SEA-Tobacco-17 Distribution: Limited

Bloomberg Global Initiative to Reduce Tobacco Use

Report of the Regional High-Level Consultation New Delhi, India, 2223 February 2007

 World Health Organization This document is not issued to the general public, and all rights are reserved by the World Health Organization (WHO). The document may not be reviewed, abstracted, quoted, reproduced or translated, in part or in whole, without the prior written permission of WHO. No part of this document may be stored in a retrieval system or transmitted in any form or by any means electronic, mechanical or other without the prior written permission of WHO. The views expressed in documents by named authors are solely the responsibility of those authors. New Delhi, October 2007

Contents
Page 1. 2. 3. 4. 5. Background................................................................................................... 1 Objectives..................................................................................................... 1 Inaugural session ........................................................................................... 2 Organization of the work of the consultation ................................................. 2 Proceedings of the consultation ..................................................................... 3
5.1 Tobacco control in South-East Asia Region Regional overview ............................... 3 5.2 Tobacco control in the South-East Asia Region Targetted countries........................ 4 5.3 Bloomberg Global Initiative to reduce tobacco use................................................... 4 5.4 Role of Bloomberg partners ...................................................................................... 4 5.4 Guided discussions on ensuring success.................................................................... 6 5.6 Video conference ..................................................................................................... 7

6. 7. 8.

Individual country and partners meeting and reporting by countries .............. 7 Next steps and closing ................................................................................... 7 Conclusion .................................................................................................... 9

Annexes 1. 2. Programme ................................................................................................. 11 List of participants ....................................................................................... 13

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1.

Background
The Mayor of New York City Mr Michael Bloomberg, has committed US$ 125 million to create the Bloomberg Global Initiative to Reduce Tobacco Use (BGI). This Initiative focuses on capacity building efforts of both the public and private sectors capacity building efforts for tobacco control. Of the 15 high tobacco burden countries around the world, four countries Bangladesh, India, Indonesia and Thailand have been selected from the South-East Asia Region under BGI. The project will be implemented through five Partners - World Lung Foundation, Campaign for Tobacco Free Kids, Johns Hopkins Bloomberg School of Public Health, the CDC Foundation and WHO. The project will provide human and financial support to these four countries to implement BGI activities within their respective tobacco control programmes. In order to work in a coordinated way, it was necessary for all partners to meet with the selected countries to get a better understanding of the Initiative and to ensure effective implementation of the project. It is against this backdrop that the Regional High-Level Consultation was organized with the participation of high level policy makers from the four Bloomberg focus countries along with all partners of the Initiative. WHO Representatives and tobacco control focal points from these four Bloomberg countries also participated in the meeting.

2.

Objectives
(1) To provide a better understanding of the Bloomberg Global Initiative to Reduce Tobacco Use Project to the high-level policy-makers in four Bloomberg countries in SEAR Bangladesh, India, Indonesia and Thailand. To ensure better coordination among Bloomberg partners, WHO and the selected Bloomberg countries for development and implementation of the activities under the Project. To ensure ownership and commitment of the Bloomberg countries to the Project.
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3.

Inaugural session
The Consultation was inaugurated by Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region. The Regional Director highlighted the tobacco burden in the Region, in particular in the four Bloomberg focus countries and welcomed the Bloomberg Initiative as an opportunity to strengthen the capacity of the countries to tackle the tobacco epidemic. He stressed the need for a sustainable and coordinated effort in tobacco control through the Bloomberg Initiative. He emphasized that BGI should be complementary to the regional tobacco control programme and also help implement the WHO Framework Convention on Tobacco Control (FCTC) in the Region. He added that close collaboration among all partners of the BGI would be critical to the success of the Initiative. He reiterated WHOs commitment to the Initiative and its support to the implementation of the project in the Region. Dr Poonam Khetrapal Singh, Deputy Regional Director, WHO SouthEast Asia Region, welcomed the Bloomberg Initiative and suggested that the focus should be towards facilitating national capacity building, developing national plans of action and in ensuring multisectoral collaboration for tobacco control through BGI. The Consultation was attended by high-level participants from ministries of health of four Bloomberg focus countries from the South-East Asia Region, namely Bangladesh, India, Indonesia and Thailand along with all the Bloomberg partners, WRs and the tobacco control focal points from these four countries. Dr Catherine Le Gales-Camus, Assistant DirectorGeneral, Noncommunicable Diseases and Mental Health from WHO/HQ and concerned staff from the Regional Office also attended the Consultation. Representatives from the Bloomberg Foundation and from all the partner organizations of the Initiative, namely WLF, CFTFK, CDC, CDCF and JHBSPH as well as participants from The Union (IUATLD), and India Resource Centre attended the Consultation.

