Every tobacco death is an avoidable tragedy. The epidemic must stop here | Margaret Chan

Tobacco use, the leading cause of death from non-communicable diseases such as heart and lung disorders and cancer, claims about 6m lives a year. On Monday, countries will gather in Delhi, India, for the seventh conference of the parties to the World Health Organisation framework convention on tobacco control, a treaty that has sparked global action to stem the epidemic.

The treaty is already one of the most widely embraced in UN history. One of my proudest accomplishments at the helm of the World Health Organisation has been rallying global efforts to drive down tobacco use. I’m pleased to say that, following the adoption of the agreement, governments around the world have taken decisive steps not only to reduce tobacco use, but also to stand up to the multinational tobacco companies standing in the way of global progress.

The tide of tobacco use is beginning to turn. After decades of Big Tobacco targeting low- and middle-income countries and years of steadily increasing sales, tobacco sales show signs of dropping.Countries are passing stronger laws to reduce demand for tobacco products not envisioned even a few years ago, and tobacco companies are losing the legal challenges they mount against these measures. From Uruguay to Australia, countries large and small have stood up to the tobacco industry by implementing plain packaging and large pictorial health warning labels. Where tobacco companies have tried to threaten and bully nations, governments have responded with firm measures to protect public health.

However, amid these clear signs of progress, the tobacco industry has made it absolutely clear that it has no intention of abandoning a business model that depends on enticing millions of new users – especially young people – to its deadly products.

The impetus of the global movement to reduce tobacco use should not be lost. More than ever, decisive action is needed. Now is the time for countries to build on the momentum established and protect their citizens. By raising tax on tobacco products, requiring graphic warning labels, conducting hard hitting mass media campaigns and banning tobacco industry advertising and marketing, countries can improve the health of their citizens, reduce healthcare costs and prevent the tobacco industry from addicting another generation of children.

Illicit trade in tobacco threatens the progress governments make in tobacco control by making cheap and unregulated products available. I am pleased to note that governments are increasingly taking action and becoming parties to the new international treaty to eliminate illicit trade in tobacco products.

I urge global leaders convening in India to see this as an opportunity to bend the course of public health history

We need to work together, as allies in global health, to fight to protect people from the dangers of tobacco. I recently appointed Michael Bloomberg as WHO global ambassador for non-communicable diseases because of his track record in tobacco control, which includes more than 10 years of support for low- and middle-income countries. Advocates like him, and many others who champion tobacco control, stand with the WHO to support governments in this fight.

I am also heartened by progress on standardised or “plain” packaging – a measure introduced by the treaty and pioneered in Australia, where smoking rates have now fallen to record lows. The early evidence from Australia shows that plain packaging, as part of a comprehensive approach to tobacco control, is diminishing the appeal of tobacco products, increasing the effectiveness of health warnings and reducing the ability of the pack to mislead. France and the UK have begun implementing plain packaging laws, and New Zealand and Hungary have recently passed legislation. Many other countries are close behind.

We have made great strides, but we have so much more to do. Tobacco use remains one of the most vexing challenges we face in the global health arena.

I urge global leaders convening in India to see this moment as an opportunity to bend the course of public health history and commit to returning home with a renewed dedication to fully implement the WHO framework convention. To make the event effective, it is vital that governments recognise the inherent conflict between public health and the interests of the tobacco industry. Representatives from the latter should be completely excluded from government delegations.

Every death from tobacco is an avoidable tragedy. It is our task to reverse the tide, effecting an irreversible decline in the number of such deaths.

We need history to show us that the turning point in the tobacco epidemic is now. We know what to do and we know how to do it. We now need to ensure that every country moves forward and no one is left behind. Future generations depend on us.

Every tobacco death is an avoidable tragedy. The epidemic must stop here | Margaret Chan

Cure all diseases? The Chan Zuckerberg plan is brilliantly bold | Ian Sample

There is ambition and there is Silicon Valley ambition. For where else on a map could a pin be placed when asked to guess where billionaire philanthropists had declared their intention to cure, prevent or manage all human disease before the end of the century?

