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COMBAT SNUFF IN COLOMBIA REFLECTION

SNUFF IN FIGHT AGAINST COLOMBIA.
Reality / Reflection

ADVANCED tobacco control, NOT ENOUGH, IT IS THE RESPONSIBILITY OF STATE LEGISLATORS MEET WITH THE CONVENTION WHO. SNUFF CONTROL

The Colombian government has the Constitutional obligation to protect public health, as well as commitment to the WHO. comply with the adoption of the "Framework Convention on World Health Organization, WHO. control of Snuff. "

The success of the struggle in each country, against smoking depend on the political commitment of their governments in the implementation of the Convention applied to the WHO.

Colombia, is doing homework, but, however, is one of the most backward countries in the anti smoking, despite having adopted the Framework Convention of the World Health Organization, WHO. control of snuff, done at Geneva on May 21, 2003, had issued the Law 1009 of 2006 approving the Convention, and to regulate this Act with Resolution 01956 of May 30, 2008.

striking is the fact that to be effective and valid WHO Convention. and Act 1009 of 2006 was expected to Case C-665 of 29 August 2007 the Convention declared enforceable, they sought to declare unconstitutional alleging defects in processed and unconstitutional, and Act 1109 of 2006 that adopted at Internally, the delay was the December 27, 2006 date approving the agreement to April 10, 2008 date on which the Colombian government does, at last, legally part of that agreement.

On May 8, 2007 have a right to petition the President of the Republic by making the following requests in order to prevent and control smoking in Colombia
establish a rule of law, within a period not exceeding six months, and it meet, governing:

1. The requirement that tobacco companies sell their cigarettes in the country to inform the government and the community at large about the complete and exact composition of chemicals contained in cigarettes, their smoke and its toxic effects on health.

2. A comprehensive evaluation system, by the Ministry of Health, about the risks and health damage from these substances, compounds and snuff products.

3. The establishment of a database on these chemicals, compounds and snuff products, public and accessible to citizens.

4. The obligation to inform tobacco companies in each pack of snuff and complete the exact composition of substances and chemical compounds in cigarettes, as well as the risks and harms associated, so simple and graphics to impact on any group population, although their educational level is low, ranking, graph, no less than 30% of the area of \u200b\u200bpackaging.

5. The obligation of the State of permanent campaigns to prevent smoking and its health consequences, including information on school programs snuff damage health.

6. Establish a percentage of the tax item that tobacco companies pay the state and is intended for health of the citizens, for specific activities to promote non-smoking and smoking prevention.

On September 17, 2007 the answer was the information forwarded the petition to the Deputy Minister of Health, Ministry of Social Protection as ordered by Section 33 of the Code Administrative.

On October 25, 2007 the Directorate General of Public Health replied that the resolution to regulate the Act (01 956 2008) will include the subject requests and proposals submitted will be handled.

Resolution 01956 of 2008 for the various actions and strategies proposed by the Convention, provides basically: a ban on smoking in public places, and activities of promotion and prevention must develop the Social Security System and the General Health Professional Risk and surprise to see that does not take into account the requests made in spite of inclusion in the WHO Convention.

Decisions of Res. 01956 of 2008 are very important in the fight against snuff, no doubt, but not enough to avoid the impact of smoking on human health.

If approved the Convention believe that actions should be less timid, more aggressive and timely, they must compromise, but to those who create the risk and need greater political will and decision of the State who is the one that has the responsibility comply with the WHO Convention. and with the Constitutional mandate to ensure Public Health.

are hundreds of diseases, sick, proven disability and death caused by the effects of smoking, with very high economic and social costs that even the Country could be avoided, and depend on the political decision of the state and its leaders.