4. Organization of the work of the consultation

Dr Indriono Tantoro, Senior Adviser to the Health Minister on Protection of Health Risk Factors, Ministry of Health, Indonesia, was elected Chairperson

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and Dr Gun Chernrungroj, Head, NCD Information Centre, Ministry of Public Health, Thailand, was elected Co-Chairperson of the Consultation. Dr Vinayak M. Prasad, Director, Ministry of Health and Family Welfare, Government of India was elected as the Rapporteur. The work of the Consultation comprised presentations on all issues listed on the agenda by delegates from the countries and Bloomberg Partners. Detailed discussions were held on every aspect of the Initiative. Each country made a presentation on the progress of implementation of tobacco control programmes and the FCTC in their respective countries. Guided discussions for ensuring success of the BGI was an important aspect of the consultation. A video conference between Dr Tom Frieden, Commissioner, Department of Health and Mental Hygiene, City of New York, and the participants was also held. Individual country and partner meetings were held on country planning exercise on key topics - timing, contacts, permissions, activities, resources, reporting, hiring of staff, logistics, etc. led by the WHO Representative of the respective countries. The Consultation was formally closed by the Deputy Regional Director.

5.
5.1

Proceedings of the consultation

Tobacco control in South-East Asia Region Regional overview
Dr Poonam Khetrapal Singh, Deputy Regional Director provided a comprehensive overview of the tobacco control efforts in the WHO SouthEast Asia Region. She mentioned that this Region was one of the worlds highest producers and consumers of tobacco and tobacco products. She added that due to widespread use of both smoking and smokeless tobacco products, tobacco control was quite a complex and difficult task in the Region. The Bloomberg Initiative, thus provided an opportunity for the Region though its implementation could be a challenge for which committed and coordinated efforts among all partners would be required for the successful implementation of the Initiative.

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5.2

Tobacco control in the South-East Asia Region Targetted countries

The four countries identified in the South-East Asia Region for the Bloomberg Initiative presented an overview of the tobacco control initiatives in their respective countries. All four countries are high burden countries and face multiple challenges to tobacco control efforts. Bangladesh and India highlighted the need for effective enforcement of the anti-tobacco control laws. India expressed the need for sensitization through awareness raising and capacity building of the states. Indonesia also highlighted the multiple challenges, including enforcement of existing tobacco control measures in the country. Thailand highlighted the need for improved tobacco surveillance, further research for tobacco control and further increase in taxes.

5.3

Bloomberg Global Initiative to reduce tobacco use

Dr Kelly Henning, Special Adviser, Office of the Commissioner, Department of Health and Mental Hygiene, New York provided an overview of the Bloomberg Global Initiative to Reduce Tobacco Use. She explained the rationale for taking up tobacco control in the developing countries; the key initiatives and the guiding principles. She said that the key implementation strategies were: strengthening the public and private sectors; gathering solid data/estimates of tobacco prevalence; optimizing interventions and rigorous evaluation of outcomes. She also introduced the five key partners in the Initiative.

