Tag Archives: letters

The scandal of big tobacco’s behaviour in the developing world | Letters

I welcome your editorial and related coverage (Stop the spread of the tobacco companies’ poison, 13 July). Tobacco smoking is still the largest single preventable cause of ill-health and death. In the UK the reduction in smoking is one of the great public health success stories. However, it is important that this achievement is not reversed. E-cigarettes should be monitored closely.

Tobacco companies have tremendous financial and political power and, despite the overwhelming medical evidence against cigarettes, they are still able to sell their products. Moreover, certain markets are expanding. Two of the world’s largest tobacco companies are based in the UK. Both continue to perform strongly and are confident about their future performances, especially as markets are growing in lower income countries where there is tremendous potential for profit.

Many of the current strategies used by tobacco companies are not new. More than 30 years ago, Peter Taylor published a seminal book which provided a comprehensive insight into the world of public health politics. The Smoke Ring discusses the ring of political and economic interests surrounding the tobacco industry.
Dr Michael Craig Watson
University of Nottingham

We are concerned, if not surprised, to read the Guardian’s exposé of big tobacco’s use of trade measures to threaten African countries into watering down their efforts to promote public health (Report, 12 July).

A major problem with trade and investment agreements is their chilling effect on public interest legislation: countries that lack the time or resources to defend themselves against a trade dispute hold back from introducing new measures that are good for the public but threaten corporate profits and could provoke a trade challenge. This is particularly problematic where corporations are able to use the investor-state dispute settlement mechanism to sue governments in private tribunals where corporate lawyers act as judges.

For example, after Philip Morris challenged Uruguay and Australia for introducing graphic warnings on cigarette packaging and plain packaging respectively, Costa Rica, Paraguay and New Zealand delayed introducing similar measures. Philip Morris lost that case, but big tobacco is still attempting to bully (particularly low and middle income) countries that attempt to put the health of their citizens before shareholder profit. This has to be stopped.

Countries must be free to pursue independent development and public health strategies. That means having the space to regulate and tax in the public interest without the threat of litigation. We would like to see trade agreements that encourage governments to promote public health objectives, rather than acting as a brake on progress. This requires a fundamental shift in the way that we approach trade deals in the future.
Matthew Bramall Health Poverty Action
Paul Keenlyside Trade Justice Movement
David McCoy Professor of Global Public Health, Queen Mary University London
Dr Penelope Milsom Medact
Deowan Mohee African Tobacco Control Alliance
Alvin Mosioma Tax Justice Network – Africa
Mary Assunta South East Asia Tobacco Control Alliance
Deborah Arnott ASH (UK)
Laurent Huber Action on Smoking and Health (US)
Chiara Bodini and David Sanders People’s Health Movement 
Andreas Wulf Medico International
Jean Blaylock Global Justice Now
Mark Dearn War on Want
Tabitha Ha STOPAIDS
Thanguy Nzue Obame People’s Health Movement Gabon

That big tobacco hinders the adoption of anti-smoking legislation is no surprise. Your leader correctly identifies the best route to behavioural change – shareholder pressure – but does not highlight the key channel to achieve this. Big tobacco needs to diversify. This is where shareholder pressure should be applied: to encourage manufacturers and associated leaf merchants to invest in non-harmful products and speed up the process of product diversification. In addition, governments in the south and their development partners should work with manufacturers and merchants to reduce big tobacco’s own addiction to the evil weed.
Dr Martin Prowse
Lund University, Sweden

It is a proud claim we make in this country that 0.7% of our GDP is committed to international development. But efforts to reduce poverty and ill health in developing countries are seriously undermined by the activities of companies such as British American Tobacco.

The tobacco industry has an unrivalled record for dishonesty in trying to prevent its customers becoming aware that there is a 50% chance that they will die from smoking-related causes. It has been a long battle in this country to establish strong measures of tobacco control which have significantly reduced the prevalence of smoking.

In response, the tobacco companies are seeking to get many more people in the developing world addicted to their products. They use the same bogus arguments that have been defeated in the UK to prevent attempts by governments in those countries to prevent this happening. They behave in this way because they make great profits.

The world would be a much better place if such dangerous products were banned. But if this cannot be done by international agreement, then we must at least ensure that we tax them in such a way as to deter such behaviour. The funds raised could also help poorer countries in their fight to establish similar measures of tobacco control to those that are working in the UK.
Chris Rennard
Liberal Democrat, House of Lords

It is deeply unethical that BAT has taken African countries to court to dilute their efforts to protect their populations’ health from tobacco. These countries are still fighting infectious diseases and face a double burden of poor health as a result of non-communicable diseases, with very limited budgets to deal with these.

According to the international covenant on economic, social and cultural rights in the context of business activities (June 2017), these countries are obliged to protect their public’s health, and this includes regulating to restrict marketing and advertising of harmful products such as tobacco.

BAT is headquartered in the UK, so the UK is required to take the necessary steps to prevent human rights violations abroad and it is “contradictory to remain passive where the conduct of an entity may lead to foreseeable harm”.

Moreover, “extraterritorial obligation to protect requires the UK to take steps to prevent and redress infringements of rights that occur outside their territories due to the activities of business entities over which they can exercise control.”

If the UK does not fulfil its extraterritorial responsibility to protect future smokers in Africa, it is possible that it could be liable for damages when many develop cancer, heart disease and strokes. It is incoherent to give British aid for healthcare to these countries while at the same time a UK company is promoting harmful products that diminish people’s right to health.

On a related subject, British MP pension fund, the Parliamentary Contributory Pension Fund (PCPF), invests in BAT and some UK local authority pensions invest large sums in the tobacco industry which many already consider unethical even before the article in the Guardian.
Dr Bernadette O’Hare
University of Malawi and University of St Andrews

Smoking remains a major public health concern, a major contributor to overall mortality and morbidity, to air and water pollution and to physical, economic, social and psychological trauma. However, I must take issue with your allusion to the size of the distance from the developed to the developing world.

