For most of the past 25 years, Hong Kong-based, British-born doctor Judith Mackay has been the tobacco control movement in Asia.
She has pushed for tougher laws and higher tobacco taxes, lobbied for bans on advertising, and advised and cajoled governments in Hong Kong, Laos, China, Vietnam and most other Asian countries.
AdvertisementShe drafted Mongolia's first post-Soviet anti-smoking law in her hotel room on the last night of her trip there, after spending most of the visit under suspicion of being an American spy.
Her success is based on her ability to convince the right person with the right power to make changes that will save lives. And she is happy to take advantage of non-democratic regimes.
"That is one of the reasons I was so active in the 1980s. Once you had democracies, you have white papers and green papers, you had public debates and forums and it went on forever," the 65-year-old said from her Hong Kong home.
"I found I could jump over quite a few fences in one go," added Mackay, who has been a senior policy adviser to the World Health Organization for more than 10 years.
Her vigour has inevitably drawn the attention of the tobacco industry -- she was once described by a trade organization as one of the three most dangerous people in the world.
She has been threatened with lawsuits, had secret dossiers prepared on her and even received death threats from one pro-smoking group.
"Every time my spirits are sagging all I have to do is be threatened with another lawsuit or a death threat and I am up and running again," she said.
In recent years, Mackay's efforts have been recognized, she was awarded an OBE by Queen Elizabeth last year, as well as many other accolades.
Most importantly, she now spearheads the growing professionalism of the Asia's anti-tobacco movement, boosted by a grant from New York Mayor Michael Bloomberg's foundation.
It funds her position at the World Lung Foundation working on cutting tobacco use in low- and middle-income countries, with a focus on Asia.
"Bloomberg has brought business management into tobacco control. It is not an option to run over deadlines, like some academics and governments," she said.
"You are now offered a career path in tobacco control. Before, there was nobody to employ you."
Mackay was born in Yorkshire and went to medical school in Edinburgh, where she was briefly a smoker, before giving up after a few months because her roommate had asthma.
She later moved to Hong Kong and worked in a hospital, but the satisfaction of saving lives dimmed as she realized that so many were coming in with the same, smoking-related problems.
"We used to joke that in the male medical wards we never admitted a non-smoker. Everyone was coming in with cancer or heart disease or chronic bronchitis or bleeding duodenal ulcers," she said.
Mackay, who completed Asia's first study on domestic violence, began writing a column for the South China Morning Post newspaper on women's health issues, and one of her early topics was smoking.
Unbeknown to her, one of the major tobacco firms prepared a dossier on her saying the anti-smoking forces in Hong Kong were "unrepresentative and unaccountable."
When it was leaked to her, she said, "I was so outraged.
"I sometimes say that I have (that company) to thank for getting into tobacco control," she said, adding that the surveillance highlighted how crucial Asia was to Big Tobacco's expansion plans.
"At that stage, Big Tobacco were looking at Asia as their utopia," she said.
"If they could persuade Asian men to change to international brand cigarettes, and persuade Asian women to smoke, everybody in North America could give up tomorrow and it wouldn't make any difference."
She became a full-time campaigner, representing Asia at conferences ("There was really only one person working in Asia," she said of herself), educating government ministers and pushing for changes, even if they were merely symbolic.
She convinced Cambodia to ban tobacco advertising during children's television programmes, even though there wasn't any. Such decisions put down a marker which can then be extended and expanded incrementally, she said.
"China has just banned vending machines selling cigarettes. I am not sure if anyone has seen a vending machine there," she said.
John Crofton, the British campaigner who found the first cure for tuberculosis and is Mackay's mentor, said she has been a powerful force.
"I have immense admiration for her energy, drive, skill in managing people and her utter devotion to saving the world from its most lethal habit," he said.
Mackay shows no sign of slowing down, despite reaching retirement age, but she remains careful not to hector governments.
"My whole modus operandi is not telling people what to do. I say 'what do you think might be the next step forward for China?' I put decisions and thinking on to the people in the country," she said.
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