5.4

Role of Bloomberg partners

All the Bloomberg partners made brief presentations on their respective roles in the Initiative as partners. CDC Foundation (CDCF) Dr Samira Asma, Associate Director, Global Tobacco Control, Office on Smoking and Health, Centers for Disease Control and Prevention made a presentation on Global Adult Tobacco Survey (GATS) which is a key component of BGI. She explained how GATS would form part of the Global

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Tobacco Surveillance System (GTSS) and would help countries in strengthening tobacco surveillance for better and effective programme formulation and implementation. She also explained the whole process regarding the development of the GATS Protocol and its implementation in countries. Johns Hopkins Bloomberg School of Public Health (JHBSPH) In his presentation, Mr Stephen Tamplin made presentation in which he explained about the Institute for Global Tobacco Control and its mission to prevent death and diseases from tobacco use around the world through research, education, evaluation, and policy development. He explained that JHBSPH is a component of BGI and its overall goal is to reverse the global epidemic of tobacco use. He also mentioned JHBSPH would work with the other partners to improve tobacco control interventions. He said that JHBSPH would collaborate in the area of tobacco related economic research, economic analysis and estimation exercise for tobacco prevalence for advocacy and communication as part of BGI. He added that JHBSPH would organize summer courses for training tobacco control advocates all over the world. Campaign for Tobacco Free Kids (CFTK) Mr Matthew Myers made a presentation on the Campaign for Tobacco Free Kids International Advocacy Resource Centre and explained the major components of CTFK and supporting advocacy efforts in the following ways: listening to incountry leaders; providing strategic planning/campaign support; providing information and policy research to support advocacy efforts; strategic media/communications assistance; legal assistance; advocacy grant fund. World Lung Foundation (WLF) Dr Judith Mackay made a presentation on the role of WLF and the International Union against TB and Lung Disease (The Union) Role in BGI. She explained how the Bloomberg Grant Mechanism established under the Initiative would be involved in receiving project proposals from the Bloomberg focus countries in particular and from all countries in general and in approving and funding those proposals.
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World Health Organization (WHO) Dr Catherine Le Gales-Camus, WHO Assistant Director-General, Noncommunicable Diseases & Mental Health, WHO/HQ in her presentation explained WHO's overall contributions to BGI, TFI's overall contributions and its expected role in the Initiative. She said that the focus would be on low income, high burden countries for two years. She explained about the funding and staffing under BGI in HQ, regional offices and in Bloomberg focus countries and how funding would be split in all these offices. She also showed the organogram of HQs Interim Bloomberg Secretariat.

5.4

Guided discussions on ensuring success

The session was moderated by Catherine Le Gales-Camus. After detailed discussions, agreement was reached on the following points: The Project should be coordinated through the National Tobacco Control Focal Point. National Public Health Institutes should be involved in the Project to the extent possible. A dedicated National Professional Officer at the Country Office level would be very useful for coordination and operationalization of the Initiative in the country as part of capacity building. Global Adult Tobacco Survey (GATS) would be implemented through the Ministry of Health and the respective country office to ensure its ownership by the countries. WHO policy for dissemination of survey findings should be agreed upon by the country and all partners. Capacity developed during the implementation of the Initiative would serve as an element of sustainability for the tobacco control programme. Planning of the Project and Monitoring progress of implementation should be coordinated among partners and at different levels. Political commitment is critical to the success of the Initiative.

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5.6

Video conference
A video conference was organized between Dr Tom Frieden, Commissioner, Department of Health and Mental Hygiene, City of New York and the participants of the Consultation. First, the chairman of the meeting briefed Dr Frieden about the outcome of the first day of the meeting. Dr Frieden expressed his satisfaction at the outcome and hoped that the meeting would come up with practical steps that would be necessary for the success of the Initiative. The participants then posed questions to Dr Frieden about all aspects of the Initiative. They also inquired about the successes achieved in the area of tobacco control, in particular in creating and expanding smoke-free environments in New York City. Dr Frieden responded to all the questions and queries.

6.

Individual country and partners meeting and reporting by countries

This session was led by national tobacco control focal points and WHO Representatives. Every Bloomberg partner met each country separately and briefed them how they would be engaged with the country in their work. Countries also sought clarification on all aspects of the work of each partner. It was agreed that each partner will closely work with the country through the Ministry of Health and coordinate their work with other Bloomberg partners. After the individual country and partner meetings, each country made a presentation on the outcome of their meeting with different Bloomberg partners and presented a road map and timeframe about how they would like to take the whole Initiative forward. Countries also made their commitment to the Initiative and pledged to work closely with WHO and other Bloomberg partners.

7.

