Friday, May 31, 2013

Poverty and Tobacco: A Time for Grand Visions

Tracking the health news over the past few months, there's been one very intriguing trend that has stood out to us here at CNiC:  Grand Visions.
 
Two examples of this that have huge implications for health are the push for eliminating extreme global poverty by 2030 and very serious discussions about moving toward an endgame for tobacco - pushing tobacco use nationally and globally toward, or very near, zero.  

For each, the stage seems set for success.

In a moving speech on Poverty, Health, and Human Future to the World Health Assembly this month, World Bank President, Jim Yong Kim, made the compelling case that visions for a poverty-free world are possible by 2030. Speaking, he said:
 A generation must rise that will drive poverty from the earth. We can be that generation. A generation must rise that will end the scourge of inequality that divides and destabilizes societies. We can be that generation. A generation must rise that will bring effective health services to every person in every community in every country in the world. We will be that generation, and you—members of this Assembly—will lead the way.
Yes, I’m optimistic. I’m optimistic because I know what global health has already achieved—what you have achieved.
Such a goal does take optimism, yet the numbers seem to point toward will and hard work as the deciding factors rather than hope and luck.  Even the often staid Economist wrote that there's an "astonishing chance to take a billion people out of poverty by 2030." 

Astonishing, as well, would be the elimination of tobacco from the national and global landscape, and a supplemental issue of the British Medical Journal: Tobacco Control is dedicated to a serious discussion of real moves in that direction.  In the opening editorial, Elizabeth Smith writes:
The need for an endgame comes from the recognition that we do not have to accept the industrial marketing of tobacco, and that current policies—successful as they have often been—will likely not make the tobacco problem disappear. Those policies were never intended to eliminate the tobacco industry; the best case scenario they offer involves endless skirmishes with the industry's ongoing attempts to expand its markets and thwart regulation. Discussion of an endgame can inspire new visions of the possible.
Even though great strides have been made against tobacco over the last number of decades, it remains a scourge on public health and is used and sold at rates that should be unthinkable.  It's encouraging to see that the time has finally come to consider tobacco's endgame - a process that is likely to be long and difficult, but one that should remain a goal as we all move forward.  

A world free of extreme poverty and tobacco is hard for most of us to imagine today, but the seeds are there and starting to grow.  The positive impact such achievements would have on national and global rates of disease and mortality would be truly astounding.

Let the endgames begin.

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