
initiative takes off
Australia’s High Court
dismissed a legal
challenge from the
tobacco industry.
From December 2012,
Australia will be the first
country to sell cigarettes
only in drab, olive-green
plain packaging.
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
32. UN High-level Meeting on NCDs (New York, 19-20 September 2011)
LANDMARK EVENT ATTENDED BY:
113 Member States
34 Presidents and Prime-Ministers
54 Vice-Presidents, Deputy Prime-Ministers,
Ministers of Foreign Affairs and Health
11 Heads of UN Agencies
Hundreds of representatives from civil society
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
33. The UN POLITICAL DECLARATION ON NCDs
We, Heads of State and Government and representatives of States and Governments,
assembled at the United Nations from 19 to 20 September 2011, to address the
prevention and control of non-communicable diseases worldwide, with a particular
focus on developmental and other challenges and social and economic impacts,
particularly for developing countries,
38. Recognize the fundamental conflict of interest between the
tobacco industry and public health;
43.(c) We therefore commit to:
Accelerate implementation by States parties of the
WHO Framework Convention on Tobacco Control
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
34. The UN POLITICAL DECLARATION ON NCDs
commits Member States
Advance the implementation of multisectoral, cost-effective
population-wide interventions in order to reduce the impact
of the common NCD risk factors
Tobacco use
Unhealthy Diet
Physical Inactivity
Harmful Use of Alcohol
Interventions: Population- or individual- based measures
('best-buys') that are very cost-effective,
feasible and low-cost
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
35. 11 voluntary global targets presented in the revised WHO Discussion Paper
Premature mortality from NCDs
25% reduction
Raised blood Salt/
pressure Tobacco smoking Physical inactivity
sodium intake
25% 30% 10%
30%
Generic Drug therapy
Raised
Obesity Fat intake Alcohol medicines and and
cholesterol technologies counselling
0% 15% 10%
20% 80% 50%
Target adopted by the World Health Assembly
Preventive interventions: the cost-effective “best-buys”|
Targets with wide support
Riyadh| 10-12 September, 2012
Targets with support for further development
36. Tobacco Industry - A Mutating Vector
Epidemiological models - Tobacco use & Malaria infection
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
37. WHO FCTC ARTICLE 5.3
In setting and implementing their public health policies with respect to tobacco
control, Parties shall act to protect these policies from commercial and other vested
interests of the tobacco industry in accordance with national law.
Forms of Tobacco Industry Interference
Manoeuvering Exaggerating Manipulating Fabricating Discrediting Intimidating
to hijack the the economic public opinion support proven governments
political and importance of to gain the through front science with litigation
legislative the industry appearance of groups or the threat
process respectability of litigation
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
38. "We have evidence, and we have instruments"
Dr Margaret Chan, Director-General of the World Health Organization
Keynote address at the 15th World Conference on Tobacco or Health, Singapore, 20 March 2012
"As a tool for fighting back, we "And we have an enemy, […] the
have the WHO FCTC. We have a tobacco industry, has changed its face
practical, cost-effective way to and its tactics. Tactics aimed at
scale up implementation of undermining anti-tobacco
provisions in the treaty on the campaigns, and subverting the WHO
ground. […] the best-buy and FCTC, are no longer covert or cloaked
good-buy measures for by an image of corporate social
reducing tobacco use set out in responsibility. They are out in the open
the MPOWER package." and they are extremely aggressive"
"[…] full implementation of the "I called on heads of state and
WHO FCTC would deliver the government to stand rock-hard
single biggest preventive blow to against the despicable efforts of
heart disease, cancer, diabetes, the tobacco industry to subvert
and respiratory disease." this treaty."
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
39. TOBACCO FREE INITIATIVE
TOWARDS A TOBACCO FREE WORLD
Preventive interventions: the cost-effective “best-buys”|
Riyadh| 10-12 September, 2012
Editor's Notes
In the age group 30 to 69 (= 14.2 million people who die from NCDs):14% die in high-income countries16% die in upper-middle income countries59% die in lower-middle income countries11% die in low-income countries
Huge disparities exist across countries in relation to the probability of death from an NCD between the ages of 30-70.Japan10%San Marino10%Switzerland10%Iceland10%Australia11%Italy11%Cyprus11%Andorra11%Israel11%Sweden11%USA 15%World average22%Swaziland35%Kyrgyzstan35%Cote d'Ivoire35%Malawi36%Afghanistan38%Kazakhstan38%Tuvalu39%Turkmenistan41%Nauru47%Marshall Islands60%
All figures are current smoking for total adults.Turkey: GATS 2012, GATS 2008, World Health Survey 2003Uruguay: GATS 2009, STEPS 2006, World Health Survey 2003Australia: National Drug Strategy Household Survey 2010, 2007 and 2004
Plain packaging is a highly effective way to counter industry’s ruthless marketing tactics. It is also fully in line with the WHO Framework Convention on Tobacco Control. …what we hope to see is a domino effect for the good of public health.The evidence on the positive health impact of plain packaging compiled by Australia’s High Court will benefit other countries in their efforts to develop and implement strong tobacco control measures to protect the health of their people and to stand resolute against the advances of the tobacco industry.Picture taken without permission from http://www.guardian.co.uk/business/2012/aug/15/tobacco-plain-packaging-australia-court
DECIDED to adopt a global target of a 25% reduction in premature mortality from NCDs by 2025EXPRESSED strong support for additional work aimed at reaching consensus on targets relating to the four main risk factors, namely tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivityDECIDED to note wide support expressed by Member States and other stakeholders around global voluntary targets considered so far including those relating to raised blood pressure, tobacco, salt/sodium and physical inactivityFURTHER noted that consultations to date, including discussions during the Sixty-fifth World Health Assembly, indicated support from among Member States development of targets relating to obesity, fat intake, alcohol, cholesterol and health system responses such as availability of essential medicines for noncommunicable diseasesNOTED that other targets or indicators may emerge in the remainder of the process established by resolution EB130.R7