Next steps and closing

The Deputy Regional Director, Dr Poonam Khetrapal Singh, formally closed the meeting. She said that this was a first of its kind Consultation where the
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countries and the partners had the opportunity to discuss all aspects of the Bloomberg Initiative for its effective and timely implementation. They came to know each other better and about the Bloomberg Initiative. The countries had the opportunity of knowing the different roles that each partner would be playing in the project as well as how to coordinate and harmonize their efforts for a better outcome. The Consultation was also able to generate ownership of the project by the countries as well as commitment to its implementation. She said that certain concrete actions would be required by all the partners including the Regional Office as follows: (1) The Regional Office will formally request all the four Country offices to immediately recruit staff as planned and budgeted for the workplan which was already communicated to all Country offices; Each Country office would also be notified the exact amount they would receive including the budget line; Whatever funds have been received in the Regional Office would be divided among countries and the Regional Office and would be transferred to the Country offices while TFI/HQ would be requested to transfer all the funds allotted and budgeted for the Region and as soon as those funds are received, the same would be transferred to Country offices; Pending the receipt of the total funds, Country offices would use their own resources for recruitment and core activities which would later be replenished once total funds are received; Countries would be requested to complete a Template for assessment of existing capabilities for undertaking Global Adult Tobacco Survey so that the Country Mission Team would have some idea about the countrys existing capacity to undertake the survey. The dates of the country mission would be finally fixed in consultation with the respective Country office and the Ministry of Health. The Regional Office would coordinate this visit. Meanwhile, the Regional Office will work closely with the Country office and to have the draft GATS protocol tested in India; National capacity building workshops would be organized in all countries. The Regional Office would work closely with India

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Resource Centre (IRC), the Country office and MoH in this regard; (7) The Regional Office would also work with IRC to organize training workshops for the NPOs to be recruited in countries so that they are better equipped to support countries to access the grant mechanism as suggested by India. It is also felt that since there are four high burden countries in the Region, IRCs strength should be expanded in order to provide services to these four countries; The Regional Office would also be in touch with CTFK and, in particular, with the group led by Ms Patricia Lambert for legal support for the litigations like in India and in Nepal and elsewhere in the Region. The Regional Office would organize a regional capacity building workshop for anti-tobacco legal experts from all countries in the Region, both from within and outside the Government sectors; The Regional Office would also encourage the Bloomberg Foundation and partners to attend the Regional Meeting of National Tobacco Control Managers to be held in Myanmar from 26 to 30 March 2007 and to attend a session to be dedicated to the Bloomberg Initiative so that non-Bloomberg focus countries in the Region can learn more about the Initiative and be encouraged to benefit from the grant mechanism.

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The participants as well as the Bloomberg partners agreed with the points made by Dr Singh.

8.

Conclusion
The participation by all the Bloomberg partners was found useful. Countries had an opportunity to have a better knowledge and ideas about the role of each Bloomberg partner. The WHO South-East Asia Region was the first Region to have organized this kind of useful and important high-level consultation on the Bloomberg Global Initiative to Reduce Tobacco Use and was able to assemble all the Bloomberg partners and Bloomberg Foundation to speak from one platform to apprise the Bloomberg focus countries in the Region about all aspects of the Initiative and their

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respective roles in it. The consultation, as a whole, and the meetings with partners, in particular, was very reassuring for the Bloomberg countries to accept the Bloomberg Initiative and make a commitment for its effective implementation. Organizing the consultation by WHO/SEARO was seen by the Bloomberg Foundation and Bloomberg Partners as the ability and commitment of the Regional Office in taking the Initiative to its fruition.

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Annex 1

Programme
Thursday, 22 February 2007 0830 0900 hrs 0900 0930 hrs Registration Opening Session

Address by Dr Samlee Plianbangchang, Regional Director Meeting objectives and outcomes Introduction of participants and administrative announcements Group photograph
0930 1000 hrs 1000 1030 hrs Tea/coffee break Tobacco Control in SEA Region

Regional overview Dr Poonam Khetrapal Singh,

Deputy Regional Director 1030 1200 hrs Tobacco Control in SEA Region Project Targeted Countries (10 min each) Ministry of Health

