The state of Tamil Nadu in southern India has been strategically building capacity in its public health functionaries to accelerate progress towards the Millennium Development Goals. State-level public health conferences have been one of the mechanisms, and the second of such conferences was held on 11-12 March in the city of Coimbatore in Tamil Nadu

The Union prioritises the TB-Tobacco link for Public Health Managers in Tamil Nadu, India

The state of Tamil Nadu in southern India has been strategically building capacity in its public health functionaries to accelerate progress towards the Millennium Development Goals. State-level public health conferences have been one of the mechanisms, and the second of such conferences was held on 11-12 March in the city of Coimbatore in Tamil Nadu.  The Union was invited as a resource on both occasions. This year it prioritised the important link between non-communicable diseases (NCDs) and infectious diseases, and how synergising control efforts on both could help. Dr. Nevin Wilson, Regional Director at the Union South-East Asia office, focussed attention on NCDs as a public health priority and used TB and tobacco control models from Union-led studies in Sudan and China to illustrate the point and provide evidence of the feasibility of such interventions.  Among others, participants also included first-line medical officers from primary healthcare centres, who are directly in touch with the people. The rationale of linking NCD control to infectious disease control at this level was seen to have important implications for public health programming in the state. 

Integrating NCDs with primary healthcare is in line with the global focus on NCDs, which account for up to 60% of deaths globally 80% of which are in low and middle income countries. With major inequality between and within countries, NCDs are undermining development. It was thus important to use local opportunities and work with local governments and communities to integrate NCD control into primary health care delivery, something that The Union could valuably assist. This would not just mainstream good public health practice and give a fillip to action but also make interventions cost effective, especially for states like Tamil Nadu that were strategically poised for it. Dr Wilson drew attention to tobacco as a common and preventable risk factor for a range of NCDs including diabetes, cancer and chronic respiratory diseases. Tobacco could kill a billion people this century unless we act now and, with 40% of smokers in just China and India, the problem in these countries was acute. Integrated local interventions from government and other sectors were both essential as well as feasible, and would contribute to health systems strengthening.  The Union drew lessons from a WHO-Union monograph on TB and tobacco control, and shared the “Health Workers Guide” for tobacco control that the Government of India had produced with Union assistance last year. The latter, which is directed at primary healthcare workers across the country and contains easily understandable information on the harms of tobacco and steps for smoking cessation, has also shown potential for use in TB case management when clinicians are implementing DOTS.