The Grenfell tragedy has shone a light on the ills of western societies where people are denied their fundamental rights to safe, clean and adequate housing; where hundreds of thousands are languishing in cramped and dangerous buildings; where homelessness, labour exploitation, knife crimes, racial and religious intolerance and joblessness are increasingly becoming hallmarks of society – and where cover up and deceit are becoming the norm rather than the exception.

To be fair, many developing countries have already recovered from the ills that still plague the developed world. Take a look in the mirror.
Dr Munjed Farid Al Qutob
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

The scandal of big tobacco’s behaviour in the developing world | Letters

I welcome your editorial and related coverage (Stop the spread of the tobacco companies’ poison, 13 July). Tobacco smoking is still the largest single preventable cause of ill-health and death. In the UK the reduction in smoking is one of the great public health success stories. However, it is important that this achievement is not reversed. E-cigarettes should be monitored closely.

Tobacco companies have tremendous financial and political power and, despite the overwhelming medical evidence against cigarettes, they are still able to sell their products. Moreover, certain markets are expanding. Two of the world’s largest tobacco companies are based in the UK. Both continue to perform strongly and are confident about their future performances, especially as markets are growing in lower income countries where there is tremendous potential for profit.

Many of the current strategies used by tobacco companies are not new. More than 30 years ago, Peter Taylor published a seminal book which provided a comprehensive insight into the world of public health politics. The Smoke Ring discusses the ring of political and economic interests surrounding the tobacco industry.
Dr Michael Craig Watson
University of Nottingham

We are concerned, if not surprised, to read the Guardian’s exposé of big tobacco’s use of trade measures to threaten African countries into watering down their efforts to promote public health (Report, 12 July).

A major problem with trade and investment agreements is their chilling effect on public interest legislation: countries that lack the time or resources to defend themselves against a trade dispute hold back from introducing new measures that are good for the public but threaten corporate profits and could provoke a trade challenge. This is particularly problematic where corporations are able to use the investor-state dispute settlement mechanism to sue governments in private tribunals where corporate lawyers act as judges.

For example, after Philip Morris challenged Uruguay and Australia for introducing graphic warnings on cigarette packaging and plain packaging respectively, Costa Rica, Paraguay and New Zealand delayed introducing similar measures. Philip Morris lost that case, but big tobacco is still attempting to bully (particularly low and middle income) countries that attempt to put the health of their citizens before shareholder profit. This has to be stopped.

Countries must be free to pursue independent development and public health strategies. That means having the space to regulate and tax in the public interest without the threat of litigation. We would like to see trade agreements that encourage governments to promote public health objectives, rather than acting as a brake on progress. This requires a fundamental shift in the way that we approach trade deals in the future.
Matthew Bramall Health Poverty Action
Paul Keenlyside Trade Justice Movement
David McCoy Professor of Global Public Health, Queen Mary University London
Dr Penelope Milsom Medact
Deowan Mohee African Tobacco Control Alliance
Alvin Mosioma Tax Justice Network – Africa
Mary Assunta South East Asia Tobacco Control Alliance
Deborah Arnott ASH (UK)
Laurent Huber Action on Smoking and Health (US)
Chiara Bodini and David Sanders People’s Health Movement 
Andreas Wulf Medico International
Jean Blaylock Global Justice Now
Mark Dearn War on Want
Tabitha Ha STOPAIDS
Thanguy Nzue Obame People’s Health Movement Gabon

That big tobacco hinders the adoption of anti-smoking legislation is no surprise. Your leader correctly identifies the best route to behavioural change – shareholder pressure – but does not highlight the key channel to achieve this. Big tobacco needs to diversify. This is where shareholder pressure should be applied: to encourage manufacturers and associated leaf merchants to invest in non-harmful products and speed up the process of product diversification. In addition, governments in the south and their development partners should work with manufacturers and merchants to reduce big tobacco’s own addiction to the evil weed.
Dr Martin Prowse
Lund University, Sweden

It is a proud claim we make in this country that 0.7% of our GDP is committed to international development. But efforts to reduce poverty and ill health in developing countries are seriously undermined by the activities of companies such as British American Tobacco.

The tobacco industry has an unrivalled record for dishonesty in trying to prevent its customers becoming aware that there is a 50% chance that they will die from smoking-related causes. It has been a long battle in this country to establish strong measures of tobacco control which have significantly reduced the prevalence of smoking.

In response, the tobacco companies are seeking to get many more people in the developing world addicted to their products. They use the same bogus arguments that have been defeated in the UK to prevent attempts by governments in those countries to prevent this happening. They behave in this way because they make great profits.

The world would be a much better place if such dangerous products were banned. But if this cannot be done by international agreement, then we must at least ensure that we tax them in such a way as to deter such behaviour. The funds raised could also help poorer countries in their fight to establish similar measures of tobacco control to those that are working in the UK.
Chris Rennard
Liberal Democrat, House of Lords

It is deeply unethical that BAT has taken African countries to court to dilute their efforts to protect their populations’ health from tobacco. These countries are still fighting infectious diseases and face a double burden of poor health as a result of non-communicable diseases, with very limited budgets to deal with these.

According to the international covenant on economic, social and cultural rights in the context of business activities (June 2017), these countries are obliged to protect their public’s health, and this includes regulating to restrict marketing and advertising of harmful products such as tobacco.

BAT is headquartered in the UK, so the UK is required to take the necessary steps to prevent human rights violations abroad and it is “contradictory to remain passive where the conduct of an entity may lead to foreseeable harm”.

Moreover, “extraterritorial obligation to protect requires the UK to take steps to prevent and redress infringements of rights that occur outside their territories due to the activities of business entities over which they can exercise control.”