Bangladesh India Indonesia Thailand

1200 1230 hrs 1230 1330 hrs 1330 1500 hrs Bloomberg Global Initiative to Reduce Tobacco Use Overview Director, Dr Kelly Henning Lunch break Bloomberg Partners and priorities (15 min followed by discussion)

CDC Foundation Johns Hopkins Bloomberg School of Public Health Campaign for Tobacco Free Kids World Lung Foundation World Health Organization by WHO/HQ
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1500 1530 hrs 1530 1730 hrs

Tea break Plenary (and Group, if required) Discussions: Ensuring Success- Guided Discussion on Key Topics

Coordination (in-country & partners) Commitment Continuity & Sustainability Planning & Monitoring Progress Dissemination
1730 hrs Reception

Friday, 23 February 2007 0900 1030 hrs Summarize guided discussion from Day One in Videoconference with Dr Tom Frieden, Commissioner, Department of Health and Mental Hygiene, City of New York Questions and Answers with Dr Tom Frieden 1030 1100 hrs 1100 1230 hrs Tea break Individual Country & Partner Meetings Country Planning Exercise on Key Topics timing, contacts, permissions, activities, resources, reporting, hiring, logistics, etc., Led by National Tobacco Focal Point and WHO Representative Lunch Break Individual Country & Partner Meetings - Country Planning Exercise on Key Topics - timing, contacts, permissions, activities, resources, reporting, hiring, logistics, etc., Led by National Tobacco Focal Point & WHO Representative (continued) Tea break Reports from Countries (15 minutes each) Next steps and closing Dr Poonam Khetrapal Singh, Deputy Regional Director

1230 1330 hrs 1330 1500 hrs

1500 1530 hrs 1530 1630 hrs 1630 1700 hrs

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Annex 2

List of participants
Bangladesh Mr M Zulfiqur Rahman Deputy High Commissioner Bangladesh High Commissin New Delhi Email: zulfiqurrahman@yahoo.com Mr Shah Asif Rahman Third Secretary Bangladesh High Commissin New Delhi Email: sarahman800@yahoo.com India Mrs Bhavani Thyagarajan Joint Secretary Ministry of Health and Family Welfare New Delhi Email: jsbt@ndu.nic.in Dr Vinayak M. Prasad Director (PH) Ministry of Health and Family Welfare Nirman Bhawan New Delhi E-mail : vinayak63@hotmail.com Indonesia Dr Indriono Tantoro Senior Adviser to the Health Minister on Protection of Health Risk Factors Ministry of Health R.I., Jakarta Indonesia Email: drindriyono@yahoo.com Dr Achmad Hardiman Director Directorate of Noncommunicable Diseases Directorate-General of DC & EH, Ministry of Health R.I., Jakarta Indonesia Email: achmad_hardiman@yahoo.com Thailand Dr Gun Chernrungroj Head of NCD Information Center Ministry of Public Health Nonthaburi E-mail: gunroj@health.moph.go.th Mr Sirichai Phantana Medical Scientist Tobacco and Alcohol Consumption Control Group Bureau of Non-Communicable Diseases Department of Disease Control Ministry of Public Health Nonthaburi E-mail: sphantana@hotmail.com Bloomberg Partners Dr Kelly J. Henning Special Advisor Office of the Commissioner 125 Worth Street, Room 349, CN28 New York, NY 10013 E-mail: khenning@health.nyc.gov Dr Julie Myers Program Associate for the Bloomberg Initiative Office of the Commissioner 125 Worth Street, Room 349, CN28 New York, NY 10013 Email:myersj75@gmail.com Email: myersj75@gmail.com Mr Charlie Stokes President and C.E.O. CDC Foundation 50 Hurt Plaza Suite 765 Atlanta, GA 30303 Email: cks8@cdc.gov

