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Day: March 17, 2021

The obesity crisis? Innovation, not nannying, will cut our calories

Britain’s obesity crisis is acute and urgent. The government’s decision to make tackling it the number one public health priority has an empirical basis. Britons are fatter than ever before, with excess body fat responsible for more deaths than smoking every year since 2014. But as sound as the public health concerns might be, when they are translated into policy, we find ourselves running into a world of problems.

A few years ago, Boris Johnson liked to talk about rolling back the “continuing creep of the nanny state”. He once promised to put an end to “sin taxes” on sugary drinks. He liked to talkabout Britain as a “land of liberty” and, for many, he represented a break with the past. Theresa May had denounced what she called the “libertarian right” upon her elevation to 10 Downing Street, opting instead for “a new centre-ground”. Boris, we were assured, would be something entirely different.

So how did we get here? We have somehow reached a point where the pillars of the Government’s anti-obesity strategy are the regressive sugar tax – which remains firmly in place – along with a draconian advertising ban on foods high in salt, sugar or fat. Plus a bizarre £100 million fund which, one way or another, will supposedly help people to drop the pounds and keep them off.

In between the old Boris and the new, the man himself slimmed down following his jarring bout of Covid-19. After he came out of hospital and recovered from coronavirus, the Prime Minister embarked on a personal slimming programme of his own, allowing him to make himself the poster boy of his Government’s anti-obesity drive.

“The reason I had such a nasty experience with the disease,” he said in October of last year, “is that although I was superficially in the pink of health when I caught it, I had a very common underlying condition. My friends, I was too fat. And I have since lost 26 pounds… And I’m going to continue that diet because you have got to search for the hero inside yourself in the hope that that individual is considerably slimmer.”

Metafictional interpretations of ‘90s song lyrics aside, Johnson’s point here is essentially correct. All the data bears out the fact that obesity has a substantial effect on the dangers posed by a coronavirus infection. But it is unclear why that should warrant an abandonment of principles of liberty in favour of gratuitous and often random state intervention in people’s lives. No nanny state told the PM how to cut his calories. So if Boris could lose weight on his own, why can’t the rest of us?

It’s not like there are no alternatives on the table, leaving costly and damaging policies like new taxes and ad bans as the only option. The menu of unintrusive and unobtrusive anti-obesity policies, free of cost to the taxpayer, is endless. Studies have shown how simple changes, like marking out a section on shopping trolleys for fruit and veg with yellow tape, or rebranding healthy foods to make them more appealing to children, can have an enormous positive effect over a short period of time.

Plus, Britain is home to some of the best scientists and research institutes in the world. Even in times of economic constraint, thanks to lockdown, innovation in the private sector is booming. It was recently discovered, for instance, that a diabetes drug called semaglutide can also function as a weight-loss “miracle cure”. Something as simple as sugar-free chewing gum can suppress appetites, cutting down on unhealthy snacking by a tenth, with very little effort. Why is the Government not enthused by this constant shower of scientific breakthroughs?

For whatever reason, ministers and officials are unwilling to explore the wealth of opportunities for cost-free nudge policies and innovative scientific investments. It is wedded to its model of centralised diet control and appears to hang on Jamie Oliver’s every word. Obesity is shaping up to be the next global health disaster and if we’re not careful – if we remain blinkered by these short-sighted policies – we might find ourselves as unprepared for the next pandemic as we were for the present one.

The Government must step up to the plate now and offer real solutions that work. That is our only hope of preventing the looming catastrophe.

Originally published here.

Vape dan Pentingnya Mempromosikan Harm Reduction di Indonesia

Harm Reduction merupakan istilah yang mungkin masih terdengar asing bagi banyak masyarakat Indonesia. Istilah ini umumnya merujuk pada advokasi dan upaya untuk mengurangi resiko dampak suatu hal atau perilaku yang bisa membahayakan kesehatan seorang individu, atau sebuah komunitas, seperti rokok, alkohol, atau obat-obatan terlarang.

