The World Health Organization (WHO) estimates that tobacco will kill up to a billion people in the 21st century, most of them in poor and middle-income countries. In an effort to cut that number, Bloombergs foundation plans to commit $250 million over four years on top of $125 million he announced two years ago. The Bill and Melinda Gates Foundation is allocating $125 million over five years.
That far outstrips current spending of about $20 million a year on anti-smoking campaigns in poor and middle-income countries, according to a recent WHO report.
The $500 million would be spent on a multi-pronged campaign nicknamed Mpower that Bloomberg and Margaret Chan, director of WHO, outlined in February. It coordinates efforts by the Bloomberg Initiative to Reduce Tobacco Use, WHO, the World Lung Foundation, the Johns Hopkins Bloomberg School of Public Health, the Centers for Disease Control and Prevention Foundation and the Campaign for Tobacco-Free Kids.
The campaign will urge governments to sharply raise tobacco taxes, outlaw smoking in public places, outlaw advertising to children and free giveaways of cigarettes, start anti smoking advertising campaigns and offer their citizens nicotine patches or other help quitting.
Health officials in developing countries, consumer groups, journalists, tax officers and others will be brought to the US for workshops on topics like lobbying, public service advertising, catching cigarette smugglers and running telephone hotlines for smokers wanting to quit.
The campaign will concentrate on five countries where most of the worlds smokers live: China, India, Indonesia, Russia and Bangladesh.
Richard Peto, an Oxford epidemiologist who leads studies on the effects of smoking in developing nations, called the announcement excellent news.
I reckon this will avoid tens of millions of deaths in my lifetime and hundreds of millions in my kids lifetime, he said.
Catherine Armstrong, a spokeswoman for British American Tobacco, one of the Western tobacco companies that focuses on sales to developing nations, would not comment directly on the new initiative. But she said, We have no problem with government organizations educating people on the risks of tobacco. Bloomberg, founder of the financial news company bearing his name and creator of the Bloomberg Family Foundation, has long been known for his antipathy to tobacco. During his administration, New York has adopted several anti-smoking measures, including a ban on smoking in bars and restaurants, and significant increases in cigarette taxes. His foundation gave $2 million to WHO to underwrite its latest tobacco report.
When I announced this initiative, I said that I hoped that others would step forward, said Bloomberg, referring to his initial $125 million commitment, in a written statement released before the afternoon news conference in Midtown Manhattan. Im delighted Bill and Melinda Gates are supporting one of the most important public health efforts of our time. It promises to be a struggle.
Cigarettes are not only highly addictive and supported by huge advertising campaigns, they are also an important source of income for many for eign governments. In some countries, tobacco is a stateowned monopoly, and low and middle-income countries collect $66 billion a year in tobacco taxes.
About 5% of countries in the world have any anti-smoking measures like those the campaign envisions.
But Dr Peto said anti-smoking campaigns were already having effects in some countries. He surveyed thousands of smokers in China in the 1990s before the government was taking it seriously, he said and found 4% who identified themselves as former smokers. In his more recent surveys, he said, there were 20%.
In India, where people have long chewed tobacco but widespread smoking is more recent, Peto said he found almost no one who had quit. India is where China was in the mid-1990s, he said.
Waves of lung cancer deaths, which typically begin about 40 years after smoking takes hold in a society help persuade the next generation that smoking is dangerous, as in the US in the 1960s, he said. And, he added, When doctors and journalists start to take it seriously, things start to change. The Gates foundations main focus has been global health, but up until now it has concentrated mostly on infectious diseases like AIDS, tuberculosis and malaria rather than chronic ones like the cancers caused by tobacco.
A spokeswoman for the foundation said that some years ago, Gates read The Tobacco Atlas, a 2002 publication from WHO describing worldwide tobacco use much of it by children. He said, Wow, why arent we looking at this? said the spokeswoman, Melissa Derry.
Gates recently gave up his post as president of Microsoft Corp. to devote himself full time to running the foundation, which has assets of about $37 billion.
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