If the UK does not fulfil its extraterritorial responsibility to protect future smokers in Africa, it is possible that it could be liable for damages when many develop cancer, heart disease and strokes. It is incoherent to give British aid for healthcare to these countries while at the same time a UK company is promoting harmful products that diminish people’s right to health.

On a related subject, British MP pension fund, the Parliamentary Contributory Pension Fund (PCPF), invests in BAT and some UK local authority pensions invest large sums in the tobacco industry which many already consider unethical even before the article in the Guardian.
Dr Bernadette O’Hare
University of Malawi and University of St Andrews

Smoking remains a major public health concern, a major contributor to overall mortality and morbidity, to air and water pollution and to physical, economic, social and psychological trauma. However, I must take issue with your allusion to the size of the distance from the developed to the developing world.

The Grenfell tragedy has shone a light on the ills of western societies where people are denied their fundamental rights to safe, clean and adequate housing; where hundreds of thousands are languishing in cramped and dangerous buildings; where homelessness, labour exploitation, knife crimes, racial and religious intolerance and joblessness are increasingly becoming hallmarks of society – and where cover up and deceit are becoming the norm rather than the exception.

To be fair, many developing countries have already recovered from the ills that still plague the developed world. Take a look in the mirror.
Dr Munjed Farid Al Qutob
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

The scandal of big tobacco’s behaviour in the developing world | Letters

I welcome your editorial and related coverage (Stop the spread of the tobacco companies’ poison, 13 July). Tobacco smoking is still the largest single preventable cause of ill-health and death. In the UK the reduction in smoking is one of the great public health success stories. However, it is important that this achievement is not reversed. E-cigarettes should be monitored closely.

Tobacco companies have tremendous financial and political power and, despite the overwhelming medical evidence against cigarettes, they are still able to sell their products. Moreover, certain markets are expanding. Two of the world’s largest tobacco companies are based in the UK. Both continue to perform strongly and are confident about their future performances, especially as markets are growing in lower income countries where there is tremendous potential for profit.

Many of the current strategies used by tobacco companies are not new. More than 30 years ago, Peter Taylor published a seminal book which provided a comprehensive insight into the world of public health politics. The Smoke Ring discusses the ring of political and economic interests surrounding the tobacco industry.
Dr Michael Craig Watson
University of Nottingham

We are concerned, if not surprised, to read the Guardian’s exposé of big tobacco’s use of trade measures to threaten African countries into watering down their efforts to promote public health (Report, 12 July).

A major problem with trade and investment agreements is their chilling effect on public interest legislation: countries that lack the time or resources to defend themselves against a trade dispute hold back from introducing new measures that are good for the public but threaten corporate profits and could provoke a trade challenge. This is particularly problematic where corporations are able to use the investor-state dispute settlement mechanism to sue governments in private tribunals where corporate lawyers act as judges.

For example, after Philip Morris challenged Uruguay and Australia for introducing graphic warnings on cigarette packaging and plain packaging respectively, Costa Rica, Paraguay and New Zealand delayed introducing similar measures. Philip Morris lost that case, but big tobacco is still attempting to bully (particularly low and middle income) countries that attempt to put the health of their citizens before shareholder profit. This has to be stopped.

Countries must be free to pursue independent development and public health strategies. That means having the space to regulate and tax in the public interest without the threat of litigation. We would like to see trade agreements that encourage governments to promote public health objectives, rather than acting as a brake on progress. This requires a fundamental shift in the way that we approach trade deals in the future.
Matthew Bramall Health Poverty Action
Paul Keenlyside Trade Justice Movement
David McCoy Professor of Global Public Health, Queen Mary University London
Dr Penelope Milsom Medact
Deowan Mohee African Tobacco Control Alliance
Alvin Mosioma Tax Justice Network – Africa
Mary Assunta South East Asia Tobacco Control Alliance
Deborah Arnott ASH (UK)
Laurent Huber Action on Smoking and Health (US)
Chiara Bodini and David Sanders People’s Health Movement 
Andreas Wulf Medico International
Jean Blaylock Global Justice Now
Mark Dearn War on Want
Tabitha Ha STOPAIDS
Thanguy Nzue Obame People’s Health Movement Gabon

That big tobacco hinders the adoption of anti-smoking legislation is no surprise. Your leader correctly identifies the best route to behavioural change – shareholder pressure – but does not highlight the key channel to achieve this. Big tobacco needs to diversify. This is where shareholder pressure should be applied: to encourage manufacturers and associated leaf merchants to invest in non-harmful products and speed up the process of product diversification. In addition, governments in the south and their development partners should work with manufacturers and merchants to reduce big tobacco’s own addiction to the evil weed.
Dr Martin Prowse
Lund University, Sweden

It is a proud claim we make in this country that 0.7% of our GDP is committed to international development. But efforts to reduce poverty and ill health in developing countries are seriously undermined by the activities of companies such as British American Tobacco.

The tobacco industry has an unrivalled record for dishonesty in trying to prevent its customers becoming aware that there is a 50% chance that they will die from smoking-related causes. It has been a long battle in this country to establish strong measures of tobacco control which have significantly reduced the prevalence of smoking.

In response, the tobacco companies are seeking to get many more people in the developing world addicted to their products. They use the same bogus arguments that have been defeated in the UK to prevent attempts by governments in those countries to prevent this happening. They behave in this way because they make great profits.

The world would be a much better place if such dangerous products were banned. But if this cannot be done by international agreement, then we must at least ensure that we tax them in such a way as to deter such behaviour. The funds raised could also help poorer countries in their fight to establish similar measures of tobacco control to those that are working in the UK.
Chris Rennard
Liberal Democrat, House of Lords

It is deeply unethical that BAT has taken African countries to court to dilute their efforts to protect their populations’ health from tobacco. These countries are still fighting infectious diseases and face a double burden of poor health as a result of non-communicable diseases, with very limited budgets to deal with these.

