#dnaEdit: Health is wealth

The Union health ministry’s move to defer the increase in size of pictorial warning on tobacco products on the ground of more deliberations needed on the issue, must not become a pretext to review the decision. Currently, the pictorial warnings cover 40 per cent of the product area. Last October, then health minister Harshvardhan had approved new warnings that would cover 85 per cent of the packets from April 1. It raised the hackles of the tobacco lobby and soon after, Harshvardhan was shown the door, rather unceremoniously. The reason cited for delaying the new warnings is that the parliamentary committee on subordinate legislations is studying the issue and has to submit its final report. But the statements of the chairman of this committee, Dilip Gandhi, questioning the link between tobacco and cancer, raises a cloud over the health ministry’s decision. Gandhi claimed there were no Indian studies to prove this link and that all the research on the topic was done outside India. He also raised the question of the livelihoods of nearly four crore people dependent on bidi-making.

As regards Gandhi’s first assertion, there are adequate number of studies pointing to the heightened risk of  cancer posed by tobacco consumption. More damagingly for the government, it has been reported that Gandhi’s committee submitted an interim report after meeting only the representatives of the tobacco industry. On an issue that has serious implications for public health, Gandhi should have prioritised his meetings with scientists and activists who have done research in this subject. It is hardly surprising then that Gandhi’s statement on the paucity of Indian studies has been ridiculed so widely. However, it must be admitted that the worries about people losing their livelihoods deserve more attention. For over a decade now, the State has been making noises about incentivising farmers to move out of tobacco cultivation and rehabilitating those dependent on bidi-making. In 2008, a Rs5,000 crore fund was set up to help farmers diversify into oilseeds, soyabean and chilli, and halve tobacco production by 2015. Instead, tobacco production has spiked occasionally in the subsequent years. Just before Harshvardhan was sacked, he convened a meeting of the agriculture and commerce ministries to discuss alternatives for tobacco crops. But without taking that initiative forward, Gandhi has chosen to pitch his arguments differently. He is using the plea — justifiable though it is — to deflect attention from the main issue. In fact, the old political trick of pitting one interest group against another without resolving the real issues is playing itself out.

Governments, these days, are propelled into action more by immediate economic interest — even as they swear in the name of public interest. By this count, discouraging tobacco consumption makes eminent economic sense. According to a WHO and health ministry supported study, the total economic costs attributable to tobacco-use related diseases in India in 2011 amounted to Rs1.04 lakh crore. This figure easily trumped the combined state and central government expenditure on health-care that year. In contrast, tobacco exports are in the range of just Rs600 crore. The savings on health-care expenditure could easily help in the rehabilitation of displaced workers and farmers. A Lancet paper by Indian researchers linked 40 per cent of all cancers in India to tobacco use claiming that it kills about 2,500 Indians daily and over 10 lakh Indians yearly. Pictorial warnings are a cost-effective way of raising awareness and discouraging tobacco use. Countries like Australia and Mauritius have increased the pictorial warnings to 90 per cent of tobacco product covers. Health minister JP Nadda has been non-committal on the pictorial warnings even as he promises to curb tobacco use. By revealing his ignorance, Gandhi has prejudiced the parliamentary committee’s standing. Nadda would do better to act independently and usher in the new warnings at the earliest.