Opinion
Bali Declaration: Is it the clarion call to #endTobacco?
By SHOBHA SHUKLA, BOBBY RAMAKANT – CNS
Tobacco use is among the unhealthy behaviours that result in preventable burden of cancers, strokes, and heart diseases, said Budi Gunadi Sadikin, Indonesia’s health minister. In Indonesia tobacco use is the second largest risk factor for untimely deaths, he added. World Health Organization had earlier underlined that without clamping tobacco use, we cannot deliver on the promises enshrined in the Sustainable Development Goals.
Indonesia has walked the talk on building a grounds-up movement against tobacco. In 2011, twelve Mayors had come together to forge a Mayors’ Alliance to advance tobacco control in their respective cities. Today in 2022, there are over 150 Mayors of different Indonesian cities that are part of this Alliance, who are adapting as well as enforcing local laws to reduce tobacco use, said Dr Bima Arya Sugiarto, Co-Chair of Asia Pacific Cities Alliance for Health and Development (APCAT) and Mayor of Bogor City in Indonesia. “Mayors’ Alliance has been the main driver for banning tobacco advertising and promotion, as well as preventing tobacco industry interference in public policy” he said.
Both were speaking at the opening ceremony of 7th Asia Pacific Summit of Mayors (7th APCAT Summit or #APCAT2022) being held in Bali, Indonesia.Another sterling example of grounds-up tobacco control movement in Indonesia is the fact that “as of November 2022, over 300 cities have adopted the local smokefree laws,” said Dr Bima Arya.
That is why Indonesian health minister called for stronger partnerships “to reduce tobacco use” and “expand the on-the-ground effective programmes for tobacco control.”
“I would like to extend my gratitude to Mayors who have passed local smokefree laws. It is important for central government to collaborate with local governments to achieve tobacco control,” said the Indonesian health minister.
Despite alarming levels of tobacco industry interference, it is indeed commendable that Mayors and sub-national leaders of Indonesia have been able to advance tobacco control.
Agrees Kelly Larson of Bloomberg Philanthropies: “We acknowledge the role of sub-national leaders in Indonesia and commend the Mayors of over 300 cities who have passed local smokefree laws, that protect 75% of the country’s population from the hazards of tobacco smoke.” Kelly Larson shared that prioritising tobacco control and public health in New York resulted in increased life expectancy of 2 years for its citizens.
Not surprisingly, tobacco industry and its front groups are trying to create hurdles when local sub-national leaders try to advance tobacco control and health promotion. Effective enforcement of strong tobacco control laws hurt the industry profits. For instance, in 2017, Bogor City had become the first Indonesian city to implement a point-of-sale tobacco display ban as part of its smokefree law. But soon after a legal battle ensued. Finally, in February 2020, the city of Bogor won the court case when Supreme Court had upheld its ban on the display of tobacco products at point-of-sale.
While exposing how tobacco industry approaches election candidates to influence public policy, Mayor of Bogor City Dr Bima Arya said in 7th APCAT Summit opening session that “every candidate of local elections was approached by the tobacco industry…”
#APCAT2022 Declaration gives hope for a better tomorrow
“We, the delegates of the 7th Asia Pacific Summit of Mayors, recognize that APCAT is a vital platform to share experiences, shape local actions, and secure greater leadership as well as look for synergistic actions between specific health and development programmes.

We commit to accelerate progress towards eventually ending tobacco use, as well as preventing the avoidable burden of NCDs, eliminating Tuberculosis, and improving synergy between health and development programmes and promoting integrated responses where possible, thereby reducing disease burden and averting untimely deaths, by:
– Leading effective implementation of tobacco control programmes that include smokefree environments; a complete ban on tobacco advertising, promotion, and sponsorship; promotion of larger graphic health warnings with plain packaging on tobacco packs; smoking cessation programmes; and a ban on electronic cigarettes, heated tobacco products, shisha, and other similar products;
– Working with national government and policy makers to raise taxes and prices on unhealthy commodities (such as, but not limited to, tobacco products, alcohol, sugary and sweetened beverages);
– Ensuring accountability to prevent interferences and rejecting funding, logistics, donations, or grants from, and partnerships with, any entity related to any unhealthy commodity industries (such as, but not limited to, tobacco, alcohol, sugary and sweetened beverages);
– Investing in tobacco control for prevention of tuberculosis, non-communicable disease, and stunting. It includes smoking cessation in TB and NCD clinics, and family health programs; universal screening for TB and NCDs
– Adopting One Health approaches and processes to ensure that “a healthy city is a resilient city”.