Saat ini, sudah hampir mustahil bisa dibantah lagi, bahwa obat-obatan terlarang seperti penggunaan narkoba dan zat-zat psikotropika, konsumsi rokok dan minuman beralkohol secara berlebihan, atau perilaku kegiatan seksual yang berganti-ganti pasangan adalah hal yang berbahaya. Rokok misalnya, secara ilmiah sudah terbukti dapat menyebabkan berbagai penyakit kronis seperti kanker dan serangan jantung, dan perilaku seksual yang berganti-ganti pasangan dapat berpotensi menimbulkan berbagai penyakit menular seksual seperti HIV/AIDS.Untuk itu, advokasi harm reduction adalah hal yang sangat penting untuk digaungkan demi mencegah dampak buruk dari berbagai hal tersebut terhadap individu dan masyarakat. Terkait dengan penyebaran penyakit menular seksual misalnya, advokasi penggunaan alat kontrasepsi seperti kondom merupakan salah satu advokasi harm reduction yang kerap digaungkan oleh berbagai aktivis dan organisasi-organisasi sipil.

Sementara itu, terkait dengan penggunaan zat-zat psikotropika, beberapa negara di dunia sudah mengeluarkan berbagai kebijakan yang berujuan untuk harm reduction dampak dari zat-zat tersebut. Portugal misalnya, pada tahun 2001 menjadi negara pelopor yang mengeluarkan kebijakan dekriminalisasi terhadap penggunaan seluruh narkoba. Tidak hanya itu, Pemerintah Portugal juga menyediakan layanan pemberian narkoba seperti heroin dan kokain kepada para pecandu dengan dosis yang dianggap aman (Time.com, 1/8/2018).

Sebagaimana dengan pengunaan obat-obatan terlarang dan perilaku seksual yang berganti-ganti pasangan, berbagai pihak juga mengusahakan upaya harm reduction untuk konsumsi produk tembakau seperti rokok yang berbahaya bagi kesehatan. Sebagaimana yang sudah diketahui secara umum, rokok adalah salah satu produk yang paling adiktif, dan mereka yang sudah menjadi penggunanya, terlebih yang sudah mengkonsumsi rokok setiap hari selama bertahun-tahun, sangat sulit untuk menghentikan kebiasaan yang sangat berbahaya tersebut.

Indonesia sendiri misalnya, merupakan salah satu negara dengan persentase perokok aktif yang tertinggi di dunia. Pada tahun 2020 lalu, 39,9% penduduk Indonesia, atau sekitar 57 juta orang, adalah perokok aktif (economy.okezone.com, 13/12/2020). Perokok di Indonesia juga didominasi oleh laki-laki dewasa, yakni sebanyak 62,9% laki-laki dewasa di Indonesia adalah perokok aktif (suara.com, 19/11/2020).Hal ini tentu adalah sesuatu yang sangat memprihatinkan. Konsumsi rokok yang tinggi di Indonesia telah menyebabkan banyak penyakit kronis hingga kematian yang disebabkan oleh konsumsi produk tersebut, Setiap tahunnya misalnya, di Indonesia, sekitar 225.000 orang meninggal disebabkan karena penyakit akibat penggunaan rokok (who.int, 30/5/2020).

Tingkat penggunaan rokok yang tinggi di Indonesia tentu juga tidak bisa dihilangkan atau diatasi dengan mudah, seperti dengan melarang paksa produk tersebut. Rokok merupakan bagian dari keseharian jutaan masyarakat Indonesia selama berhari-hari, dan pelarangan atau pembatasan penggunaan rokok tentu adalah kebijakan yang tidak efektif. Selain itu, bukan tidak mungkin langkah tersebut justru menjadi kebijakan yang kontra-produktif karena akan semakin meningkatkan penjualan rokok ilegal yang pastinya jauh lebih berbahaya karena peredarannya tidak diatur dan diregulasi oleh pemerintah.

Untuk itu, adanya produk yang lebih aman untuk dapat menggantikan rokok merupakan sesuatu yang sangat penting, demi mereduksi dampak negatif yang disebabkan dari rokok. Salah satu dari produk tersebut yang terbukti jauh lebih aman daripada rokok adalah rokok elektronik, atau yang dikenal dengan nama vape.Berdasarkan laporan yang dikeluarkan oleh lembaga kesehatan publik Inggris, Public Health England (PHE), rokok elektronik atau vape adalah produk yang 95% lebih aman daripada rokok konvensional yang dibakar (Public Health England, 2015). Hal ini disebabkan karena dua bahan utama yang terkandung dalam cairan yang digunakan oleh rokok elektronik adalah bahan yang dikenal dengan nama propylene glycol (PG) dan vegetable glycerin (VG).