According to the international covenant on economic, social and cultural rights in the context of business activities (June 2017), these countries are obliged to protect their public’s health, and this includes regulating to restrict marketing and advertising of harmful products such as tobacco.

BAT is headquartered in the UK, so the UK is required to take the necessary steps to prevent human rights violations abroad and it is “contradictory to remain passive where the conduct of an entity may lead to foreseeable harm”.

Moreover, “extraterritorial obligation to protect requires the UK to take steps to prevent and redress infringements of rights that occur outside their territories due to the activities of business entities over which they can exercise control.”

If the UK does not fulfil its extraterritorial responsibility to protect future smokers in Africa, it is possible that it could be liable for damages when many develop cancer, heart disease and strokes. It is incoherent to give British aid for healthcare to these countries while at the same time a UK company is promoting harmful products that diminish people’s right to health.

On a related subject, British MP pension fund, the Parliamentary Contributory Pension Fund (PCPF), invests in BAT and some UK local authority pensions invest large sums in the tobacco industry which many already consider unethical even before the article in the Guardian.
Dr Bernadette O’Hare
University of Malawi and University of St Andrews

Smoking remains a major public health concern, a major contributor to overall mortality and morbidity, to air and water pollution and to physical, economic, social and psychological trauma. However, I must take issue with your allusion to the size of the distance from the developed to the developing world.

The Grenfell tragedy has shone a light on the ills of western societies where people are denied their fundamental rights to safe, clean and adequate housing; where hundreds of thousands are languishing in cramped and dangerous buildings; where homelessness, labour exploitation, knife crimes, racial and religious intolerance and joblessness are increasingly becoming hallmarks of society – and where cover up and deceit are becoming the norm rather than the exception.

To be fair, many developing countries have already recovered from the ills that still plague the developed world. Take a look in the mirror.
Dr Munjed Farid Al Qutob
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

The scandal of big tobacco’s behaviour in the developing world | Letters

I welcome your editorial and related coverage (Stop the spread of the tobacco companies’ poison, 13 July). Tobacco smoking is still the largest single preventable cause of ill-health and death. In the UK the reduction in smoking is one of the great public health success stories. However, it is important that this achievement is not reversed. E-cigarettes should be monitored closely.

Tobacco companies have tremendous financial and political power and, despite the overwhelming medical evidence against cigarettes, they are still able to sell their products. Moreover, certain markets are expanding. Two of the world’s largest tobacco companies are based in the UK. Both continue to perform strongly and are confident about their future performances, especially as markets are growing in lower income countries where there is tremendous potential for profit.

Many of the current strategies used by tobacco companies are not new. More than 30 years ago, Peter Taylor published a seminal book which provided a comprehensive insight into the world of public health politics. The Smoke Ring discusses the ring of political and economic interests surrounding the tobacco industry.
Dr Michael Craig Watson
University of Nottingham

We are concerned, if not surprised, to read the Guardian’s exposé of big tobacco’s use of trade measures to threaten African countries into watering down their efforts to promote public health (Report, 12 July).

A major problem with trade and investment agreements is their chilling effect on public interest legislation: countries that lack the time or resources to defend themselves against a trade dispute hold back from introducing new measures that are good for the public but threaten corporate profits and could provoke a trade challenge. This is particularly problematic where corporations are able to use the investor-state dispute settlement mechanism to sue governments in private tribunals where corporate lawyers act as judges.

For example, after Philip Morris challenged Uruguay and Australia for introducing graphic warnings on cigarette packaging and plain packaging respectively, Costa Rica, Paraguay and New Zealand delayed introducing similar measures. Philip Morris lost that case, but big tobacco is still attempting to bully (particularly low and middle income) countries that attempt to put the health of their citizens before shareholder profit. This has to be stopped.

Countries must be free to pursue independent development and public health strategies. That means having the space to regulate and tax in the public interest without the threat of litigation. We would like to see trade agreements that encourage governments to promote public health objectives, rather than acting as a brake on progress. This requires a fundamental shift in the way that we approach trade deals in the future.
Matthew Bramall Health Poverty Action
Paul Keenlyside Trade Justice Movement
David McCoy Professor of Global Public Health, Queen Mary University London
Dr Penelope Milsom Medact
Deowan Mohee African Tobacco Control Alliance
Alvin Mosioma Tax Justice Network – Africa
Mary Assunta South East Asia Tobacco Control Alliance
Deborah Arnott ASH (UK)
Laurent Huber Action on Smoking and Health (US)
Chiara Bodini and David Sanders People’s Health Movement 
Andreas Wulf Medico International
Jean Blaylock Global Justice Now
Mark Dearn War on Want
Tabitha Ha STOPAIDS
Thanguy Nzue Obame People’s Health Movement Gabon

That big tobacco hinders the adoption of anti-smoking legislation is no surprise. Your leader correctly identifies the best route to behavioural change – shareholder pressure – but does not highlight the key channel to achieve this. Big tobacco needs to diversify. This is where shareholder pressure should be applied: to encourage manufacturers and associated leaf merchants to invest in non-harmful products and speed up the process of product diversification. In addition, governments in the south and their development partners should work with manufacturers and merchants to reduce big tobacco’s own addiction to the evil weed.
Dr Martin Prowse
Lund University, Sweden

It is a proud claim we make in this country that 0.7% of our GDP is committed to international development. But efforts to reduce poverty and ill health in developing countries are seriously undermined by the activities of companies such as British American Tobacco.

The tobacco industry has an unrivalled record for dishonesty in trying to prevent its customers becoming aware that there is a 50% chance that they will die from smoking-related causes. It has been a long battle in this country to establish strong measures of tobacco control which have significantly reduced the prevalence of smoking.