I do not see why?, The Colombian government expects to take all necessary decisions and actions proposed in the WHO Convention., If accepted, Law 01109 2006:

Constitutional responsibility to protect public health.
The tobacco epidemic is a global problem with serious consequences for public health.
The increase in consumption and production of cigarettes and other snuff products in the world, particularly in developing countries.
Science has unequivocally demonstrated that the consumption of snuff and snuff smoke exposure are causes mortality, morbidity and disability, and that the snuff-related illnesses do not appear immediately after you start smoking or smoke exposure to snuff, or otherwise consume snuff products.
cigarettes and some other products containing snuff are very sophisticated designed to create and maintain dependence, and that many of the compounds they contain and the smoke they produce are pharmacologically active, toxic, mutagenic and carcinogenic, and that snuff dependence as a disorder other than in major international classifications of diseases.
Prenatal exposure to tobacco snuff generated adverse conditions health and child development.
The significant increase in smoking and snuff consumers in other forms among children and adolescents in the world, and particularly the fact that they start smoking at increasingly early ages.
The impact of all forms of advertising, promotion and sponsorship aimed at encouraging the use of snuff products.

and believes in Resolution 01956 of May 30, 2008 that:

Cigarette smoke contains over 4,000 toxic chemicals of which 60 are human carcinogens including cadmium, benzene, ammonia, benzopyrene, hydrogen cyanide , traces of lead and arsenic.
According to WHO, worldwide, snuff consumption is the cause of 30% of total cardiovascular disease, 80% of all chronic obstructive pulmonary disease, 90% of lung cancer and 30% of all other types of cancer.
In Colombia, about 68 die each day from diseases related to the consumption of snuff and its derivatives.
That the United States Agency for environmental protection, EPA has classified secondhand smoke snuff in the environment as a carcinogen in group A (proven to cause cancer in humans) to typical ambient levels.
That in accordance with Article 2 of the Constitution, the authorities of the Republic are instituted to protect all persons residing in Colombia, in his life, honor, property, beliefs and other rights and freedoms and to ensure compliance with the social obligations of state and individuals.

When it comes to saving lives, there is a responsibility to do everything necessary and possible, and in a timely manner.

Recall that in Colombia each passing day 68 people die from causes related to tobacco smoking, how many more will keep dying? and How many illnesses and deaths could be prevented by applying all the strategies and tools of the WHO Framework Convention for the Control of the snuff?

What can be more important or worth more than the life of human beings? NOW THAT IS

BEING A COUNTRY BACK IN THE MOST tobacco control, we wanted to reverse the FEW ACHIEVEMENTS, thankfully did not happen.

WE WILL BE CAREFUL TO COMPLY WITH THE ILO CONVENTION.

Rojas Carlos Grisales MD. MSO. Overseer
Delegate for SGRP. Citizens for Veeduría
SGSSI. Prosesa (pro-Social Security)

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amending Articles 11 and 17 of Resolution 2346 of 2007 and other provisions