It was clear from the start that the announcement from Priscilla Chan and her husband, Mark Zuckerberg, nudged at the boundaries of belief. Writing in praise in the US journal, Science, David Baltimore, a Nobel laureate at California Institute of Technology concedes the goal “may raise eyebrows”. Even Cori Bargmann, the renowned neurobiologist who will lead the charge, is aware how it might be perceived. It is “ambitious”, she says, “but not completely ridiculous”.

It is tempting to dismiss the Chan Zuckerberg Initiative as hubris. But the best part of a century is a long time in medicine. Most babies born in 1900 did not live to see the age of 50. Medicine has not been the only reason for the dramatic rise in life expectancy since, but it was a crucial factor. “By 2100 we’ll be shocked by how much we’ve achieved, and we’ll be more shocked with initiatives like this,” says Jim Smith, chief of strategy at the UK’s Medical Research Council.

If not hubris, then what about one-upmanship? Bill Gates wants to eradicate malaria in a generation. Elon Musk wants a Mars colony in a decade. Yuri Milner has set his sights on sending a spacecraft to a star at one-fifth the speed of light. How better to leave your mark higher on the wall than to make every human disease obsolete within your child’s lifetime? Or at least find a way to manage awful conditions, so they no longer mar people’s lives?

But audacious goals are precisely what are needed. “We have to be bold about the scale of the challenge we face in improving human health,” says Steve Craddick, professor of chemical biology at University College London and director of innovation at the Wellcome Trust, the world’s largest biomedical research charity. “What is truly important about this kind of approach is that it creates the hope you need to go from exploratory science to making the world a better place.” He goes on: “Aspiration is essential. This idea that if we put our minds to it, almost anything is possible – that is what can sustain people through the peaks and troughs of decades of research.”

Chan and Zuckerberg will stump up at least $ 3bn (£2.3bn) for the effort over the next 10 years. That is not a vast sum for the task ahead. The new Francis Crick Institute in London, now filling with 1,400 scientists, could be built and run for 10 years on that. The Wellcome Trust itself will spend £5bn on biomedical research in the next five years alone. But part of Chan and Zuckerberg’s hope is to grow a movement to fund science: where they have led, they want other wealthy individuals to follow. An audacious, long-term goal backed by world-class scientists is the way to make that happen.

As Chan and Zuckerberg state, four types of diseases cause most of the deaths in the world: heart disease, cancer, neurological diseases and infectious diseases. The research kicked off by the initiative will focus on the basic science underlying them. The rationale is sound: it takes fundamental breakthroughs to make a real difference in medicine.

The first step is a $ 600m “Biohub” that will draw scientists and engineers from the Bay Area’s leading institutions: Stanford, the University of California, San Francisco and the University of California, Berkeley. The hub has two major projects lined up already. The Human Cell Atlas will map out the internal workings of every cell type in the body, a mammoth task that is bound to open up new avenues in medicine. The Infectious Disease Initiative aims to bring fresh thinking to drug design, diagnostic tests and vaccines. According to Tom Solomon, a neurologist and director of the Institute of Infection and Global Health at Liverpool University, such radical new approaches could be as important as the money itself.

And yet in Silicon Valley, it seems the only solutions are hi-tech solutions. This is one area where Chan and Zuckerberg may fall short in their aim to leave the world a better place for children. Only 10% of health research funds are spent in developing countries, where 90% of preventable deaths occur. The Chan Zuckerberg Initiative will apparently direct three-quarters of its efforts towards heart disease, cancer and neurological disease, the chronic conditions of the west. That may leave too little emphasis on infectious diseases.

A recent report from the World Health Organisation made clear that unless developing countries have the means to gather and study their own medical data, public health is unlikely to improve. It is the old adage about teaching a man to fish. Childbirth still kills hundreds of thousands of mothers and babies in low-income countries. To prevent those deaths does not require a scientific breakthrough. It takes know-how and facilities.