In response, the tobacco companies are seeking to get many more people in the developing world addicted to their products. They use the same bogus arguments that have been defeated in the UK to prevent attempts by governments in those countries to prevent this happening. They behave in this way because they make great profits.

The world would be a much better place if such dangerous products were banned. But if this cannot be done by international agreement, then we must at least ensure that we tax them in such a way as to deter such behaviour. The funds raised could also help poorer countries in their fight to establish similar measures of tobacco control to those that are working in the UK.
Chris Rennard
Liberal Democrat, House of Lords

It is deeply unethical that BAT has taken African countries to court to dilute their efforts to protect their populations’ health from tobacco. These countries are still fighting infectious diseases and face a double burden of poor health as a result of non-communicable diseases, with very limited budgets to deal with these.

According to the international covenant on economic, social and cultural rights in the context of business activities (June 2017), these countries are obliged to protect their public’s health, and this includes regulating to restrict marketing and advertising of harmful products such as tobacco.

BAT is headquartered in the UK, so the UK is required to take the necessary steps to prevent human rights violations abroad and it is “contradictory to remain passive where the conduct of an entity may lead to foreseeable harm”.

Moreover, “extraterritorial obligation to protect requires the UK to take steps to prevent and redress infringements of rights that occur outside their territories due to the activities of business entities over which they can exercise control.”

If the UK does not fulfil its extraterritorial responsibility to protect future smokers in Africa, it is possible that it could be liable for damages when many develop cancer, heart disease and strokes. It is incoherent to give British aid for healthcare to these countries while at the same time a UK company is promoting harmful products that diminish people’s right to health.

On a related subject, British MP pension fund, the Parliamentary Contributory Pension Fund (PCPF), invests in BAT and some UK local authority pensions invest large sums in the tobacco industry which many already consider unethical even before the article in the Guardian.
Dr Bernadette O’Hare
University of Malawi and University of St Andrews

Smoking remains a major public health concern, a major contributor to overall mortality and morbidity, to air and water pollution and to physical, economic, social and psychological trauma. However, I must take issue with your allusion to the size of the distance from the developed to the developing world.

The Grenfell tragedy has shone a light on the ills of western societies where people are denied their fundamental rights to safe, clean and adequate housing; where hundreds of thousands are languishing in cramped and dangerous buildings; where homelessness, labour exploitation, knife crimes, racial and religious intolerance and joblessness are increasingly becoming hallmarks of society – and where cover up and deceit are becoming the norm rather than the exception.

To be fair, many developing countries have already recovered from the ills that still plague the developed world. Take a look in the mirror.
Dr Munjed Farid Al Qutob
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

The scandal of big tobacco’s behaviour in the developing world | Letters

I welcome your editorial and related coverage (Stop the spread of the tobacco companies’ poison, 13 July). Tobacco smoking is still the largest single preventable cause of ill-health and death. In the UK the reduction in smoking is one of the great public health success stories. However, it is important that this achievement is not reversed. E-cigarettes should be monitored closely.

Tobacco companies have tremendous financial and political power and, despite the overwhelming medical evidence against cigarettes, they are still able to sell their products. Moreover, certain markets are expanding. Two of the world’s largest tobacco companies are based in the UK. Both continue to perform strongly and are confident about their future performances, especially as markets are growing in lower income countries where there is tremendous potential for profit.

Many of the current strategies used by tobacco companies are not new. More than 30 years ago, Peter Taylor published a seminal book which provided a comprehensive insight into the world of public health politics. The Smoke Ring discusses the ring of political and economic interests surrounding the tobacco industry.
Dr Michael Craig Watson
University of Nottingham

We are concerned, if not surprised, to read the Guardian’s exposé of big tobacco’s use of trade measures to threaten African countries into watering down their efforts to promote public health (Report, 12 July).

A major problem with trade and investment agreements is their chilling effect on public interest legislation: countries that lack the time or resources to defend themselves against a trade dispute hold back from introducing new measures that are good for the public but threaten corporate profits and could provoke a trade challenge. This is particularly problematic where corporations are able to use the investor-state dispute settlement mechanism to sue governments in private tribunals where corporate lawyers act as judges.

For example, after Philip Morris challenged Uruguay and Australia for introducing graphic warnings on cigarette packaging and plain packaging respectively, Costa Rica, Paraguay and New Zealand delayed introducing similar measures. Philip Morris lost that case, but big tobacco is still attempting to bully (particularly low and middle income) countries that attempt to put the health of their citizens before shareholder profit. This has to be stopped.

Countries must be free to pursue independent development and public health strategies. That means having the space to regulate and tax in the public interest without the threat of litigation. We would like to see trade agreements that encourage governments to promote public health objectives, rather than acting as a brake on progress. This requires a fundamental shift in the way that we approach trade deals in the future.
Matthew Bramall Health Poverty Action
Paul Keenlyside Trade Justice Movement
David McCoy Professor of Global Public Health, Queen Mary University London
Dr Penelope Milsom Medact
Deowan Mohee African Tobacco Control Alliance
Alvin Mosioma Tax Justice Network – Africa
Mary Assunta South East Asia Tobacco Control Alliance
Deborah Arnott ASH (UK)
Laurent Huber Action on Smoking and Health (US)
Chiara Bodini and David Sanders People’s Health Movement 
Andreas Wulf Medico International
Jean Blaylock Global Justice Now
Mark Dearn War on Want
Tabitha Ha STOPAIDS
Thanguy Nzue Obame People’s Health Movement Gabon

That big tobacco hinders the adoption of anti-smoking legislation is no surprise. Your leader correctly identifies the best route to behavioural change – shareholder pressure – but does not highlight the key channel to achieve this. Big tobacco needs to diversify. This is where shareholder pressure should be applied: to encourage manufacturers and associated leaf merchants to invest in non-harmful products and speed up the process of product diversification. In addition, governments in the south and their development partners should work with manufacturers and merchants to reduce big tobacco’s own addiction to the evil weed.
Dr Martin Prowse
Lund University, Sweden

It is a proud claim we make in this country that 0.7% of our GDP is committed to international development. But efforts to reduce poverty and ill health in developing countries are seriously undermined by the activities of companies such as British American Tobacco.

