The EconomistAugust 3rd 2019 Asia 291S
ounding more like an anguished
health worker than a profit-seeking
businessman, James Monsees delivers his
pitch to a crowded ballroom in Jakarta. The
e-cigarettes made by his company, Juul
Labs, can save smokers from an early death,
he insists. Pointing to government-backed
studies from Britain and elsewhere, Mr
Monsees argues that e-cigarettes, which
heat a liquid laced with nicotine into a va-
pour that can be inhaled without actually
burning anything, are far less harmful than
normal cigarettes. “We can have one of the
largest positive public-health impacts in
history,” he enthuses.
Indonesia could certainly do with a
boost to public health. Around 75m of its
189m adults smoke, according to the World
Bank, a higher number than in any other
country bar China and India. Smoking
rates among men (76%) are the second-
highest in the world after Timor-Leste,
which itself used to be part of Indonesia.
What is more, they are rising, unlike in
most Asian countries (see chart). Euro-
monitor, a research firm, reckons Indone-
sians spend a hefty $25bn or so a year on
cigarettes, including kretek, local favour-
ites which contain cloves as well as tobacco
and are especially unhealthy.
Needless to say, Indonesia’s tobacco
companies do not share Mr Monsees’s
dream of a smoke-free Indonesia. The big
ones—Sampoerna (owned by Philip Mor-
ris), Gudang Garam, Djarum and Bentoel
(owned by British American Tobacco)—
form a weighty lobby. The industry pays a
big chunk of the country’s taxes and em-
ploys around 6m people.
That may help explain the authorities’JAKARTA
The government seeks to curb
e-cigarettes, but not the normal sortPublic health in IndonesiaNo smoking
without a fire
Up in smoke
Prevalence of smoking any tobacco product
among males aged 15 years and over, %Source:WHO *ForecastBangladesh
ChinaIndiaIndonesiaJapan2005 10 15 20*1007550250W
hen yasuhiko funago was diag-
nosed in 2000 with amyotrophic lat-
eral sclerosis (als), better known as Lou
Gehrig’s disease, a degenerative illness
with no cure, he went through a period of
complete despair. In late July, nearly two
decades later, crowds cheered as he be-
came the first alspatient to be elected to Ja-
pan’s parliament, the Diet. “I am full of
emotions that this moment has arrived,”
Mr Funago said in a speech read out by his
helper. “I may appear weak, but I have more
guts than others as it has been a matter of
life and death for me.”
Mr Funago, a member of the opposition
group Reiwa Shinsengumi, is one of two
wheelchair-bound lawmakers to win seats
in the upper house in elections on July 21st,
along with Eiko Kimura, who is paralysed
from the neck down. Disabled people are
7.4% of Japan’s population, but Mr Funago
and Ms Kimura will be the only two of the
Diet’s 713 members in wheelchairs. Only a
handful of disabled people have ever won
seats. (The 535 members of America’s cur-
rent Congress, by contrast, include at least
four people who have lost arms, legs or an
eye, among other disabilities.)
“Japanese politics is still centred
around able-bodied men,” says Jun Ishi-
kawa, head of a government commission
on disabilities. Political parties do not field
many disabled candidates. The authorities
tend to hide people with disabilities away
in institutions, secluded from the rest ofsociety. Students with special needs usual-
ly attend special schools. “Japan has fo-
cused more on creating segregated institu-
tions than integrating the disabled into
local communities,” says Mr Ishikawa.
This has bred stigma and isolation.
The government has been slow to admit
the problem. It took seven years to ratify
the unConvention on the Rights of Per-
sons with Disabilities, making it the 140th
country to do so. It did not agree until this
year to pay compensation to thousands of
people with disabilities who were forcibly
sterilised under a eugenics law that was
only repealed in 1996. Last year several gov-
ernment agencies were found to have falsi-
fied the number of disabled people they
employ, in some cases for decades, to meet
official targets, instead of just hiring more.
Prejudice against the disabled has also
turned violent. Nineteen people at a care
facility in Sagamihara, south of Tokyo,
were fatally stabbed in 2016 by a man who
“wanted disabled people to disappear”.
With the election of Mr Funago and Ms
Kimura, many are hopeful for change. “It’s
definitely a step up from before,” says Mr
Koji Oyama of the Japan alsAssociation.
The two new lawmakers have vowed to
push for more inclusive education and bet-
ter health care for the disabled. At the very
least, they are changing the Diet, where al-
terations under way will improve wheel-
chair access and rules are being amended
to allow carers into closed meetings. 7TOKYO
Voters send two politicians in wheelchairs to parliamentJapanesewithdisabilitiesChairbound but seated