Strengthening Risk Prevention Policies effective engagement of sectors such as transport, education and finance to capitalize on he potential for greatly reducing population exposures. Clearly, the world is facing global risks to health. Yet it is equally clear that dramatic reductions in risk and a healthier future for all can be achieved. What is required now is a global response, with strong and committed leadership, supported by all sectors of society concemed with promoting health Box 6. 3 Examples of successful international concerted action tiona entific uncertainty should not be allowed to delay the control of large and important risk factors, given the evidence that substantial future reduc- could be achieved International partnerships have proved to be a powerful way forward, as the following examples show Framework Convention for Tobacco Control Stop-TB Partnership Global Alliance for vaccines and Each year tuberculosis causes two million immunization(GAVI Unless prevention is given a high priority, deaths, many in association with HIV/AIDS. It is a Following a fall in immunization coverage tobacco will kill about 10 million people each disease of poverty, for which a very cost-effective in many poor developing countries, this new in ear by 2030 and 70% of the deaths will be in drug treatment(DOTS)is available. n 2000, minis- ternational public-private partnership was developing countries. The Framework Conven- ters from 20 of the 22 countries which account for launched in January 2000, with an initial dona- tion is being developed by the World Health Or- 80% of the global TB burden issued the tion of US$ 750 million from the Bill and Melinda ganization, based on its Constitution, and is Amsterdam Stop-TB Declaration, setting explicit Gates Foundation. Other members are govem- currently under negotiation between the great objectives to reduce the disease. The Stop-TB Part- ments, UNICEF, the World Bank, nongovemme ajority of Member States. It will be an interna- nership, which has an open membership of gov- tal organizations and the vaccine industry. It tional legal instrument to which countries can ernments, nongovernmental organizations, hosted by the World Health Organization and sign up, to reduce the harm caused by tobacco. It foundations, individuals and others, is hosted by has a board and specialized task forces. It aims omprises aspects such as advertising, regulation, the World Health Organization. It is an advocacy to raise coverage in the 74 poorest countries and end national borders, regional and cure 85% of them by 2005 and to halve deaths making a five-year commitment. By June 2002, international cooperation is called for The Frame- from TB by 2010. This called for a global DOTS ex- over USS 900 million had been committed to 60 work Convention facilitates a multisectoral ap- pansion plan, strengthening of national control countries, mainly in Africa and Asia. GAVI has also proach but also recognizes that the health sector programmes, ensuring universal access to TB drugs, been seen as a potential model for the new Glo- has a leading responsibility to combat the to- and promoting research into new drugs and vac- bal Fund to Fight AlDS, Tuberculosis and Malaria bacco epidemic. The first full draft Convention cines websitehttp://www.vaccinealliance.org wasissuedinJuly2002anditisexpectedtobewebsitehttp://www.stoptb.org adopted in May 2003. In the next phase indi- vidual protocols will be developed. websitehttp://ww REFERENCES 1. Rose G. The strategy of preventive medicine. Oxford: Oxford University Press: 1992. 2. Rose G. Strategy of prevention: lessons from cardiovascular disease. British Medical Journal 1981; 282:1847-51. 3. Rose G Sick individuals and sick populations. International Joumal of Epidemiology 1985: 14: 32-8. 4. Kinlay S, OConnell D, Evans D, Halliday J. The cost-effectiveness of different blood-cholesterol lowerin strategies in the prevention of cardiovascular disease. Australian Joumal of Public Health 1994; 18: 105 Reducing the global burden of blood pressure-related cardiovascular disease. Joumal of Hypertension Magnus P, Beaglehole R. The real contribution of the major risk factors to coronary epidemics-time to end the"Only 50%"myth. Archives of Intemal Medicine 2001; 161: 2657-60 7. Rose G, Day S. The population mean predicts the number of deviant individuals. British Medical Journal 1990:301:1031-4Strengthening Risk Prevention Policies 157 Box 6.3 Examples of successful international concerted action Scientific uncertainty should not be allowed to delay the control of large and important risk factors, given