The tobacco industry has an unrivalled record for dishonesty in trying to prevent its customers becoming aware that there is a 50% chance that they will die from smoking-related causes. It has been a long battle in this country to establish strong measures of tobacco control which have significantly reduced the prevalence of smoking.

In response, the tobacco companies are seeking to get many more people in the developing world addicted to their products. They use the same bogus arguments that have been defeated in the UK to prevent attempts by governments in those countries to prevent this happening. They behave in this way because they make great profits.

The world would be a much better place if such dangerous products were banned. But if this cannot be done by international agreement, then we must at least ensure that we tax them in such a way as to deter such behaviour. The funds raised could also help poorer countries in their fight to establish similar measures of tobacco control to those that are working in the UK.
Chris Rennard
Liberal Democrat, House of Lords

It is deeply unethical that BAT has taken African countries to court to dilute their efforts to protect their populations’ health from tobacco. These countries are still fighting infectious diseases and face a double burden of poor health as a result of non-communicable diseases, with very limited budgets to deal with these.

According to the international covenant on economic, social and cultural rights in the context of business activities (June 2017), these countries are obliged to protect their public’s health, and this includes regulating to restrict marketing and advertising of harmful products such as tobacco.

BAT is headquartered in the UK, so the UK is required to take the necessary steps to prevent human rights violations abroad and it is “contradictory to remain passive where the conduct of an entity may lead to foreseeable harm”.

Moreover, “extraterritorial obligation to protect requires the UK to take steps to prevent and redress infringements of rights that occur outside their territories due to the activities of business entities over which they can exercise control.”

If the UK does not fulfil its extraterritorial responsibility to protect future smokers in Africa, it is possible that it could be liable for damages when many develop cancer, heart disease and strokes. It is incoherent to give British aid for healthcare to these countries while at the same time a UK company is promoting harmful products that diminish people’s right to health.

On a related subject, British MP pension fund, the Parliamentary Contributory Pension Fund (PCPF), invests in BAT and some UK local authority pensions invest large sums in the tobacco industry which many already consider unethical even before the article in the Guardian.
Dr Bernadette O’Hare
University of Malawi and University of St Andrews

Smoking remains a major public health concern, a major contributor to overall mortality and morbidity, to air and water pollution and to physical, economic, social and psychological trauma. However, I must take issue with your allusion to the size of the distance from the developed to the developing world.

The Grenfell tragedy has shone a light on the ills of western societies where people are denied their fundamental rights to safe, clean and adequate housing; where hundreds of thousands are languishing in cramped and dangerous buildings; where homelessness, labour exploitation, knife crimes, racial and religious intolerance and joblessness are increasingly becoming hallmarks of society – and where cover up and deceit are becoming the norm rather than the exception.

To be fair, many developing countries have already recovered from the ills that still plague the developed world. Take a look in the mirror.
Dr Munjed Farid Al Qutob
London

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The NHS is not the envy of the world | Letters

The Commonwealth Fund’s analysis of healthcare systems is dangerously misleading (Report, 14 July). While our processes might out-do the other 10 healthcare systems considered in the study, unfortunately the NHS’s outcomes – in other words, how patients fare when treated – rank second-to-last. Hardly “the envy of the world”, the UK has one of the highest rates of avoidable deaths in western Europe; indeed, thousands of lives could be saved each year if NHS patients who suffered from a stroke or had a condition like cancer were treated by social health insurance systems in Germany or Belgium.

Our processes may be second to none, but somehow they result in terrible outcomes. It’s all very well to say the UK has the safest and most affordable healthcare system, but if more patients are dying in the care of the NHS than in other healthcare systems, something is not right.

While it’s tempting to use this study as an excuse to sweep the NHS’s failures under the rug, the study highlights that we have a lot to learn from other systems when it comes to patient care. And yes, all these systems provide universal coverage, just like the NHS. In the light of the study’s findings, it’s time we took reform seriously because, for the sake of patients’ lives, it cannot come soon enough.
Mark Littlewood
Director general at the Institute of Economic Affairs

Polly Toynbee’s piece (Driving students away from nursing is a spectacular act of political self-harm, theguardian.com, 13 July) is a repeat of misleading claims that fewer nurses are being trained. As pointed out to the Guardian previously, the reality is that Health Education England has increased adult nurse commissions significantly in each of the three years we have been responsible for new nurses. We have grown adult nurse-training places by nearly 15%.

Although our remit is primarily for the future workforce, we have also taken decisive short-term action to help the service. Our ongoing return-to-practice campaign has already secured 3,596 nurses on programmes. The new nursing associate role and more flexible training pathways into nursing, such as apprenticeships, will help to support the service. We are also working with NHS partners to reduce turnover and improve retention in the existing nurse workforce.
Professor Ian Cumming
Chief executive, Health Education England

Henry Marsh states (8 July) that there is “free” healthcare in all Scandinavian countries. This is not the case.

In Sweden everybody over 18 and below 85 has to pay to see a GP, visit A&E or stay overnight in hospital. Fees vary slightly, but in Stockholm they are: A&E visit, £37; GP visit, £18; hospital stay, £9 per night.

