Two-thirds of Indonesian men smoke and more than half of Chinese men
smoke. Even more disturbing is that 40 per cent of 13-15-year-old
Indonesian boys smoke. How have these levels been reached while the
world has known for more than 50 years that tobacco is such a deadly
habit?
In China, it is now estimated that 114 million people have
diabetes. South Africa has one of the highest per capita alcohol
consumption rates in the world, with more than 30 per cent of the
population struggling with an alcohol problem or on the verge of having
one. Cafe Creme
Tobacco, alcohol, and diabetes related to overweight and
obesity all have one feature in common. They are each largely driven,
and in the case of tobacco completely caused, by powerful commercial
interests in the form of transnational corporations. It has been said
that China's booming economy has brought with it a medical problem that
could bankrupt the health system.
We now face a major dilemma: unrestrained commercial
development is pitted against the health and wellbeing of populations.
This dilemma is not new - opponents of the abolition of slavery
complained it would ruin the economy - but it is manifesting in more
obvious ways in the 21st century.
The tobacco, alcohol and ultra-processed (''junk'') food and
drink industries have been rapidly expanding in low and middle-income
countries. In the past decade, tobacco retail sales growth in these
countries was 20 times that of the developed world. For alcohol
consumption it was three times; sugar-sweetened beverages it was twice.
But it isn't only Indonesia, China and South Africa where we find this
dilemma; it is alive and well in Australia.
For years we have known that the tobacco industry promotes
and funds biased research findings, co-opts policy makers and health
professionals, lobbies politicians and officials to oppose public
regulation, and influences voters to oppose public health measures
through expensive public relations campaigns. This success has been
noticed and over the past decade alcohol and ultra-processed food and
drink companies have been emulating these very same tactics.
This is of little surprise given the flow of people, funds
and activities across the industries. For example Philip Morris owned
both Kraft and Miller Brewing; the board of SAB Miller (the second
largest alcohol manufacturer) includes at least five past or present
tobacco company executives and board members; and the Diageo executive
director responsible for public affairs spent 17 years in a similar role
at Philip Morris.
Economic development plays an important role in the health
and wellbeing of populations. Income, employment and education levels
are all major determinants of good health. Businesses create wealth,
provide jobs and pay taxes (but as we have seen, not all of them). One
of the best ways to protect and promote health is to ensure people have
safe, meaningful jobs. The more evenly wealth and opportunity are
distributed, the better the overall health and wellbeing of a
population.
But clearly not all businesses are good or healthy - yet we
see some of them expanding their markets and influence across the globe -
seemingly with no capacity to diminish or mitigate the harm they do. It
is astonishing that an industry such as tobacco, which is so harmful to
human health, can wield so much power. In Indonesia, Philip Morris and
its affiliate, Sampoerna, will invest $US174 million to improve
production capacities so, as Sampoerna's president has said, ''Indonesia
would be the centre of the Marlboro brand production to cater [for]
demands in the Asia-Pacific region''.
Why do they need to expand their activities? Aren't the
existing 700 million smokers in the region enough? Especially when we
know that more than half of them will die prematurely, losing about 20
years of life to tobacco.
The major tobacco, food, and alcohol companies have assets
that are greater than many countries and can wield this power in
parliament, law courts and the media, against the interests of the
public's health.
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