WHO’s Refusal to Embrace THR Continues to Produce Policy Failures in Countries With Limited Healthcare Infrastructure—Experts

Experts at the Good COP 2.0 currently underway observes that the World Health Organisation’s (WHO) refusal to embrace tobacco harm reduction (THR) continues to produce policy failures in countries with limited healthcare infrastructure.

In its 3rd day, the Good COP 2.0 evaluated regional evidence that exposes the WHO’s failures and offers a sweeping look at the scientific, consumer, and regulatory realities facing more than 600 million smokers across the Asia-Pacific region.

A media alert from the conference indicates that the speakers took great concern that new research on the South-East Asia Region (SEAR) and the Western Pacific Region (WPR) “unveiled deep inconsistencies between the data and the WHO’s policy recommendations.”

The experts highlighted that consumer advocacy remains under attack in many Asian countries, yet demand for safer alternatives is growing rapidly: “We need countries to step up and make it clear that they don’t want to be a part of this prohibitionary process, and advocate for a holistic harm reduction approach,” said David Williams, Chief Executive of the UK’s Tax Payers’ Alliance (TPA).

On the African perspective, Gabriel Oke — a medical laboratory scientist and PRO who advances THR through research, training and advocacy in low- and middle-income countries, observed that the continent has a large percentage of people who smoke.

“It is really important that we are part of the discussion and decision-making. You cannot deny that the WHO has done a lot for healthcare in Africa, and the WHO Framework Convention on Tobacco Control (FCTC)-related activities, unfortunately, undermine that work.”

Ahead of the Good COP 2.0, Oke observed that the road to more rapidly reducing smoking-related harms in Africa, “is fraught with obstacles, as reflected by today’s scarce availability or knowledge of tobacco harm reduction products and the absence of meaningful regulation.”

“But tomorrow’s knowledgeable healthcare providers can be critical sources of information for the public, and important advocates at a policy level,” he said.

In the keynote address; ‘Tobacco Harm Reduction: A Pathway to Public Health in Southeast Asia’, Prof. Tikki Pangestu emphasised that, “evidence-based policymaking is key,” adding that there is a need for joint research across the region on prevalence, economics and the health impacts of e-cigarette use.

“The lack of research has been a real problem in ASEAN countries,” said Indonesian Prof. Pangestu, who is the WHO’s former director of research policy & cooperation. “Technology is moving very quickly, and regulators are struggling to keep up with the pace of innovation.

“Ten percent of government income comes from taxes on tobacco — are you ready to remove that income?” questioned Prof. Pangestu, who has held academic appointments in leading universities in Asia and is now senior independent consultant at the Centre for Healthcare Policy & Reform Studies in Jakarta, Indonesia.

From the voices of the Asian Pacific, Clarisse Yvette Virgino and Asa Saligupta, clarified that consumer advocates in the Philippines are still trying to ask their government “for a more balanced and impartial approach to regulation.”

“Thailand says that you cannot claim to have ‘quit’ tobacco unless you completely abstain from nicotine. I guess that means I’ll have to quit eating tomatoes and eggplant because they contain nicotine,” argued Asa Saligupta.

Yvette Virgino observed that prohibition “rules right now are very stringent, and the people demand a more humane approach. It’s not just about revenue; it’s about the consumers.”

Dr. Rohan Sequeira, a distinguished consultant cardio-metabolic physician from Mumbai, India, with an extensive career spanning over 20 years, hinted that, “the experience with nicotine replacement therapy has been disappointing as patients often find themselves without an exit strategy.”

“There has to be a better alternative available. India has 40% of the world’s oral cancer, 95% of which can be traced to tobacco. When you have a modifiable risk factor, why are you not allowing people to modify it?” questioned Dr. Sequeira, who specialises in non-invasive cardiology, diabetes, endocrinology and obesity management.

The key takeaways from the 3rd day were that new South-East Asia Region (SEAR) and the Western Pacific Region (WPR) research shows that the WHO’s anti-THR stance is harming public health; and that Asia-Pacific nations face high smoking burdens but are denied effective harm reduction pathways — with regional voices stressing that innovation must be part of public health, not treated as a threat.

Nancy Loucas concluded by saying: “While the WHO champions needle exchange programs for HIV, substitution programs for opioid use, and moderation-based approaches for alcohol consumption, it has systematically excluded tobacco harm reduction from the conversation.”

Loucas’ THR advocacy began in 2015 as one of the founders of Aotearoa Vapers Community Advocacy (AVCA) in New Zealand — advancing the battle for the rights of vapers to be able to access what they need to become or remain smoke-free.