PG dan VG sendiri adalah bahan yang digunakan untuk membentuk uap dan menambah rasa di produk rokok elektronik. Kedua bahan tersebut merupakan bahan yang umum dan digunakan dalam berbagai makanan, seperti perasa kue, dan telah dinyatakan aman oleh berbagai lembaga regulator di seluruh dunia, salah satunya adalah oleh lembaga regulasi obat dan makanan Amerika Serikat, U.S. Food and Drugs Administration (FDA) (U.S. Food and Drugs Administration, 2019). Dengan melegalkan dan menyediakan produk alternatif yang lebih aman, diharapkan para perokok di Indonesia dapat semakin terbantu untuk mereka dapat menghilangkan kebiasaan merokok mereka, yang sangat berbahaya bagi kesehatan. Kebijakan yang berorientasi pada harm reduction terhadap dampak negatif rokok sendiri merupakan kebijakan yang sudah diberlakukan di berbagai negara, salah satunya adalah di Inggris.

Pasca laporan PHE tahun 2015 mengenai dampak vape yang lebih aman dibandingkan dengan rokok konvensional yang dibakar, Pemerintah Inggris lantas memberlakukan kebijakan kesehatan publik yang berorientasi pada harm reduction. Lembaga kesehatan nasional Inggris, National Health Service (NHS) misalnya, mengadvokasi penggunaan vape kepada para perokok untuk membantu mereka berhenti dari kebiasaan merokoknya. Produk-produk vape juga dijual di berbagai rumah sakit di Inggris (Consumer Choice Center, 2020).

Hal ini pula yang diungkapkan oleh Direktur World Vaper’s Alliance (WVA), Michael Landl. WVA sendiri merupakan organisasi pegiat hak-hak vapers di seluruh dunia dan untuk melawan berbagai miskonsepsi terhadap produk-produk vape, dan mendukung regulasi yang baik.Landl, dalam salah satu interview yang saya lakukan, mengatakan bahwa saat ini, Inggris merupakan salah satu negara yang memiliki kebijakan paling baik terkait dengan regulasi vape. Pemerintah Inggris secara aktif mengadvokasi warganya yang perokok, yang belum siap berhenti, untuk mengganti kebiasaannya ke rokok elektronik atau vape (Landl, 2021). Dampak dari kebijakan tersebut sangat positif. Kebijakan kesehatan publik yang berorientasi pada harm reduction dampak rokok melalui advokasi penggunaan vape telah berhasil membuat 1,5 juta perokok di Inggris menghentikan kebiasaan merokoknya (Consumer Choice Center, 2020).

Di Indonesia sendiri, agar upaya harm reduction dapat berhasil, ada beberapa aspek yang sangat penting untuk diperhatikan. Dosen Departemen Politik dan Pemerintahan, FISIPOL, Universitas Gadjah Mada (UGM), Wawan Mas’udi, menulis bahwa setidaknya ada empat poin penting agar upaya harm reduction dapat berjalan dengan baik di negeri kita (vapemagz.co.id, 18/9/2020).

Pertama, harus ada sistem dan rezim pemerintahan yang berorientasi pada resiko untuk mempertimbangkan kebijakan yang akan diambil. Hal tersebut merupakan prasyarat pokok yang sangat penting. Kedua, harus ada sistem kelembagaan yang dapat mendukung pemberlakuan dari upaya harm reduction, dan harus ada sinergi yang baik antar sektor kelembagaan tersebut.

Ketiga, harus ada langkah yang menguatkan keterlibatan dari komunitas agar upaya tersebut dapat berjalan efektif dan mendapat dukungan dari masyarakat. Dan yang terakhir, harus ada sumber daya personil yang terampil dan memiliki kemampuan untuk mengkomunikasikan serta meyakinkan para pemangku kepentingan agar upaya harm reduction tersebut dapat berjalan dengan baik. Melalui keempat aspek tersebut, diharapkan upaya harm reduction dalam rangak mengurangi dampak negatif dari rokok bisa berjalan lancar di Indonesia.

