Asbestos kills, that's for sure

The Public Health Ministry under the leadership of Minister Pradit Sintanawarong is never short of controversies. Amid a severe shortage of physicians in rural areas, Dr Pradit issued a policy to cut their hardship allowances.

Effective treatment requires physicians to spend time with patients to gather details of their symptoms and personal backgrounds so they can make an accurate diagnosis. Yet the minister imposed a pay-for-performance system that rewards physicians on the quantity of tasks performed and requires doctors to document each and every task, which turns hospitals into factory assembly lines and a hell of paperwork.

His policy has triggered fierce protests from rural doctors. They accuse him of trying to demoralise and directly force them to work for private hospitals in the city under the government's medical hub policy push.

They also view the ministry's move to vilify the Government Pharmaceutical Organisation and its focus on generic drug production as a move to serve big pharma. The minister's effort to weaken the National Health Security Office (NHSO) is also seen as a bid to control the NHSO's huge budget for health care.

The latest incident that has further shaken public confidence in the ministry is its refusal to recognise that asbestos, a known human carcinogen used in construction materials, is dangerous to health.

Deputy secretary-general Charnwit Tharathep last week said there is not enough medical evidence to support the view that asbestos poses a health danger. His statement flies in the face of the asbestos ban imposed by the World Health Organisation (WHO) and more than 50 countries.

The powerful asbestos lobby has been trying to mislead the public into believing that chrysotile, a type of asbestos that is used in Thailand, is safe. This is not true, says the WHO; all forms of asbestos are carcinogenic to humans and may cause mesothelioma and cancer of the lung, larynx and ovaries as well as difficulty in breathing and severe coughing.

In 2010, the National Economic and Social Development Board (NESDB) proposed a ban on asbestos. The cabinet approved it in 2011. With the Industry and Public Health ministries insisting on more and more studies, the ban has been delayed for two years now.

Thailand is the world's second biggest importer of asbestos, mainly from Russia and Canada.

Asbestos is used heavily in the construction industry for insulating materials and floor covering. It is also used for brake linings, clutch assemblies and heat-resistant household appliances such as toasters, irons and ovens.

It becomes a serious health hazard when people inhale its very fine durable fibres that damage their lungs. Workers at asbestos plants, construction and demolition sites, and consumers are exposed to the health risks. The WHO says there are 125 million of them around the world and more than 107,000 people die each year from asbestos-related diseases resulting from occupational exposure.

Yet the ministry still refuses to recognise asbestos health dangers. Meanwhile, the NESDB says low figures for asbestos-related diseases here result from poor reporting and diagnosis in the healthcare system itself.

Public confidence in the ministry is now at its lowest. To restore credibility, it must prove it is not serving business interests as alleged. It could start by accepting asbestos as a heath hazard, which has long been acknowledged worldwide.