Every tobacco-related death is preventable
The 7th Asia Pacific Summit of Mayors, which opened today in Bali, Indonesia, is jointly organised by the Asia Pacific Cities Alliance for Health and Development (APCAT), Ministry of Health, Republic of Indonesia; Ministry of Home Affairs, Republic of Indonesia; National Centre for Health Promotion, Ministry of Health, Cambodia; Bloomberg Philanthropies; Cities of Bogor, Denpasar and Klungkung of Indonesia; Balanga City, Philippines; Association of All Health Offices Indonesia (ADINKES), Indonesia Mayor and Regent Alliance, Indonesian Public Health Association; Udayana Central; Campaign for Tobacco Free Kids, Vital Strategies; Tobacco Free Generation International, The International Union Against Tuberculosis and Lung Disease (The Union); APCAT Parliamentarians and Asia Pacific Media Alliance for Health and Development (APCAT Media).
Over 1000 national and sub-national leaders, public health experts are attending the 7th APCAT Summit in Bali, Indonesia in person and virtually. Participants include mayors, governors, ministers, members of parliament, tobacco control advocates, and media from across the Asia Pacific region.
Over 8.67 million people die of tobacco use every year (out of which one million die due to second and third-hand tobacco smoke). Despite the crippling onslaught of COVID-19 public health emergency and humanitarian crises, tobacco industry has heightened its deceptive strategies to protect and expand its markets. In addition to the mountainous death toll and avoidable disease burden, tobacco use has also resulted in an annual economic loss of nearly USD 2 trillion to the global economy.
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Opinion
Why so unbuddhist?
Hardly a week goes by, when someone in this country does not preach to us about the great, long lasting and noble nature of the culture of the Sinhala Buddhist people. Some Sundays, it is a Catholic priest that sings the virtues of Buddhist culture. Some eminent university professor, not necessarily Buddhist, almost weekly in this newspaper, extols the superiority of Buddhist values in our society. Some 70 percent of the population in this society, at Census, claim that they are Buddhist in religion. They are all capped by that loud statement in dhammacakka pavattana sutta, commonly believed to have been spoken by the Buddha to his five colleagues, when all of them were seeking release from unsatisfactory state of being:
‘….jati pi dukkha jara pi dukkha maranam pi dukkham yam pi…. sankittena…. ‘
If birth (‘jati’) is a matter of sorrow, why celebrate birth? Not just about 2,600 years ago but today, in distant port city Colombo? Why gaba perahara to celebrate conception? Why do bhikkhu, most prominent in this community, celebrate their 75th birthday on a grand scale? A commentator reported that the Buddha said (…ayam antima jati natthi idani punabbhavo – this is my last birth and there shall be no rebirth). They should rather contemplate on jati pi dukkha and anicca (subject to change) and seek nibbana, as they invariably admonish their listeners (savaka) to do several times a week. (Incidentally, Buddhists acquire knowledge by listening to bhanaka. Hence savaka and bhanaka.) The incongruity of bhikkhu who preach jati pi duklkha and then go to celebrate their 65th birthday is thunderous.