After you have paid more than £101 you can apply for a “free-card”, which entitles you to free visits to GPs and A&Es, but not for overnight stays in hospital and not for missed appointments.
David Hargil Ingemarsson
London

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The NHS is not the envy of the world | Letters

The Commonwealth Fund’s analysis of healthcare systems is dangerously misleading (Report, 14 July). While our processes might out-do the other 10 healthcare systems considered in the study, unfortunately the NHS’s outcomes – in other words, how patients fare when treated – rank second-to-last. Hardly “the envy of the world”, the UK has one of the highest rates of avoidable deaths in western Europe; indeed, thousands of lives could be saved each year if NHS patients who suffered from a stroke or had a condition like cancer were treated by social health insurance systems in Germany or Belgium.

Our processes may be second to none, but somehow they result in terrible outcomes. It’s all very well to say the UK has the safest and most affordable healthcare system, but if more patients are dying in the care of the NHS than in other healthcare systems, something is not right.

While it’s tempting to use this study as an excuse to sweep the NHS’s failures under the rug, the study highlights that we have a lot to learn from other systems when it comes to patient care. And yes, all these systems provide universal coverage, just like the NHS. In the light of the study’s findings, it’s time we took reform seriously because, for the sake of patients’ lives, it cannot come soon enough.
Mark Littlewood
Director general at the Institute of Economic Affairs

Polly Toynbee’s piece (Driving students away from nursing is a spectacular act of political self-harm, theguardian.com, 13 July) is a repeat of misleading claims that fewer nurses are being trained. As pointed out to the Guardian previously, the reality is that Health Education England has increased adult nurse commissions significantly in each of the three years we have been responsible for new nurses. We have grown adult nurse-training places by nearly 15%.

Although our remit is primarily for the future workforce, we have also taken decisive short-term action to help the service. Our ongoing return-to-practice campaign has already secured 3,596 nurses on programmes. The new nursing associate role and more flexible training pathways into nursing, such as apprenticeships, will help to support the service. We are also working with NHS partners to reduce turnover and improve retention in the existing nurse workforce.
Professor Ian Cumming
Chief executive, Health Education England

Henry Marsh states (8 July) that there is “free” healthcare in all Scandinavian countries. This is not the case.

In Sweden everybody over 18 and below 85 has to pay to see a GP, visit A&E or stay overnight in hospital. Fees vary slightly, but in Stockholm they are: A&E visit, £37; GP visit, £18; hospital stay, £9 per night.

After you have paid more than £101 you can apply for a “free-card”, which entitles you to free visits to GPs and A&Es, but not for overnight stays in hospital and not for missed appointments.
David Hargil Ingemarsson
London

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Stop making poor people mentally ill | Letters

I was moved by Deborah Orr’s capacity to entertain and inform when bravely writing about her own mental health problems and experience with antidepressants (I took my first antidepressant this week. The effects were frightening, 8 July). She draws attention to the “soaring demand” for NHS mental health services. I have worked with and for a single unemployed adult receiving antidepressants. His income was stopped by a three-month benefit sanction imposed by the jobcentre, creating unmanageable debt. He was immediately referred by his GP to the NHS for therapy.

The Department for Work and Pensions never considers the undeniable evidence that low income, let alone no income, creates mental and physical ill health. The Royal College of Psychiatrists has been telling governments for decades that low income and debt create mental health problems. The minds of ministers seem incapable of grasping that the prevention of ill health by the provision of adequate minimum incomes by the DWP is better than “soaring demand” for mental health services in the NHS, on humanitarian grounds alone, while the NHS would be relieved of £9bn poverty-related extra costs.
Rev Paul Nicolson
Taxpayers Against Poverty

Without diminishing in any way Deborah Orr’s experiences, I was prescribed citalopram two years ago for anxiety and depression. In that time my condition has improved immeasurably and I have suffered barely any side-effects. My treatment by the NHS in Wales was sensitive and open, and at no stage did I feel I had no voice. I am concerned that Ms Orr’s account may have deterred some people from taking up medication that could greatly improve their condition.
Neil Schofield
Cardiff

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Pay cap has left public services at risk of collapse | Letters

It comes as no surprise that research has demonstrated that public sector workers have experienced deep pay cuts in real terms (Scale of public sector salary cuts revealed, 4 July), and it is time that the government recognised this and lifted the pay cap. The chancellor insists he will not change direction and talks about fairness between workers and taxpayers. Leaving aside the fact that public sector workers are themselves taxpayers, it is clear that the burden of balancing the books has fallen disproportionately on some sections of society, and that “fairness” does not adequately describe the present situation. The government must urgently re-examine its tax and spend policies in order to redress this, or we risk seeing public services collapse as droves of public sector workers are forced to leave their jobs in search of adequate pay.
Jonathan Wallace
Newcastle upon Tyne

First Nicky Morgan, then Heidi Allen, and now a slew of cabinet members are opposing the government cap on public sector pay. Let’s not forget that even when her government had a majority of 17, Theresa May couldn’t get her grammar schools policy through parliament, she had to withdraw tax increases for the self-employed, and previously Osborne and Cameron (remember them?) had to withdraw plans for cuts to tax credits. May might be able to have a confidence and supply deal to try for a majority with the DUP, but she can’t guarantee the same with her own party. That is why she and her government will have a short life.
Cllr Barry Kushner
Labour, Liverpool city council

I was one of many thousands who marched in protest at Tory party policies on Saturday. The public sector pay cap was one the big issues, but it will only be scrapped under a Labour government. Boris Johnson is cynically trying to boost his popularity in pursuit of the Tory party leadership. I fear that if any concessions are made on public sector pay they will be selective, in the hope of keeping one section of the NHS workforce happy. Divide and rule must be resisted. The pay cap is having a devastating effect on all public sector workers. A member of my family is one of the army of non-medical NHS staff, organising appointments and clinics, liaising with patients and staff – ie keeping the whole show on the road. The salary is £18,000. The department manager earns less than the national average wage. This is no joke in a place like Winchester with a dire shortage of affordable housing and astronomical private rents. The Tories simply don’t get it. The Labour party, under Jeremy Corbyn, do.
Karen Barratt
Winchester