Sebagai penutup, upaya harm reduction sangat penting untuk meminimalisir dampak negatif dari berbagai produk atau perilaku yang dapat membahayakan kesehatan seseorang atau komunitas. Untuk itu, diharapkan Pemerintah Indonesia serta berbagai kelompok masyarakat di Indonesia dapat mendukung berbagai upaya tersebut, untuk menciptakan Indonesia yang lebih sehat di masa yang akan datang.

Originally published here.

Sugar is the new tobacco. Here’s what we should do about it!

Whichever way you look at it, Britain is facing an obesity crisis. A study into long-term public health in England and Scotland published earlier this month reached the startling conclusion that obesity is causing more deaths than smoking, with nearly two thirds of British adults now overweight.

This past year has brought rising obesity levels into sharp focus because of the effect that being overweight seems to have on the fatality of Covid-19. According to research from the World Obesity Federation, nine out of ten deaths from coronavirus occurred in countries with high obesity levels, which might go some way towards explaining why the UK has seen a disproportionately high death toll.

This issue has not passed the Government by. Led by a man who was elected on a platform of halting ‘the continuing creep of the nanny state’, this Conservative Government has unveiled a raft of policies designed to ease the pressure on Britain’s weighing scales, including the sugar tax, a ‘junk food’ advertising ban and even a fund – with a £100m price tag – which is apparently designed to bribe people into losing weight.

The problems with these policies are too numerous to count. Sin taxes hit the poor harder than anyone else, making the weekly shopping trip more expensive for families who are already struggling. The junk food ad ban is set to remove around 1.7 calories, or half a Smartie’s worth of energy intake, from children’s diets per day – according to the Government’s analysis of its own policy. And the state-funded version of Slimming World sounds like something that comes out of a pop-up book of policies. Yes, and ho!

It is unclear why Boris Johnson, who was able to lose weight after his brush with Covid without any of these new Government-sponsored initiatives in place, is now so firmly of the belief that the Government must crack down on unhealthy eating if we are to have any hope of slowing down the increase in obesity rates – especially when the private sector is doing most of the hard work voluntarily.

Tesco, for instance, recently bowed to external pressure by committing itself to increasing its sales of healthy foods to 65% of total sales by 2025. Time and time again, when there is an issue people care about, companies go out of their way to do their bit – even at the expense of their bottom line. We saw the same thing happen when the world woke up to the reality of climate change, with businesses eagerly signing up to costly net-zero plans.

Positive moves like this from incumbent giants are complemented by the wealth of innovation taking place around obesity. Semaglutide, a diabetes drug, was recently found to be extraordinarily effective in helping people lose weight. Even something as innocuous as sugar-free chewing gum might just represent part of the solution. Datasuggests that the mere act of idle chewing suppresses the appetite, resulting in a 10% reduction in the consumption of sweet and salty snacks.

Crucially, these remarkable steps towards a less obese Britain can take place at no cost to the taxpayer, free of the grip of Whitehall bureaucracy and at an astonishing pace. We have just lived through a year in which the Government pumped billions into a near-useless ‘test and trace’ system and repeatedly failed to clarify whether or not drinking coffee on a park bench is illegal. If there is one incontrovertible lesson we can surely take from that, it is that we should not leave such important tasks to the state.

Sugar is the new tobacco, so we need to be smart in how we tackle it. Sporadic, ill-thought-out Government interventions like banning Marmite adverts are not the answer. Private-sector innovation, not centralised policy, is Britain’s best hope of slimming down.

Originally published here

DelVal Communities Sue for Right to Ban Plastic Bags. But What Does the Science Say?

Earlier this month, a handful of Delaware Valley communities sued the state over their right to choose to ban the sale and use of plastic shopping bags. The issue raises questions about local authority vs. state power, one that got tangled up in the public policy over handling the threat of COVID-19.

Interestingly the question few people are asking is “What does the science say?” The answer is far more complicated than plastic bag opponents have acknowledged.

On March 3, Philadelphia, West Chester, Narberth, and Lower Merion filed suit claiming GOP state lawmakers violated the constitution when they inserted a ban on banning plastic bags, straws and other single-use plastic products into the budget last year. However, Philly’s efforts to ban the bags go back to well before December 2019, when the city council passed an anti-bag ordinance. Four previous attempts to ban plastic bag use in the city failed.

That ban was blocked, not only by state lawmakers, but by the coronavirus pandemic, which gave plastic shopping bags a second life.