For all this, we are one of the most violent societies in the world: during the first 15 days of this year (2026), there has been more one murder a day, and just yesterday (13 February) a youngish lawyer and his wife were gunned down as they shopped in the neighbourhood of the Headquarters of the army. In 2022, the government of this country declared to the rest of the world that it could not pay back debt it owed to the rest of the world, mostly because those that governed us plundered the wealth of the governed. For more than two decades now, it has been a public secret that politicians, bureaucrats, policemen and school teachers, in varying degrees of culpability, plunder the wealth of people in this country. We have that information on the authority of a former President of the Republic. Politicians who held the highest level of responsibility in government, all Buddhist, not only plundered the wealth of its citizens but also transferred that wealth overseas for exclusive use by themselves and their progeny and the temporary use of the host nation. So much for the admonition, ‘raja bhavatu dhammiko’ (may the king-rulers- be righteous). It is not uncommon for politicians anywhere to lie occasionally but ours speak the truth only more parsimoniously than they spend the wealth they plundered from the public. The language spoken in parliament is so foul (parusa vaca) that galleries are closed to the public lest school children adopt that ‘unparliamentary’ language, ironically spoken in parliament. If someone parses the spoken and written word in our society, there is every likelihood that he would find that rumour (pisuna vaca) is the currency of the realm. Radio, television and electronic media have only created massive markets for lies (musa vada), rumour (pisuna vaca), foul language (parusa vaca) and idle chatter (samppampalapa). To assure yourself that this is true, listen, if you can bear with it, newscasts on television, sit in the gallery of Parliament or even read some latterday novels. There generally was much beauty in what Wickremasinghe, Munidasa, Tennakone, G. B. Senanayake, Sarachchandra and Amarasekara wrote. All that beauty has been buried with them. A vile pidgin thrives.
Although the fatuous chatter of politicians about financial and educational hubs in this country have wafted away leaving a foul smell, it has not taken long for this society to graduate into a narcotics hub. In 1975, there was the occasional ganja user and he was a marginal figure who in the evenings, faded into the dusk. Fifty years later, narcotics users are kingpins of crime, financiers and close friends of leading politicians and otherwise shakers and movers. Distilleries are among the most profitable enterprises and leading tax payers and defaulters in the country (Tax default 8 billion rupees as of 2026). There was at least one distillery owner who was a leading politician and a powerful minister in a long ruling government. Politicians in public office recruited and maintained the loyalty to the party by issuing recruits lucrative bar licences. Alcoholic drinks (sura pana) are a libation offered freely to gods that hold sway over voters. There are innuendos that strong men, not wholly lay, are not immune from seeking pleasures in alcohol. It is well known that many celibate religious leaders wallow in comfort on intricately carved ebony or satin wood furniture, on uccasayana, mahasayana, wearing robes made of comforting silk. They do not quite observe the precept to avoid seeking excessive pleasures (kamasukhallikanuyogo). These simple rules of ethical behaviour laid down in panca sila are so commonly denied in the everyday life of Buddhists in this country, that one wonders what guides them in that arduous journey, in samsara. I heard on TV a senior bhikkhu say that bhikkhu sangha strives to raise persons disciplined by panca sila. Evidently, they have failed.
So, it transpires that there is one Buddhism in the books and another in practice. Inquiries into the Buddhist writings are mainly the work of historians and into religion in practice, the work of sociologists and anthropologists. Many books have been written and many, many more speeches (bana) delivered on the religion in the books. However, very, very little is known about the religion daily practised. Yes, there are a few books and papers written in English by cultural anthropologists. Perhaps we know more about yakku natanava, yakun natanava than we know about Buddhism is practised in this country. There was an event in Colombo where some archaeological findings, identified as dhatu (relics), were exhibited. Festivals of that nature and on a grander scale are a monthly regular feature of popular Buddhism. How do they fit in with the religion in the books? Or does that not matter? Never the twain shall meet.
by Usvatte-aratchi
Opinion
Hippocratic oath and GMOA
Almost all government members of the GMOA (the Government Medical Officers’ Association). Before joining the GMOA Doctors must obtain registration with Sri Lanka Medical Council (SLMC) to practice medicine. This registration is obtained after completing the medical studies in Sri Lanka and completing internship.
The SLMC conducts an Examination for Registration to Practise Medicine in Sri Lanka (ERPM) – (Formerly Act 16 in conjunction with the University Grants Commission (UGC), which the foreign graduates must pass. Then only they can obtain registration with SLMC.
When obtaining registration there are a few steps to follow on the as stated in the “
GUIDELINES ON ETHICAL CONDUCT FOR MEDICAL & DENTAL PRACTITIONERS REGISTERED WITH THE SRI LANKA MEDICAL COUNCIL” This was approved in July 2009, and I believe is current at the time of writing this note. To practice medicine, one must obtain registration with the SLMC and complete the oath formality. For those interested in reading it on the web, the reference is as follows.
https://slmc.gov.lk/images/PDF_Main_Site/EthicalConduct2021-12.pdf
I checked this document to find the Hippocratic Oath details. They are noted on page 5. The pages 6 & 7 provide the draft oath form that every Doctor must complete with his/her details. Oath must be administered by
the Registrar/Asst. Registrar/President/ Vice President or Designated Member of the Sri Lanka Medical Council and signed by the Doctor.
