In a world that is increasingly complex with evolving health challenges, how can we create a sustainable healthcare system? The Public Health Colloquium (PHC) 2024, organized by the Faculty of Public Health (FPH) Universitas Indonesia (UI), attempts to answer this question. Held on October 1-2, 2024, PHC carried the theme “Sustainable Health(care)” and served as a platform for global researchers to come together to discuss the urgent challenges of sustainable health and share their latest research findings. PHC targeted researchers, lecturers, and students from various countries, fostering discussions on public health, medicine, and related fields. The event consisted of three main activities: oral presentations, workshops, and seminars.
The PHC 2024 was officially opened by Dr. Ir. Asih Setiarini, M.Sc., Vice Dean for Education, Research, and Student Affairs of FPH UI. In her opening speech, Dr. Asih emphasized the importance of collaboration in sustainable health research, saying, “PHC 2024 is a crucial moment to bring together researchers from various fields to discuss health issues that are relevant to the current global situation.” Dr. Al Asyary, S.K.M., M.P.H., Editor in Chief of the Kesmas Journal, also gave a speech. Dr. Al Asyary expressed his hope that participants would gain valuable experiences and contribute to the development of public health knowledge, stating, “We hope that participants have memorable experiences and take part in advancing public health knowledge. This colloquium is organized for researchers to facilitate and create a positive impact on public health.” The event was moderated by Fitri Kurniasari, Ph.D., a lecturer at the Department of Environmental Health, FPH UI.
Prof. Coral Gartner from The University of Queensland presented on the link between tobacco control and the Sustainable Development Goals (SDGs), as well as the environmental impacts of the tobacco industry. She emphasized the importance of tobacco control as part of efforts to achieve the SDGs, considering the significant environmental impact caused by the tobacco industry. “Integrating tobacco control with sustainability goals is a critical step, given the enormous environmental burden from the tobacco industry’s lifecycle,” she explained. Prof. Gartner also introduced the “endgame” concept in tobacco control, which involves strategic actions to end tobacco consumption worldwide. She provided an overview of global plans related to this. In her presentation, Prof. Gartner detailed how the tobacco production lifecycle, from planting to processing, generates significant pollution. Tobacco cultivation and curing can lead to deforestation, soil degradation, loss of biodiversity, and the use of harmful pesticides. Additionally, the drying process (flue-curing) produces CO2 emissions and air pollution. “The tobacco production cycle creates long-lasting environmental problems, and its effects are not only limited to air pollution but also damage the soil, water, and the well-being of workers in agriculture,” Prof. Gartner emphasized.
Moreover, tobacco consumption leaves a large environmental footprint. For example, a person who smokes 20 cigarettes a day for 50 years will generate an equivalent amount of CO2 emissions, requiring 132 tree seedlings to be planted and grow for 10 years to offset the impact. The use of fossil fuels is also significant, equivalent to the average household electricity consumption in India for 15 years. “These numbers highlight the environmental cost of smoking, not just its impact on human health,” she added. Prof. Gartner stressed the importance of integrating these various policies as part of a larger global effort to end tobacco consumption. She also cited international examples such as Bhutan’s total tobacco ban, New Zealand’s innovative action plans, and progressive policies in Malaysia and the UK, showing that an “endgame” approach can succeed.
In alignment with Prof. Gartner’s presentation, Dr. Siti Nadia Tarmizi, M.Epid, Director of Disease Prevention and Control at the Ministry of Health of the Republic of Indonesia, discussed the national health targets focused on addressing health issues caused by tobacco consumption. Dr. Siti Nadia explained that the Indonesian government is committed to reducing smoking prevalence, especially among youth and women. “We realize that tobacco control is not just the responsibility of the Ministry of Health, but requires collaboration from various sectors, including education, the environment, and public policy,” Dr. Siti Nadia stated. Additionally, she highlighted the need for a holistic approach to tobacco control, including public health education on the dangers of smoking, strengthening regulations, and promoting smoke-free policies in public places. An integrated strategy is expected to reduce the harmful impact of tobacco on public health and achieve the targets set in the National Medium-Term Development Plan (RPJMN). “It is crucial for community involvement to raise awareness about the dangers of tobacco, which will have a positive impact on overall public health,” she said.
Next, Dr. Kylie Morphett from The University of Queensland presented on the environmental impact of tobacco product waste, including issues related to vape product waste. She discussed how these wastes negatively impact both the environment and public health. Dr. Kylie explained that tobacco product waste, including cigarette butts and vapes, has serious environmental consequences. These wastes are often discarded improperly, leading to soil and water pollution. Cigarette butts, for instance, contain harmful chemicals that can damage plants and disrupt ecosystems, including reducing soil quality and harming plant growth. Dr. Kylie emphasized, “Tobacco product waste is not just a health issue, but also an urgent environmental problem. We need to raise awareness about the impact of this waste so that the public can contribute to environmental protection.” This aligns with Prof. Wahyu Sulistiadi’s opinion, “Seventy percent of consumers report discarding cigarette butts improperly, causing toxicity to plants and animals,” he said. Improperly discarded cigarette butts can reduce the germination of grass and clover seeds, harm the DNA of marine worms, and are toxic to fish, both from burned and unburned butts.
Furthermore, according to Prof. Dr. drg. Wahyu Sulistiadi, M.A.R.S., a Professor at FPH UI, various challenges are faced in addressing these issues. These challenges include health system resilience, weaknesses in the healthcare system, inequality in access to services, the increasing burden of diseases due to climate change, and the limited number of healthcare workers. “Health system resilience is not only about service capacity, but also about the ability to adapt to changes, both in terms of disease and climate challenges,” said Prof. Wahyu. He also explained the Strategic Plan for Community-Based Health Systems (RSSH), which emphasizes the importance of planning and governance in the health sector to create integrated and people-centered services. To strengthen and maintain the implementation of community-based healthcare/Integrated People-Centered Services (IPCS), the Ministry of Health encourages advocacy for optimizing local government (APBD) and village budgets, as well as allocating funds for community health workers and medical supplies. Additionally, optimizing the Special Allocation Fund (DAK), including health operational assistance (BOK) and other funding transfers, is an important step to support the sustainability of local healthcare services.
On the second day of the event, a workshop titled “Reducing Tobacco Litter Through Smoke-Free Environments: Australia and Indonesia” was held, led by Mr. David Sellars, M.Sc., from James Cook University. This workshop discussed efforts to reduce tobacco waste through the implementation of smoke-free environments in Australia and Indonesia. The panel discussion featured Dr. Al Asyary, S.K.M., M.P.H., and Meita Veruswati, S.K.M., M.K.M., Ph.D. (cand.), who provided perspectives from both countries on the environmental impact and policies that could be adopted to reduce tobacco waste. The event continued with oral presentations from several participants on relevant topics.
Through various programs and competent speakers, PHC 2024 is expected to drive innovation in sustainable health research and make a significant contribution to the development of health policies in Indonesia and globally. (DFD)