DRAFT - WORKING DOCUMENT (Note: the draft is
authorship of the Ministry of Social Protection) Whereby
amending Articles 11 and 17 of Resolution 2346 of 2007, and enacting other provisions
THE MINISTER OF SOCIAL
Using its legal powers, especially those conferred by Article 348 of the Labor Code, paragraph a) of Article 83 of Law No. 09 of 1979 paragraph 12 of Article 2 of Decree 205 of 2003 and Article 56 Decree 1295 of 1994,
RESOLVED:
ARTICLE 1. Amend Article 11 of Resolution 2346 of 2007, which will read:
Article 11. RECRUITMENT AND COST OF OCCUPATIONAL MEDICAL EVALUATIONS AND ASSESSMENTS UP.
The cost of occupational medical evaluations and tests or additional assessments as may be required will be paid by the employer in its entirety. In any case, may be charged or requested from the applicant or employee.
The employer may contract out of the occupational medical evaluations to institutions providing occupational health services, which should have specialists in occupational medicine or occupational health, licensed occupational health or referred directly to the professionals.
PARAGRAPH. The employer must, protect and ensure that occupational medical evaluations are conducted by specialists in occupational medicine or occupational health, licensed occupational health, otherwise subject to the penalties provided in this resolution.
ARTICLE 2. Amend Article 17 of Resolution 2346 of 2007, which will read:
Article 17. CUSTODY OF OCCUPATIONAL MEDICAL EVALUATIONS AND OCCUPATIONAL MEDICAL RECORDS.
The following rules apply to the custody of occupational medical evaluations and occupational histories:
a) The custody of occupational medical evaluations and occupational history will be the responsibility of the provider of occupational health services that generated in the course of care, meeting the requirements and filing procedures under the current legislation.
DRAFT - WORKING DOCUMENT
b) The responsible entity may submit a copy of the occupational history foliated the user or his legal representative at his request, for the purposes provided for in existing legislation.
c) In case of death of the patient, may request a copy of the occupational history, only your spouse, partner (or) continuing their sons and successors, and those expressly authorized by existing legislation.
d) In the event that there are documents of occupational history in various entities, the responsible entity, which requires information contained therein may solicitar copia a la entidad a cargo de los mismos, previa autorización del paciente o de su representante legal.
e) Cada entidad responsable, debe dejar constancia del traslado entre entidades responsables de la historia clínica ocupacional de un usuario, en las actas o registros de entrega o de devolución, firmadas por los funcionarios de las entidades encargadas y responsables de su custodia.
f) En caso de disolución o liquidación de una entidad responsable, la historia clínica ocupacional se deberá entregar al usuario o a su representante legal. Ante la imposibilidad de su entrega al usuario o a su representante legal, el liquidador de la empresa designará a cargo de quien estará la custodia de la historia clínica occupational, even by the end of retention provided by law. This was communicated in writing to the Directorate Section, District Health and Local authority, which shall file or record store these communications to inform the user or the competent authority in the custody of that entity is the history occupational.
PARAGRAPH 1. The archive, security, production, receipt, distribution, consultation, organization, retrieval and disposal of occupational medical records through data messages, is governed by the laws in force for the general history and the parameters set by the Directorate General of Occupational Hazards.
PARAGRAPH 2. The transition of the occupational history information systems, shelf life and its conservation through data messages, is governed by the laws in force for the general history and the parameters established by the General Risks professionals.
PARAGRAPH 3. Medical specialists in occupational medicine or occupational health, which are part of the medical services company, will have custody of the occupational history and are responsible for ensuring its confidentiality, as provided in Article 16. the
DRAFT - WORKING DOCUMENT
Resolution 2346 of 2007, the rules that substitute, complement or supplement.
In any case employers may have, keep or attach a copy of medical evaluations and occupational history to resume the worker.
ARTICLE 3. PENALTIES. Failure to comply with Resolution 2346 of 2007 and other regulations that add to it, modified or replaced, shall be punished as provided in subparagraphs a) and c) of Article 91 of Decree Law 1295 of 1994 and the National Health Authority in its jurisdiction.
The administrative inquiry and punishment will be the responsibility of the Regional Directorates of the Ministry of Social Protection, in accordance with the provisions of Article 115 of Decree Law 2150 of 1995.
ARTICLE 4. This resolution is effective as of the date of its publication and amends articles 11 and 17 of Resolution 2346 of 2007.

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RESOLUTION REQUEST RIGHT OF PETITION RIGHT

Santiago de Cali, March 10, 2009




Doctor. Ana Maria Cabrera
Videla.
Professional Risk Manager.
Ministry of Social Protection.



right of petition.

Based on Article 23 of the Constitution and the Decree 01 of 1984 (Code Administrative) I turn to you, in a respectful and courteous to make the following requests:

ARGUMENTS:

Resolution 2346 of 2007 which regulates the practice of occupational medical evaluations and management and content of stories occupational clinics, whose spirit is undeniably good and necessary for the development of occupational health in the country business and also to protect workers' rights, suffers from procedural defects that have prevented their full implementation and compliance actors in the General System of Occupational Hazards, especially those directly involved with responsibilities and duties: Occupational health physicians, IPSSO., EPS and employers, grievances and disagreements of the various stakeholders that led to this resolution, although this effect is under review for more than 15 months, to date, looking fit so it can be adhered to.

Compliance not only creates difficulties in operationalizing the custody of the occupational histories, but will load cost responsibility associated logistical and economic course for doctors, not only in custody, if not carrying out studies and statistical reports on health of workers who are evaluated situations previously warned the DGRP.

