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Timor-Leste mayors unite for stronger action on tobacco control, NCDs prevention and ending TB

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Declaration endorsed and Timor-Leste Mayors Alliance for Health and Development established

The first ever Timor-Leste Mayors Summit for Health and Development successfully concluded in Dili with the unanimous adoption of a historic declaration calling for stronger local action on tobacco control, prevention of non-communicable diseases (NCDs) and progressing towards ending tuberculosis (TB).

Well-coordinated responses are critical for improving health and development outcomes. That is why this Mayors Summit is a landmark event with strong commitments from the mayors of all five jurisdictions of Timor-Leste, but also the Minister of Health, Minister of Finance, former Prime Minister and experts from the World Health Organization (WHO), among others.

First Timor-Leste Mayors Summit

The declaration adopted at the Summit commits national and local leaders to prioritise key interventions, including:

  • Implementing and enforcing smoke-free policies
  • Prohibiting tobacco advertising and sponsorship
  • Urging the ban of alcohol advertising and sponsorship
  • Improving local TB control programs
  • Adopting a One Health approach for better pandemic preparedness

This Summit, jointly organised by Mayors of Dili and Ermera Municipalities, Ministry of Health, Asia Pacific Cities Alliance for Health and Development (APCAT), the National Alliance for Tobacco Control in Timor-Leste (ANCT-TL), and the International Union Against Tuberculosis and Lung Disease (The Union), recognised the pivotal role of mayoral leadership in advocating for healthy behaviours, particularly in reducing smoking and tobacco use.

Timor-Leste currently faces one of the highest tobacco smoking rates globally. Recent statistics from the WHO revealed that around 35% of the population aged 15 years and older are tobacco users, approximately 267,900 people,  with particularly alarming rates among males at 61%. Among these users, about 60% are daily consumers of tobacco, which includes cigarettes and smokeless forms.

Moreover, tobacco use is a significant risk factor for life-threatening non-communicable diseases (NCDs), such as heart diseases and stroke, diabetes, cancers, and other chronic respiratory diseases. As per the latest WHO Global TB Report, tobacco smoking ranked second (after undernourishment) among the top five TB risk factors. Recognising the urgency to tackle these issues, the Mayors Summit emphasised the need for evidence-based tobacco control measures to advance NCD prevention and TB control.


Timor-Leste Mayors Alliance for Health and Development established

During the Summit, Guilhermina Filomena Saldanha Ribeiro, Mayor of Dili Municipality announced the establishment of Aliansa President Munisipiu no Administrador  Saúde no Dezenvolvimento (APSAD), also known as Mayors and Administrators Alliance for Health and Development. Mayors from Ermera, Baucau, Bobonaro, and Special Administrative Region Oecusse-Ambeno Municipalities, nominated the Mayor of Dili to be the Chair of this Alliance, with ANCT-TL serving as the Secretariat. This alliance aims to empower mayoral leadership in implementing effective health policies and programs, particularly focusing on curbing tobacco use, alcohol consumption, and unhealthy diets. It also emphasises the importance of mayoral accountability in resource allocation, stakeholder engagement and regular evaluation of health policies and programmes.


Well-coordinated response to tobacco control is vital

Ribeiro stated: “Mayors need to collaborate with national and international partners to reduce smoking prevalence, so that we can be free from diseases caused by smoking. We should also empower district heads to implement evidence-based policies, reduce factors contributing to non-communicable diseases, motivate each other in prevention efforts, and lead the promotion of healthy living at the community level. Together, mayors can create healthier cities and a disease-free future for the nation.”

Dr Odete Maria Freitas Belo, Minister of Health, expressed concern about the easy availability of cigarettes to young people, highlighting the influence of social media and illicit trade. Dr Odete stressed: “The Ministry of Health will collaborate with the Mayors Alliance to strengthen regulations, carry out regular inspections, and ensure compliance with age restrictions. The Ministry of Health will also enforce inspections for illicit cigarettes and implement a ban on smoking in public places. These measures will play a significant role in safeguarding the health and prospects of our young generation.”

Rui Augusto Gomes, Minister of Finance, said: “It is crucial to shift our focus from discussing problems to implementing effective solutions. One pressing issue is the increasing presence of illicit cigarettes, especially following tax hikes. It is recommended that the government takes decisive action to control the sale and distribution of tobacco within the country. By addressing this issue, we can mitigate the negative consequences and ensure better regulation of the tobacco market. It is time to take proactive steps to tackle this challenge and protect the well-being of our citizens.”

Former Prime Minister Dr Rui de Araujo highlighted the challenges associated with enforcing tobacco laws, such as the absence of well-structured enforcement agencies. He underscored the significance of mayors and sub-national leaders in establishing effective task forces dedicated to tobacco control. Through the formation of these task forces, they can enforce stricter measures, create smoke-free places, and implement bans on tobacco advertising, promotion, and sponsorship. 

Dr Tara Singh Bam, Director of The Union Asia Pacific, said: “There is clear evidence that mayors possess the potential to provide effective leadership, fostering accountability across the entire government, facilitating the successful implementation of tobacco control, and promoting increased bottom-up participation and resource mobilization to ensure long-term sustainability.”

He expressed admiration for the commitment demonstrated by the Ministry of Health and the Ministry of Finance in their endeavours to make Timor-Leste a tobacco-free country. He commended on various initiatives, such as the expansion of pictorial health warnings, the establishment of tobacco cessation clinics, and the introduction of higher taxes on tobacco products. Moreover, he encouraged them to continue progressing their efforts by embracing standardised packaging for tobacco products and further raising taxes and prices on tobacco products.

Dr Arvind Mathur, WHO Representative to Timor-Leste, stressed the importance of discouraging youth and non-smokers from starting smoking and providing support for those who wish to quit. The Ministry of Health, with WHO support, has established tobacco cessation centres and plans to establish more by the end of 2023.

Around 90 people participated in the inaugural Mayors Summit, including mayors, Ministry of Health and Ministry of Finance representatives, government stakeholders, the WHO, The Union, APCAT, academics, civil society organisations and the media. This collaborative effort reflects the local leadership's commitment to address health challenges and improve the well-being of the population in Timor-Leste.