Now I wish to quote the details of the oath.
I solemnly pledge myself to dedicate my life to the service of humanity;
The health of my patient will be my primary consideration and I will not use my profession for exploitation and abuse of my patient;
I will practice my profession with conscience, dignity, integrity and honesty;
I will respect the secrets which are confided in me, even after the patient has died;
I will give to my teachers the respect and gratitude, which is their due;
I will maintain by all the means in my power, the honour and noble traditions of the medical profession;
I will not permit considerations of religion, nationality, race, party politics, caste or social standing to intervene between my duty and my patient;
I wish to ask the GMOA officials, when they engage in strike action, whether they still comply with the oath or violate any part of the oath that even they themselves have taken when they obtained registration from the SLMC to practise medicine.
Hemal Perera
Opinion
Where nature dared judges hid
Dr. Lesego the Surgical Registrar from Lesotho who did the on-call shift with me that night in the sleepy London hospital said a lot more than what I wrote last time. I did not want to weaken the thrust of the last narrative which was a bellyful for the legal fraternity of south east Asia and Africa.
Lesego begins, voice steady and reflective, “You know… he said, in my father’s case, the land next to Maseru mayor’s sunflower oil mill was prime land. The mayor wanted it. My father refused to sell. That refusal set the stage for everything that followed.
Two families lived there under my dad’s kindness. First was a middle-aged man, whose descendants still remain. The other was an old destitute woman. My father gave her timber, wattle, cement, Cadjan, everything free, to build her hut. She lived peacefully for two years. Then having reconciled with her once estranged daughter wanted to leave.
She came to my father asking for money for the house. He said: ‘I gave you everything free. You lived there for two years completely free and benefitting from the produce too. And now you ask for money? Not a cent.’ In hindsight, that refusal was harsh. It opened the door for plunderers. The old lady ‘sold’ the hut to Pule, the mayor’s decoy. Soon, Pule and his fellow compatriots, were to chase my father away while he was supervising the harvesting of sunflowers.
My father went to court in September 1962, naming Thasoema, the mayor, his Chief clerk, and the trespassers as respondents. The injunction faltered for want of an affidavit, and under a degree of compulsion by the judge and the attending lawyers, my father agreed to an interim settlement of giving away the aggressors total possession with the proviso that they would pay the damages once the court culminates the case in his favour. This was the only practical alternative to sharing the possession with the adversaries.
From the very beginning, the dismissals and flimsy rulings bore the fingerprints of extra‑judicial mayoral influence. Judges leaned on technicalities, not justice. They hid behind minutiae.
Then nature intervened. Thasoema, the mayor, hale and hearty, died suddenly of what looked like choking on coconut sap which later turned out to be a heart attack. His son Teboho inherited the case. Months later, the Chief clerk also died of a massive heart attack, and his son took his place. Even Teboho, the mayor’s young son of 30 years died, during a routine appendectomy, when the breathing tube was wrongly placed in his gullet.
About fifteen years into the case, another blow fell. A 45‑year‑old judge, who had ruled that ‘prescription was obvious at a glance, while adverse possession was being contested in court all the time, died within weeks of his judgment, struck down by a massive heart attack.
After that, the case dragged on for decades, yo‑yoing between district and appeal courts. Judges no longer died untimely deaths, but the rulings continued to twist and delay. My father’s deeds were clear: the land bought by his brother in 1933, sold to him in 1936, uninterrupted possession for 26 years. Yet the courts delayed, twisted, and denied.
Finally, in 2006, the District Court ruled in his favour embodying every detail why it was delivering such a judgement. It was a comprehensive judgement which covered all areas in question. In 2015, the Appeal Court confirmed it, his job being easy because of the depth the DC judge had gone in to. But in October 2024, the Supreme Court gave an outrageously insane judgment against him. How? I do not know. I hope the judge is in good health, my friend said sarcastically.
Lesego paused, his voice heavy with irony “Where nature dared, judges hid. And that is the truth of my father’s case.”
Dr.M.M.Janapriya
UK
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