“It is not as sexy as saying you are going to develop a drug or a vaccine, but what is needed is research capacity development,” says Trudie Lang, director of the global health network at Oxford University. “Nurses, midwives and community health workers need to be trained and supported. It’s hard to get funding for it, because you can’t show how many lives you have saved, but it is absolutely vital,” she says. “It’s a slow win, but it’s what they should be doing.”

Cure all diseases? The Chan Zuckerberg plan is brilliantly bold | Ian Sample

Mark Zuckerberg and Priscilla Chan pledge $3bn to end all disease - video

Facebook chief executive Mark Zuckerberg and his wife, Priscilla Chan unveil plan to spend more than $ 3bn over 10 years to ‘cure, prevent or manage all disease within our children’s lifetime’. Investments will include a bioscience research centre, plans for a microchip to diagnose diseases, continuous bloodstream monitoring and a map of cell types in the body.

Mark Zuckerberg and Priscilla Chan pledge $3bn to end all disease - video

Mark Zuckerberg and Priscilla Chan aim to "cure, prevent and manage" all disease

Mark Zuckerberg and his wife Priscilla Chan have laid out plans to invest $ 3bn over the next 10 years with the not insignificant goal of tackling all diseases.

“Can we cure, prevent or manage all disease by the end of this century?” asked Zuckerberg, speaking in front of a packed lecture theater at the University of California, San Francisco (UCSF) William J Rutter Center.

The Chan Zuckerberg Initiative will focus on some of the world’s biggest killers, including heart disease, cancer, infectious diseases and neurological diseases.

One of its biggest investments is to be a $ 600m “Biohub” at UCSF, which will bring together scientists and engineers from Stanford, Berkeley and UCSF – which haven’t collaborated in this way before – to develop tools to treat diseases.

The second focus will be transformative technology, all of which will be made available to all scientists everywhere.

“Throughout the history of science most of the major scientific breakthroughs have been preceded by some new tool and technology that allows you to see in new ways,” explained Zuckerberg. “The telescope helped us understand astronomy and the universe, the microscope helped us understand cells and bacteria to help us develop treatments for infectious diseases, while DNA sequencing and editing helps us fight cancer and genetic disorders.”

Zuckerberg suggested that artificial intelligence could help with brain imaging to treat neurological diseases, machine learning could be used to analyse cancer genomes, while chips and blood monitors could identify diseases quickly. “These are the kinds of tools we want to focus on building at the Chan Zuckerberg Initiative,” he said.

Acclaimed American neurobiologist Cornelia Bargmann, who will lead the initiative, gave the example of a “cell atlas”, a comprehensive resource that maps the locations, types and molecular properties of all of the cells in the human body.

“We need this to develop new understanding and cures for diseases in all areas of medicine,” she said.

The Chan Zuckerberg Initiative is a limited liability company that the couple uses to make donations and investments to advance their philanthropic causes. It was launched at the birth of the couple’s first daughter Max in December 2015. The couple has committed 99% of their Facebook stock, valued at $ 45bn, to the initiative which makes charitable donations and for-profit investments.

The organization initially focused on the education space, funding Indian company BYJU’s, which helps students learn maths and science and Nigerian company Andela, which trains up African software developers. It has now turned its attention to science.

The organization will achieve its objective by focusing on building tools and technology, bringing scientists from across the world together and growing a movement to fund more science.

Wiping back tears in an emotional opening talk, Chan described her work as a paediatrician.

“I have worked with families at their most difficult moments in their lives, from making the devastation diagnosis of leukaemia to sharing with them that we were unable to resuscitate their child,” she said. “By investing in science today we hope to build a future in which all of our children can live long and rewarding lives.”

Zuckerberg and Chan acknowledged it’s an ambitious undertaking. “It’s a big goal,” said Zuckerberg. However, he said that he and Chan have spent two years talking to Nobel Prize-winning scientists and researchers and believe it’s not unrealistic.

“Can we all together work to cure, prevent or manage all disease within our children’s lifetime? We think it’s possible and so do scientists,” Chan added. “It’s not that we won’t ever get sick, but that our children and their children will get sick a lot less.”

Mark Zuckerberg and Priscilla Chan aim to "cure, prevent and manage" all disease