Health: Whose Responsibility Is It?
The first International Conference on Health Promotion, meeting in Ottawa on the 21st day of November 1986, presented their charter for action to achieve Health for All by the year 2000 and beyond. The charter stated that ‘health promotion’ is the process of enabling people to increase control over, and to improve, their health. It called for ‘joint action [that] contributes to ensuring safer and healthier goods and services’.
Judicial process is one way of ensuring safer and healthier goods and services, although recently we had the ‘unhealthy’ example of Ceylon Tobacco Company, almost fully owned by British American Tobacco, successfully reducing the size of pictorial health warnings on cigarette packs through a judicial process.
Sophisticated campaigners are expected to take the corporations to court—those who sell us unsafe and unhealthy goods and services—thus ensuring health promotion in the ‘Ottawa’ style. One would expect such action to happen in Colombo first, so the less sophisticated in the outstations would take a leaf out of the book of Colombo’s Health Promotion story.
However, when one looks at what really happens, there unfolds a contrastingly different story. It seems the outstations are teaching Colombo a hard lesson, although it comes sporadically.
In 2008, newspapers reported a remarkable landmark court case from Polonnaruwa. The Court of Appeal, in a historic judgment, held that a widow from Sevagama, Polonnaruwa had cause of action to claim compensation from Ceylon Tobacco Company Ltd. for the death of her husband who died of cancer due to smoking cigarettes. She claimed Rs. 5 million as compensation and won her case at the district court. The Tobacco Company’s appeal to the Appeal Court against the District Court order was dismissed with cost.
In the same year, there were unverified reports from Uhana, Ampara, that a PHI (Public Health Inspector) informed the court about the misleading nature of a TV commercial for a major calcium-enriched milk brand. The court is said to have issued an order to change or remove the said commercial from circulation. In a later year, newspapers reported that a Health Ministry spokesman revealed that the Food Advisory Committee of the Ministry of Health had taken issue with a segment of an Anlene television advertisement and compelled the company to edit it out. He is reported to have said: “There was a segment in the particular advertisement where it indicates that the woman will not be able to lift her children after getting osteoporosis and implying she should drink Anlene milk to overcome that. The committee felt this particular segment induced fear among the public.”
In 2011, Kahatagasdigiliya Magistrate Court ordered, according to reports, the manufacturers of Astra margarine to specify in their margarine packets that Astra margarine is harmful to children under three years of age due to one of its chemical components, namely E-319. The court order followed a case filed by an Anuradhapura PHI, bringing to the notice of the court this lapse on the part of the Astra margarine manufacturers.
Now, in 2014, again from a faraway place, this time Dehiattakandiya, comes a remarkable report: the Dehiattakandiya Magistrate Court decided to proceed with a court case filed by, again, a PHI against two people who hired a person under 21 years of age to sell cigarettes. The defendants’ lawyers’ many attempts to thwart the hearing of the case were unable to swing the judge’s decision in their favor. The judge decided that this case is within the purview of the National Authority of Tobacco and Alcohol (NATA) Act and that the PHI is a rightful representative of NATA.
This example of joint action in health promotion is exceptional due to its powerful message: We are watching! The health ‘destroyers’ in this country are under watch by health promoters. The judgment is a coherent, comprehensive, and articulate signpost for the future of health promotion.
Citizens campaigning for health promotion, especially some PHIs, have been able to effect strong action that contributes to ensuring safer and healthier goods and services for us in this country. These actions have been happening in faraway places such as Dehiattakandiya and Kahatagasdigiliya. Perhaps it is time for those in Colombo and major cities to take a leaf out of the books of these brave men and women.