the evidence that substantial future reduc￾tions could be achieved. International partnerships have proved to be a powerful way forward, as the following examples show. Framework Convention for Tobacco Control (FCTC) Unless prevention is given a high priority, tobacco will kill about 10 million people each year by 2030 and 70% of the deaths will be in developing countries. The Framework Conven￾tion is being developed by the World Health Or￾ganization, based on its Constitution, and is currently under negotiation between the great majority of Member States. It will be an interna￾tional legal instrument to which countries can sign up, to reduce the harm caused by tobacco. It comprises aspects such as advertising, regulation, smuggling, taxation, smoke-free zones and treat￾ment of addiction. As many of these issues tran￾scend national borders, regional and international cooperation is called for. The Frame￾work Convention facilitates a multisectoral ap￾proach but also recognizes that the health sector has a leading responsibility to combat the to￾bacco epidemic. The first full draft Convention was issued in July 2002 and it is expected to be adopted in May 2003. In the next phase indi￾vidual protocols will be developed. web site http://www.who.int/tobacco/ Stop-TB Partnership Each year tuberculosis causes two million deaths, many in association with HIV/AIDS. It is a disease of poverty, for which a very cost-effective drug treatment (DOTS) is available. In 2000, minis￾ters from 20 of the 22 countries which account for 80% of the global TB burden issued the Amsterdam Stop-TB Declaration, setting explicit objectives to reduce the disease. The Stop-TB Part￾nership, which has an open membership of gov￾ernments, nongovernmental organizations, foundations, individuals and others, is hosted by the World Health Organization. It is an advocacy and advisory public–private partnership that aims to detect 70% of all new infectious TB cases and cure 85% of them by 2005 and to halve deaths from TB by 2010. This called for a global DOTS ex￾pansion plan, strengthening of national control programmes, ensuring universal access to TB drugs, and promoting research into new drugs and vac￾cines. web site http://www.stoptb.org Global Alliance for Vaccines and Immunization (GAVI) Following a fall in immunization coverage in many poor developing countries, this new in￾ternational public–private partnership was launched in January 2000, with an initial dona￾tion of US$ 750 million from the Bill and Melinda Gates Foundation. Other members are govern￾ments, UNICEF, the World Bank, nongovernmen￾tal organizations and the vaccine industry. It is hosted by the World Health Organization and has a board and specialized task forces. It aims to raise coveragein the 74 poorest countries and to introduce new vaccines, including hepatitis B and Haemophilus influenzae type B. GAVI is making a five-year commitment. By June 2002, over US$ 900 million had been committed to 60 countries, mainly in Africa and Asia. GAVI has also been seen as a potential model for the new Glo￾bal Fund to Fight AIDS, Tuberculosis and Malaria. web site http://www.vaccinealliance.org effective engagement of sectors such as transport, education and finance to capitalize on the potential for greatly reducing population exposures. Clearly, the world is facing global risks to health. Yet it is equally clear that dramatic reductions in risk and a healthier future for all can be achieved. What is required now is a global response, with strong and committed leadership, supported by all sectors of society concerned with promoting health. REFERENCES 1. Rose G. The strategy of preventive medicine. Oxford: Oxford University Press; 1992. 2. Rose G. Strategy of prevention: lessons from cardiovascular disease. British Medical Journal 1981; 282:1847-51. 3. Rose G. Sick individuals and sick populations. International Journal of Epidemiology 1985; 14:32-8. 4. Kinlay S, O’Connell D, Evans D, Halliday J. The cost-effectiveness of different blood-cholesterol lowering strategies in the prevention of cardiovascular disease. Australian Journal of Public Health 1994; 18:105- 10. 5. Rodgers A, Lawes C, MacMahon S. Reducing the global burden of blood pressure- related cardiovascular disease. Journal of Hypertension 2000; 18(Supplement):S3-6. 6. Magnus P, Beaglehole R. The real contribution of the major risk factors to coronary epidemics – time to end the “Only 50%” myth. Archives of Internal Medicine 2001; 161:2657-60. 7. Rose G, Day S. The population mean predicts the number of deviant individuals. British Medical Journal 1990; 301:1031-4