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Report of the Regional High-Level Consultation Mr William Parra Chief Operating Officer Bloomberg Initiative CDC Foundation 50 Hurt Plaza, Suite 765 Atlanta, Georgia 30303 E-mail: wparra@empatha.com Dr Samira Asma Associate Director Global Tobacco Control Office on Smoking and Health Centers for Disease Control and Prevention 4770 Buford Highway, MS K-50 Atlanta Georgia 30341 Email: SAsma@cdc.gov Ms Lorna English Deputy Director Office on Smoking and Health U.S. Centers for Disease Control and Prevention 4770 Buford Highway, MS K-50, Atlanta, GA 30341 USA Email: LZM8@cdc.gov Mr Matthew Myers President Campaign for Tobacco Free Kids 1400 Eye Street NW Suite 1200 Washington, DC 20005 Email: mmyers@tobaccofreekids.org Ms Patricia Lambert Director of the Legal Consortium Campaign for Tobacco Free Kids 1400 Eye Street, NW, Suite 1200 Washington, DC 20005 E-mail: vkhublall@tobaccofreekids.org Ms. Shoba John Programme Director India Health Bridge C/o Cancer Patients Aid Association King George V Memorial Bombay - 400 011 E-mail: sjohn@healthbridge.in Mr Stephen Tamplin Institute for Global Tobacco Control Johns Hopkins Bloomberg School of Public Health 615 North Wolfe St. Room W6041 Baltimore, MD 21205 Email: stamplin@jhsph.edu Dr Judith Mackay Project Coordinator, BGI, WLF Component Riftswood, 9th Milestone DD 229, Lot 147 Clearwater Bay Road Kowloon, Hong Kong Email: jmackay@worldlungfoundation.org Dr Katrin Janus Project Manager, BGI, Union International Union against Tuberculosis and Lung Disease (The Union) 68, boulevard Saint-Michel 75006 Paris, France E-mail: kjanus@iuatld.org Dr Sinad Jones Coordinator, Capacity Building, BGI, Union 187 Granton Road Edinburgh Direct Tel: +44 (0)131 625 0606 Tel/fax: +44 (0)131 477 3321 E-mail: sjones@iuatld.org Mr Eric LeGresley Legal Counsel, Tobacco Control and Policy BGI, Union 4 Bank Note Pvt. Ottawa, Ontario, K1Z 1C7 Canada E-mail: elegresley@iuatld.org Dr Nevin Wilson Director India Resource Centre 2nd floor, YWCA Centre for Special Education Station Road, Nizamuddin East New Delhi 110 013 Email: NWilson@iuatld.org Dr P.P. Mandal Regional Programme Coordinator for Tobacco Control India Resource Center 2nd floor, YWCA Centre for Special Education Station Road, Nizamuddin East New Delhi 110 013 Email: PPMandal@iuatld.org

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Observer Dr Poonam Dhavan Research Specialist Public Health Foundation of India 4/2, PHD House Siri Fort Institutional Area August Kranti Marg New Delhi 110016 Email: poonam.dhavan@phfi.org WHO/HQ Dr Catherine Le Gales-Camus Assistant Director-General WHO Noncommunicable Diseases & Mental Health 20, Avenue Appia GE-1211 Geneva 27, Switzerland Email: legalescamusc@who.int WHO Secretariat SEARO Dr Than Sein Director Noncommunicable Diseases and Mental Health E-mail: thansein@searo.who.int Dr Khalilur Rahman Regional Adviser Tobacco Free Initiative E-mail: rahmank@searo.who.int Dr Dhirendra N. Sinha Short Term Professional Tobacco Free Initiative Email: sinhad@searo.who.int Country Offices Dr Duangvadee Sungkhobol WHO Representative Dhaka Bangladesh E-mail: sungkhobold@searo.who.int

Dr M. Mostafa Zaman National Professional Officer (NCD) WHO Country Office Bangladesh E-mail: zamanm@searo.who.int Dr Salim J.Habayeb WHO Representative New Delhi India E-mail: Habayabs@searo.who.int Ms Vineet Munish Gill National Professional Officer WHO Country Office India E-mail: munishvg@searo.who.int Dr Albert Maramis National Professional Officer (NCD) WHO Country Office Indonesia E-mail: MaramisA@who.or.id Dr P.T. Jayawickramarajah WHO Representative Permannent Secretary Bldg. 3, 4th Floor, Ministry of Public Health Tiwanon Rd. Nonthaburi 11000 Thailand Email: jayawickramarajah@searo.who.int Mr Narintr Tima Tobacco control focal point WHO Country Office Thailand E-mail: Narintr@searo.who.int

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