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Promoting Cancer Control in Indonesia

, by Kalina Duncan

The mission of the National Cancer Institute, Center for Global Health is to create sustainable international partnerships, support programs that address global gaps in research and scientific training, and disseminate information and best practices that drive improvements in cancer research and cancer control. In partnership with the US Center for Disease Control and Prevention and USAID, I had the wonderful opportunity to travel to Indonesia on detail with the Ministry of Health this past spring to address important global issues of cancer control and cancer research I was positioned in the MOH, Cancer Sub-Directorate, and worked closely with Dharmais National Cancer Hospital, academic partners, the World Health Organization (WHO), and other non-profit organizations to pursue U.S-Indonesia cooperation on tobacco control and research opportunities.

In Indonesia, the current smoking situation is nothing short of a dire public health emergency. Tobacco smoking prevalence is very high among Indonesian men with 67% of men smoking, and although smoking is low among women, it appears that rates among women are increasing rapidly. Additionally smoking rates are quite high among youth with 41 percent of boys starting at an earlier age, when compared to neighboring countries.   Nevertheless, it is an unfortunate reality that for those youth that do not smoke, 78 percent are still exposed to secondhand smoke at home or in public places and 69 percent are exposed to secondhand smoke at home.  Overall, smoking kills at least 225,000 people each year in Indonesia.

Despite rampant tobacco use, Indonesia remains the only WHO member country in Southeast Asia that has not yet ratified the Framework Convention on Tobacco Control (FCTC), the first international public health treaty that reaffirms the right of all people to the highest standard of health by requiring evidence-based tobacco control policies and interventions.  Although Indonesia has passed some laws requiring smoke-free public spaces and pictorial warnings on cigarette packages and advertisements, enforcement of these regulations is scattered, at best.

In recognition of the need for more evidence and capacity building in tobacco control, NCI has partnered with USAID on the PEER Health program. NCI recently funded two research projects under the PEER Health umbrella looking at the effect of a smoke-free home on neo-natal health and the effect of air pollution in early life on infant and maternal health.  NCI is exploring research partnership opportunities to build partnerships between NCI-funded researchers in the U.S. and Indonesian scientists to address priority research questions needed to further evidence-based tobacco control measures in Indonesia.  Additionally, to contribute to building capacity in country, NCI will work with partners to introduce a tobacco control curriculum into the Field Epidemiology Training Program (FETP).

The NCI, Center for Global Health will continue in its support of cancer control efforts worldwide.  We will work closely with our partners in Indonesia to aid in the strengthening of public health policies that will meet their needs in addressing tobacco control priorities.   

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More than 300 million people in at least 70 countries use smokeless tobacco