Doctors can make the statistical reports and health diagnoses, but costs need not be made by doctors, should be the responsibility of employers are putting the risk to workers and are required monitor and maintain the health of their workers.

The resolution must include provisions governing the conditions under which the contract and not let the free supply and demand for services that are required because these situations create inequality and injustice in the system.

The SGRP. no decisions should be improved with costs charged to doctors, that are not theirs, we are ready and accept the responsibilities characteristic of our work and services assigned to us by the System, provided that each have a payment, and fair pay.

This resolution also opens the door to the EPS. IPSSO to assemble. to provide occupational health services, which goes against the vertical integration that aims to control a monopoly on the provision of health services to the EPS., with IPS. owned and limited to only lend up to 30% of IPS. Own, If the limited health system monopoly is not just legal or in SGRP. enable them to participate in the provision of services.

consider whether provisions of this resolution have to do with our work and affect our fair wage, have the right to comment on it, so we need to know the revised draft resolution prior to penalty to make objections and clarifications to prevent our rights from being injured and taken measurements that can make this resolution applicable to While the SGRP. and all its stakeholders, based on the articles of the Constitution: Article 25. Everyone has the right to decent work and fair., Article 53. Remuneration commensurate with the amount and quality of work. and Section 74. everyone has the right to access public documents, and the law of Oversight Citizen make the following requests:

REQUESTS:

Send the draft Resolution 2347 of 2007 and revised before its enactment.

Establish a reasonable time for review, study and to get to the Risk Management Professionals objections and suggestions.

take into account the observations and recommendations attesting justified applicable resolution, cumplibles and fair.









Sincerely.

Carlos Arturo Rojas Grisales MD. MSO. Overseer
Delegate to the General System of Occupational Hazards.





"For a SGRP. best and fair "

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Santiago de Cali, March 26, 2009.

Doctor.

Ana Maria Cabrera Videla.

Director General of Occupational Hazards.
Ministry of Social Protection.

right of petition.

Based on Article 23 of the Constitution and the Decree 01 of 1984 (Administrative Code) I am writing to you in a respectful and courteous to make the following requests:

REQUESTS.

Establish or include in the body of the resolution amending Resolution 2346 or herself:

1. Article 11 of Resolution 2346 Recruitment and cost of occupational medical evaluations a paragraph to clarify that employers may not hire occupational medical evaluations with EPS. or IPS. Occupational Health or property associated with the EPS.

2. Section 11 of Resolution 2346 Recruitment and cost of medical evaluations , as amended, which costs Diagnostics Health conditions are made the exclusive responsibility the employer.

3. analyze in greater detail, carefully and in consultation with the different actors of SGRP. and especially Medical Specialists Occupational Health Who or entities who would be to the custody of HCO with proper guarantees for their conservation and the necessary logistics for the movement and use of these documents among the actors system when necessary and under the conditions permitted by law, must be flexible, timely and safe?

Before taking the decision referred to the draft of Resolution 2346, which I think is not the most appropriate and will surely lead to serious injuries that are indexed to compromise the efficiency of the procedure for managing the HCO. and other processes related to it, the SGRP., plus the reliability and prestige of the DGRP. and the MPS.

ARGUMENTS.

ARGUMENTS OF PETITION 1.

Social Security System in Health ordered set a limit or cap on the EPS. in providing health care to IPS. Own up to 30% of them, to avoid the monopoly of the EPS. managing and providing service

The SGRP. can not go against vertical integration path, opening doors to the EPS. in providing health services when they are being limited in the health system.

EPS. to provide occupational health services IPSSO. own or linked to them, specifically occupational medical evaluations, may come into bias in diagnostic assessments and concepts of occupational medical evaluations, which are key elements in the rating of the health event source, which may influence the decision of who coverage is the responsibility of income, gender inequality and injustice in the system.

ARGUMENTS OF REQUEST 2.

costs of occupational medical evaluations and occupational health program should be borne by the employer only.