Concerns about “surface contagion” made reusable cloth bags, carried in and out of homes and stores, a pathogen-carrying pariah. Philadelphia Mayor Jim Kenney announced on April 22 — Earth Day, ironically — the city was postponing the July 1, 2020 start date for its bag ban.

“This is not an announcement we want to make during Earth Week. We know the climate crisis and plastic pollution remain two very serious threats to our planet and society, even during the global pandemic,” the mayor said.

Politicians throughout the country took similar steps. New Hampshire Gov. Chris Sununu, issued an executive order urging residents “to keep reusable bags at home given potential risks to baggers, grocers, and customers.” In New York, a state senator called for the state’s plastic bag prohibition to be suspended for similar reasons.

Meanwhile, in Harrisburg, lawmakers in 2020 extended a 2019 moratorium on plastic bag bans by placing it inside a budget bill (HB1083) just hours before a full vote by the General Assembly. The measure banned municipalities from imitating fees or restrictions on single-use plastics, such as bags and utensils.

The measure, in effect, prevented Philadelphia from implementing its 2019 plastic bag ban It also postponed bag bans in West Chester and Narberth, and stalled a similar ban from going forward in Lower Merion. Left unchallenged, this meant bag bans in all four municipalities could not be implemented until November 2021.

And so now they’re suing.

“In Philadelphia and across the commonwealth, local governments are increasingly concerned about the health and environmental effects of plastic bags,” Mayor Kenney said. “Yet, once again, we face a state legislature that is focused more on tying the hands of cities and towns than on solving the actual problems facing Pennsylvania.”

According to a WHYY report, the Commonwealth Court lawsuit challenges “the state’s ban on the bans, at least until July 1, 2021, or six months after Gov. Tom Wolf lifted the COVID-19 state of emergency. Under the current state of emergency, that would delay the implementation of the municipal bans at least until November of this year.”

Philadelphia officials say they will enact the bag ban on July 1, regardless of state law. If that happens, the result could be Pennsylvania’s attorney general, Democrat Josh Shapiro, representing the state against the liberal stronghold of Philadelphia and over an issue Democrats have widely embraced.

Meanwhile, state Rep. John Hershey (R-Juniata County), who supports the state’s actions, said the bans would have a negative effect on the livelihoods of the families who live and work near the Novolex plastics plant in Milesburg.

This puts the “small-government” GOP in a fight against local governance, a principle Republicans tend to embrace.

Amid the complex politics, however, a larger issue remains largely ignored: Are plastic bag bans smart environmental policy?

If the goal is to reduce greenhouse gas emissions, the science is settled: No. Multiple studies have confirmed that, as Stanford Magazine put it,”single-use plastic bags have the smallest carbon footprint.” A report from the MIT Office of Sustainability concluded: “Based on greenhouse gas emissions of material production, the paper bag would require five uses in order to have a lower impact per use than the polyethylene bag, whereas the jute bag would require 19.”

And it’s not just in the U.S. David Clement of the Consumer Choice Center wrote for InsideSources: “When Denmark considered a ban on single-use plastic grocery bags, its studies found they were far superior in comparison to alternatives. The Danes came to that conclusion based on 15 environmental benchmarks, including climate change, toxicity, ozone depletion, resource depletion, and ecosystem impact. They calculated paper bags would need to be reused 43 times to have the same total impact as a plastic bag.”

But what about litter and plastic pollution in the water? Delaware Valley Journal recently reportedon a study from the nonprofit environmental advocacy group PennEnvironment Research and Policy Center that found samples from every one of the state’s 53 popular waterways contained microplastics.

But despite complaints about plastic bags fouling our streets and sewers, the definitive litter study—the 2009 Keep America Beautiful Survey—found all retail plastic bags (which includes sandwich bags, dry cleaning bags, etc) account for just 0.6 percent of visible litter nationwide.

And a recent study revealed the United States is responsible for about 1 percent of the plastic litter in the world’s oceans.

Jenn Kocher, a spokeswoman for Republican state Sen. Jake Corman, said the desire of local municipalities to enact bans on single-use plastic ought to be balanced with economic concerns, as well as the loss of jobs. Corman stated that “bans hurt the economy” and that “the employers that manufacture these bags provide family-sustaining jobs in communities throughout Pennsylvania.”

Originally published here

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