Tobacco-related diseases kill 4.3 million people each year in low- and middle-income countries. That’s more than HIV/AIDS, 
malaria, and tuberculosis combined (see figure). So could someone please explain why it isn’t a ‘mainstream development issue’?
Chocolate is good for you: The Chance Result the Whole World Yearned to Believe [h/t Richard King]
What did Otpor (Serbian protest movement) get right, that Occupy got wrong? Analysis by Harvard Business Review [h/t Rakesh Rajani]
Think we’ll be seeing more of this cartoon in the run up to the Paris climate change summit in December.
The ‘us’ & ‘them’ in trade agreements (e.g. the TPP) is not nation v nation, but investors (one dollar/one vote) v voters (one person/one vote)
72 countries have more than halved the proportion of undernourished people. Global total down to 795 million. The FAO’s new State of Food Insecurity report
There was quite a lot about football on twitter last week, for some reason (John Oliver provides essential background):
“Football has nothing to do with fair play. It is bound up with hatred, jealousy, boastfulness, disregard of all rules and sadistic pleasure in witnessing violence: in other words it is war minus the shooting.” George
Orwell quoted by Matt Andrews, who argues that football income is a bit like natural resources – money out of the ground, with a high likelihood of corruption.
‘A clean FIFA will get rid of African/Asian influence and ignore ¾ of the poor world.’ Branko Milanovic worries that a
cleaned-up soccer will end up looking like tennis.
And it’s not just about corruption: in Qatar, “As things stand, more than 62 workers will die for each game played during the 2022 tournament.”
And finally, I rather liked this WaterAid spoof for last Thursday’s World Menstrual Hygiene Day, but still prefer the ad below – wonder if Richard now regrets his Facebook post? It was one of 8 chosen by the Guardian in advance of the Cannes ‘glass lion awards’ later this month. Interesting to see just how good private sector is at targeting attitudes and beliefs – maybe we should leave that bit to them, and they should give up on the service delivery?…..
Duncan Green
This is a conversational blog written and maintained by Duncan Green, strategic adviser for Oxfam GB and author of ‘From Poverty to Power’. This personal reflection is not intended as a comprehensive statement of Oxfam's agreed policies.
Issues of sin-shaming aside, there are good reasons not to use death rates alone to compare the development burden of tobacco versus the communicable diseases mentioned. Tobacco tends to kill later in life, after users have had an opportunity to enjoy much of what life has to offer and “contribute” (economically, socially) to society; and very often it kills without years and years of painful and debilitating leadup as, say, AIDS or chronic TB often does. A much better comparison would be the effect of these diseases on QALYs, DALYs, or indicators of individual economic or social contribution/participation.
Good point Christine, got any sources for comparisons in terms of those other measures?
Duncan,
OK, here are some figures for DALYs, which combine years of life lost due to premature death with years of healthy life lost due to illness and disability. They are the most commonly used of the above indicators and are readily available in annual WHO stats on disease burdens.
Tobacco use stats are a little trickier to find than the others because tobacco use is a risk factor, not the actual cause of death. The most recent comparable figures I could find were from a pair of WHO reports, based on 2004 data:
Disability-Adjusted Life Years, Low- and Middle- income Countries (LMIC), 2004 (in millions)
(all LMIC)
Diarrhoeal diseases – 72.3
HIV/AIDS – 57.9
Tobacco Use – 44.0
Tuberculosis – 34.0
Malaria – 33.9
(low-income only)
Diarrhoeal diseases – 59.2
HIV/AIDS – 42.8
Tobacco Use – 13.0
Tuberculosis – 22.4
Malaria – 32.8
(middle-income only)
Diarrhoeal diseases – 13.1
HIV/AIDS – 15.0
Tobacco Use – 31.0
Tuberculosis – 11.7
Malaria – 1.2
TL;DR: globally, the situation is dominated by the low-income countries’ burden of diarrhoeal diseases and HIV/AIDS, but tobacco use is actually a bigger problem in middle-income countries, and deserves a sharper policy focus there.
In fact, for low-income countries, tobacco use did not even place in the top 10 “risk factors” identified by the WHO (in total DALYs), whereas it was the third-highest risk in middle-income countries (alcohol and high blood pressure came first and second, respectively).
No room for complacency, with tobacco use on the rise in LMIC. As the 2009 report notes: “Because of the long time lags for development of cancers and chronic respiratory diseases associated with smoking, the impact of smoking caused diseases on mortality in low- and middle-income countries – and for women in many regions – will continue to rise for at least two decades, even if efforts to reduce smoking are relatively successful.”
Sources—-
WHO (2004). The Global Burden of Disease: 2004 update. Annex A: Deaths and DALYs 2004, p. 69.
http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf
WHO (2009). Global Health Risks: Mortality and burden of disease attributable to selected major risks, p. 12.
http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf?ua=1&ua=1
This is really helpful Christine, many thanks
Excellent HRB write-up, albeit with all the issues that come from flashy business case studies.
A stark reminder that achieving empowerment is no less subject to the demands and pressures that other power seeking entities (states, political parties, or firms) have to deal with.