On the value of occupational medical evaluations should assume the employer, pursuant to Section 348 of the CST literal b) of Article 30 of Decree 614 of 1984 and no. 1 of Article 10 of Res. 1016 of 1989 (content of the program occupational health)

Concerning the cost of occupational health program should also be borne by the employer, as provided by paragraph 1 of Article 4 of the Res. 1016 of 1989 which says, "employers or employers are required to allocate human, financial, and physical development and essential for the full implementation of occupational health program"

Art 56. 1295 Decree 1994 provides that the employer is responsible for the prevention of occupational hazards and implementation of occupational health program

The diagnosis of health conditions of workers in a company referred to article 18 of Resolution 2346 is part of activities basic and major subprogramme of work Preventive Medicine and Occupational Health Program, to: a standardized planning and monitoring health conditions of workers in the workplace, designing disease prevention programs, unification criteria in the implementation of occupational medical evaluations, statistical information, its analysis are applied in the development of epidemiological surveillance systems, comprehensive rehabilitation programs and qualification processes and origin of loss of earning capacity, therefore the costs of this diagnosis should be borne entirely by the employer and not have to be carried out by doctors, although they make.

In short, the employer must pay the costs (for each) of the occupational medical evaluations, tests or additional assessments and the Diagnosis of health conditions of workers a company.

If the ARP. and EPS. can not assume or replace directly or indirectly by law the responsibilities incumbent on the employer and in particular those obligations and commitments under the Occupational Health Program why that is charged the costs, as in the case Diagnosis of health conditions, the doctor or IPSSO. and does not establish clearly and unequivocally that this service must be paid by the employer, otherwise it would not be enforceable tax and, if no optional in each case.

ARGUMENTS OF REQUEST 3.

regard to the custody of employment and medical history are not considered appropriate that the IPSSO. and doctors who perform medical evaluations that the custodians, for the dispersion that would be generated from them with the respective risks of confusion and loss thereof, affects the security, agility and speed the use of these documents allowed by law

The occupational medical records are private documents, and subjected to compulsory reservation, whose loss has legal implications for whom the custody and for whom particular case laws on the organization of it.

should be clear that the occupational medical evaluation is not occupational medical history, which is formed by or pre occupational medical evaluations, periodic, etc., Complementary examinations and registration of medical evaluations. Physicians or IPSSO. to make medical evaluations, evaluation custodiarían and medical examinations, no occupational medical history.

If the documents are part of the main and sub programs of preventive medicine and the work of occupational health programs, which is the responsibility of the employer who is who puts the risk the worker, he must bear the costs of filing and safekeeping.

The logistics for the use and transfer of these documents among the actors of SGRP. and even the judges of the republic is not clear and expeditiously, as outlined in the draft resolution 2346, there are inaccuracies and gaps in form and substance attributable to provisions made in the resolution would cause confusion, loss, and failure of opportunity.

is not appropriate for this important and definitive resolution SGRP pair. can again be inappropriate and ineffective, that does not happen all that should be necessary.

For all arguments presented and substantiated, and those covered in Law 23 of 1981 Section 34 and following, the 3380 Decree 1981 of this Act, the resolution 1995 of 1999 which regulates the issue of medical records in Colombia, Resolution 1715 of 2005 partially amending the previous Resolution and the Constitution of Colombia, if the resolution is in the terms set forth in Resolution 2346 and the draft amendment would be vulnerable, because it violates the rules raised in this petition law to be unconstitutional and contrary to fundamental rights of doctors, as the right work, to fair remuneration for work performed and equality.

is my right as a doctor SGRP actor. who knows and is actively involved with work experience, and my duty as a citizen and Overseer Officer for the SGRP. early warning of the vacuum that may be the resolution, so that in this way and fulfilling one of the objectives of a preventive Veeduría the highest level legislate in the best interest of the SGRP. and its actors,

Please note the comments of the rights request on the previous issue.

Sincerely

Carlos Arturo Rojas Grisales MD. MSO.

Overseer Officer for the SGRP.

Citizen Veeduría System Comprehensive Social Security Prosesa

(pro - Social Security)