Apart from facing the challenges of COVID-19, the world is facing various other challenges which contribute to the severity of the pandemic, such as non-communicable diseases (NCDs). Tobacco is among the major risk factors of NCDs and also an important risk factor for tuberculosis (TB), the world’s biggest infectious disease killer, and early evidence is showing the increased risk of serious outcomes of COVID-19 in people with TB. In order to tackle these issues, The Union along with other partners including Global TB Caucus, organized a series of webinars on government’s accountability in responding to covid-19, noncommunicable diseases, tobacco smoking and Tuberculosis. The first two sessions of the webinar were held in Nepal (Sunday 31 May 2020) and Indonesia (Wednesday 10 June 2020).
The purpose of the webinar is to share experiences in handling COVID-19, managing NCDs, accelerating Tobacco Control and managing Tuberculosis. Also to accelerate implementation of smoke free policies, ban tobacco advertising and promotion and reject industry donation and partnership and building public awareness on smoking cessation. Then to gain the commitments and support of the subnational government to strengthen the health system for effective management in responding to the issues above. The webinar brought together various stakeholders such as Members of Parliament, Mayors, health officials and health providers, academicians and researchers.
Nepal has a very high number of adult smokers with 48.3% of adult males users of tobacco. In Nepal, tobacco kills more than 27,000 people annually, which accounts for 15.68% of all deaths. Moreover, Tobacco smoking is a leading common risk factor for non-communicable diseases (NCDs) adding to the high burden of diseases and deaths in Nepal that kills 183,000 (accounts for 66 % of all deaths) people in 2018. As per the Report Of The Joint Monitoring Mission for Tuberculosis 2019 shows that Nepal is not on track to meet milestones and targets of the End TB Strategy. According to the national TB prevalence survey 2018-2019, currently over 117,000 people are living with TB disease in Nepal. TB incidence is much higher (1.6 times) than previously estimated. About 7000 people die from TB each year in Nepal.
The situation is no different in Indonesia. It has the highest prevalence of adult smokers in the world with 76% of adult males smoking. Tobacco kills 225,720 people annually in Indonesia, which accounts for 14.7% of all deaths. Indonesia has an increased prevalence of youth smokers from 7.2% in 2013 to 9.1% in 2018. Moreover, Tobacco smoking is a leading common risk factor for non-communicable diseases (NCDs) adding to the high burden of diseases and deaths in Indonesia that kill 1.4 million (accounts for 73% of all deaths) people in 2018.
The incidence rate of TB in Indonesia is relatively high, i.e., 316 per 100,000 population and it is estimated to have 845,000 people with TB. Over 98,000 people die from TB each year in Indonesia. According to the WHO, “while experience on COVID-19 infection in TB patients remains limited, it is anticipated that people ill with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted.” Therefore, during COVID-19 lockdown periods, health services, including national programmes to combat TB, need to be actively engaged in ensuring an effective and rapid response to COVID-19 while ensuring that TB services are maintained and uninterrupted.
The webinars were able to connect policy makers and implementers to share lessons learnt and experiences. It built awareness on government accountability and transparency in responding COVID-19 and sustained implementation of tobacco control, maintained and uninterrupted of NCDs and TB services.
Hon. Anggia from The House of Representatives of Republic of Indonesia reiterated the commitment of the Health Commission of Indonesia to work together with civil society and partners to find the best solution to solve the problems, particularly Tuberculosis. Dr Wiendra Waworuntu from the Ministry of Health Indonesia also strengthened this commitment by saying that increasing TB budget and access to services will be among the main focus of the government after the pandemic as part of national health reforms.