November 7, 2021

A clarion call on behalf of several LMIC context networks of health/medicine students and young professionals and academics

We are elected representatives of students globally as volunteer functionaries of non-profit organizations and initiatives involving recent graduates or students from faculties of health sciences spanning Low-and Middle-Income Countries (LMIC) around the world. In effect, our network spans disciplines from Public Health, Medicine, Pharmacy, Psychology, Global Health, Dentistry and spans geographically from western Africa, around the equator to Kenya, Tanzania, Sudan, Rwanda, Burundi and more after circumnavigating the earth mainly passing through LMIC.

Many of us are focused on human rights-based approaches to ameliorating pressing health issues where health needs are expensive and/or technically advanced treatments aren’t financially possible or accepted enough to be focal areas for our Governments. Wherefore, what remains is quit or die approaches and harm reduction in one form or the other.

The last few years have seen a rise in attention to tobacco as a massive and growing health issue with a latency that is difficult to address. Smoking is still seen as a habit in the personal sphere and regarded also as normal in many of our settings, much more so than a lethal problem killing one in two, self-perpetuating as role model behavior and harming children and bystanders. The costs and suffering involved when disease from harmful tobacco use present themselves are then no longer possible to reverse but can possibly be halted or slowed by cessation. This is an issue catastrophically misunderstood to not have reasonable harm reduction potential, whereas the actual data speak volumes for the opposite. Given sufficient information and availability of safer alternatives, the future massive weight on the health care systems from sick and dying users of harmful tobacco products can be virtually eradicated without necessarily impacting levels of nicotine use in the society. We, as young representatives of national and international health systems leadership, in 2040 simply cannot accept waiting for a magic bullet to solve the tobacco epidemic, given the rate of growth in use and the measures selectively chosen from the FCTC (Framework Convention on Tobacco Control) as acceptable areas of work, which clearly are no longer effective and perhaps never were.

To the best of our knowledge the only jurisdiction globally that unambiguously follows a multipronged approach including but certainly not limited to harm reduction as an integral and important part of Tobacco Control is the UK. The importance and value of this cannot be overstated and it is not even necessary that it is an intentional or deliberate stance. It is invaluable to our work and plans for our nation’s futures simply by virtue of existing and with incontrovertible evidence more than sufficient to answer our most pressing issue in 2021 of ‘how to ensure massive transition away from the most dangerous forms of tobacco/nicotine consumption and minimizing uptake of use of those most harmful products by our youths.

Everything else must by definition be understood to be secondary to this overriding goal. Nothing can be a more valuable investment in the future health of our populations than reducing the global burden of disease from using nicotine/tobacco by 95% and likely much more at virtually no cost whatsoever to our health systems and quickly, positively impacting foreign development aid utilization through freed up resources and focus. The underlying rationales and the ongoing evidence collection for the UK positions, like publications from Cochrane Tobacco Addiction Group (TAG), Public Health England  (formerly, now National Institute for Health Protection), CRUK (Cancer Research UK), National Institute for Health and Care Excellence (NICE), Royal College of Physicians (RCP) and more. All these form a crucial center and mass of knowledge for LMIC in formulating our own way forward, suited to our conditions and capabilities, in order to avoid our health systems caving in under massive, mainly combustion related disease pressure in 15-20 years.

We therefore lend and send our genuine support for the celebratory Rally in London honoring and recognizing the genuine, positive and crucial global importance of the UK’s position and stance on Tobacco Harm Reduction.

On a final note we feel this is important to raise awareness also on the fact that none of the organisations who are key consumer organizations are to be admitted to even quietly observe the WHO-FCTC Global conference COP9 to be held November 8-13. In effect, meaning 181 parties meet for the 9th time to formulate policy and regulation specifically aimed at 1.4 billion people, without having a single representative of those 1.4 billion in the room. The mantras ‘Nothing about us without us’ ‘leaving no one behind’ are not just mere sayings but are key elements that the organizers of WHO-FCTC Global Conference need to employ to create healthy policies for everyone.

 

Respectfully yours,

Isaac Olushola Ogunkola and colleagues

On behalf of organisations and people spanning the earth with young future leaders in health, medicine, governance, and economy

 

 

Isaac Olushola Ogunkola

Faculty of Public Health, student, University of Calabar, Nigeria

Engaged THR Advocate, Calabar Ambassador for African THR grassroots civil society Campaign for Safer Alternatives

Ambassador for London School of Hygiene and Tropical Medicine

Board member, Students for Sensible Drug Policy International

Immediate Past President for SSDP Calabar Chapter

KAC Scholar

 

Yussuf Adebisi Yusuff Adebayo, MsC Pharmacy, Ilorin, Nigeria

Director for Research and Thought Leadership på Global Health Focus – GHF

Intern at National Agency for Food and Drug Administration and Control, Abuja, Nigeria

2021 Diana Award winner

 

Attaullah Ahmadi, MD, Kabul, Afghanistan

Director of Research for Asia at Global Health Focus (GHF)

Research Associate, Kateb University, Kabul, Afghanistan

KAC scholar from Afghanistan

Harm Reduction Advocate | Health Researcher | Global Health Enthusiast

 

Melody Okereke,

Policy Coordinator, African Regional Office of the International Pharmaceutical Students’ Federation (IPSF-AfRO).

Professional Development Committee, International Pharmaceutical Students’ Federation (IPSF).

Research Intern, International Pharmaceutical Federation (FIP).

Associate Member, Research Committee, Pharmaceutical Society of Nigerian (PSN).