What is frightening about the NHS is the fact that it has been allowed to get into this state. Current headlines are all about stress, overwork, closures and going on strike, while the government is intent on selling off as much as possible and shopping around to try to employ cheap foreign labour. Recruitment is falling across the board, no matter how many more are trained, because only the most dedicated want to work in a service like that, and proposing to force graduates to work in it for years after they finish training can only reduce the number of students. A grudging pay rise which could be withdrawn at any time is unlikely to solve the problem. What we want is a service owned by the public and its staff, in which they can take pride and which aims to be the best in the world again. People would be prepared to pay for it provided that the increase in taxation would be spent on this service rather than on other government priorities.
Dr Richard Turner
Harrogate

I am dismayed by the cap on pay increases for nurses, firefighters, ambulance drivers and other workers who work hard to keep this country going. They are dedicated and often brave in carrying out these tasks, compared to many in the private sector, who are often in it for what they can get out of it. I would be more than happy to pay a higher tax to enable the cap to be lifted. I cannot be the only person to feel this.
Pat Brandwood
Broadstone, Dorset

Social workers should also be added to the list of those underpaid in the public sector (Don’t leave dustmen out of the pay debate, Letters, 3 July).

I’m married to a retired social worker and saw at one remove the “damned if you do, damned if you don’t” hazards of a job undervalued and underresourced. The majority of us may never need the services of social workers – one reason for them being overlooked in debates about wages in the caring professions, I believe.

However, the level of responsibility required in decision-making that will often have far-reaching and possibly life-changing consequences – especially in child protection and matters relating to children and families – is equal to that of doctors, teachers, nurses etc.

Care of the vulnerable in society deserves as much recognition as those rightly valued professions.
Jonathan Newth
Bradford on Avon, Wiltshire

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Pay cap has left public services at risk of collapse | Letters

It comes as no surprise that research has demonstrated that public sector workers have experienced deep pay cuts in real terms (Scale of public sector salary cuts revealed, 4 July), and it is time that the government recognised this and lifted the pay cap. The chancellor insists he will not change direction and talks about fairness between workers and taxpayers. Leaving aside the fact that public sector workers are themselves taxpayers, it is clear that the burden of balancing the books has fallen disproportionately on some sections of society, and that “fairness” does not adequately describe the present situation. The government must urgently re-examine its tax and spend policies in order to redress this, or we risk seeing public services collapse as droves of public sector workers are forced to leave their jobs in search of adequate pay.
Jonathan Wallace
Newcastle upon Tyne

First Nicky Morgan, then Heidi Allen, and now a slew of cabinet members are opposing the government cap on public sector pay. Let’s not forget that even when her government had a majority of 17, Theresa May couldn’t get her grammar schools policy through parliament, she had to withdraw tax increases for the self-employed, and previously Osborne and Cameron (remember them?) had to withdraw plans for cuts to tax credits. May might be able to have a confidence and supply deal to try for a majority with the DUP, but she can’t guarantee the same with her own party. That is why she and her government will have a short life.
Cllr Barry Kushner
Labour, Liverpool city council

I was one of many thousands who marched in protest at Tory party policies on Saturday. The public sector pay cap was one the big issues, but it will only be scrapped under a Labour government. Boris Johnson is cynically trying to boost his popularity in pursuit of the Tory party leadership. I fear that if any concessions are made on public sector pay they will be selective, in the hope of keeping one section of the NHS workforce happy. Divide and rule must be resisted. The pay cap is having a devastating effect on all public sector workers. A member of my family is one of the army of non-medical NHS staff, organising appointments and clinics, liaising with patients and staff – ie keeping the whole show on the road. The salary is £18,000. The department manager earns less than the national average wage. This is no joke in a place like Winchester with a dire shortage of affordable housing and astronomical private rents. The Tories simply don’t get it. The Labour party, under Jeremy Corbyn, do.
Karen Barratt
Winchester

What is frightening about the NHS is the fact that it has been allowed to get into this state. Current headlines are all about stress, overwork, closures and going on strike, while the government is intent on selling off as much as possible and shopping around to try to employ cheap foreign labour. Recruitment is falling across the board, no matter how many more are trained, because only the most dedicated want to work in a service like that, and proposing to force graduates to work in it for years after they finish training can only reduce the number of students. A grudging pay rise which could be withdrawn at any time is unlikely to solve the problem. What we want is a service owned by the public and its staff, in which they can take pride and which aims to be the best in the world again. People would be prepared to pay for it provided that the increase in taxation would be spent on this service rather than on other government priorities.
Dr Richard Turner
Harrogate

I am dismayed by the cap on pay increases for nurses, firefighters, ambulance drivers and other workers who work hard to keep this country going. They are dedicated and often brave in carrying out these tasks, compared to many in the private sector, who are often in it for what they can get out of it. I would be more than happy to pay a higher tax to enable the cap to be lifted. I cannot be the only person to feel this.
Pat Brandwood
Broadstone, Dorset

Social workers should also be added to the list of those underpaid in the public sector (Don’t leave dustmen out of the pay debate, Letters, 3 July).

I’m married to a retired social worker and saw at one remove the “damned if you do, damned if you don’t” hazards of a job undervalued and underresourced. The majority of us may never need the services of social workers – one reason for them being overlooked in debates about wages in the caring professions, I believe.

However, the level of responsibility required in decision-making that will often have far-reaching and possibly life-changing consequences – especially in child protection and matters relating to children and families – is equal to that of doctors, teachers, nurses etc.

Care of the vulnerable in society deserves as much recognition as those rightly valued professions.
Jonathan Newth
Bradford on Avon, Wiltshire

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters