I attended the 25th Anniversary of Liberation Day in Kigali on July 4, 2019, commemorating the end of the genocide. The contrast between “then” and today was extraordinary.

Rwanda has made progress since 1994 toward attaining many Sustainable Development Goals (SDGs). Some drivers of change are:

• Outstanding national leadership (starting with President Kagame);
• Deep investment in science, technology, and innovation that surpasses legacy systems (from improved access to the internet to the use of drones for blood distribution to remote clinics);
• The emergence of women in positions of power and authority (for example, 67% of parliamentarians are women);
• Private-public partnerships across all realms of development; and
• Investment in young people as future scientists, entrepreneurs, and leaders.

During the Kigali Global Dialogue held July 3-5 that straddled Liberation Day, many of these issues were discussed from a Rwandan and broader African and Indian perspective. For example, we learned about the development of Kigali Innovation City to galvanize scientific progress. Speakers provided tangible examples of how the increased engagement of women in high-level policy settings affects what is discussed and how issues are addressed. Societal needs and those closely related to SDGs get high priority.

One of the most compelling speeches was by the Former President of the Maldives, Mohamed Nasheed. His speech on ending climate change carried the same urgency and focus Rwanda is achieving more broadly. He outlined many features of a desired and needed coal-free era that I believe have implications for a smoke-free world, including:

• Availability of technology to make alternatives possible and economically feasible. The expansion of reduced-harm products does that for the combustible cigarette sector and for toxic smokeless tobacco products.
• Private-public innovation supported by consumer demand is helping to shift from coal to renewable energy sources, from wood and charcoal to natural gas, from discarded and polluting human waste to biomass production, and even from the internal combustion engine to electric cars. So it should be for efforts to end combustible cigarette products and end the use of harmful smokeless products like gutkha and pan.
• In some countries, regulatory innovation is encouraging the switch. Nasheed cited progress in the United Kingdom, where the coal is no longer being used for electricity – a massive shift given that coal powered the industrial revolution. He mentioned examples from Rwanda and India of how government actions were actively stimulating shifts to clean energy, even by supporting related action in international forums.
• Sadly, there are few examples of such enlightened regulatory support to end smoking. The United Kingdom and New Zealand have been very important early leaders in doing so. Many other countries supported by the World Health Organization (WHO) have policies that will maintain the status quo (cigarette smoking) as the desirable norm – with severe consequences for the health of a billion smokers and smokeless users. The examples of shifts in policy on coal though, particularly in the United Kingdom, suggest that, in time, science and public demand will win out.
• The former president also highlighted a critical factor that has hampered progress on climate change, namely structural aspects of the United Nations (UN) convention process. It favors a “lowest common denominator” approach versus seeking the best possible option for rapid change. He was referring to the UN Framework Convention on Climate Change, but his comments also apply to the WHO Framework Convention on Tobacco Control. He believes that we need to encourage the formation of leadership “coalitions of the willing” to raise norms and expectations in multinational initiatives.
• Breakthrough innovations, like cleaner and healthier technologies, do poorly in UN conventions. Private sector innovation and consumer demand are years ahead of sluggish UN processes. That is partly because many senior delegates to convention processes come from decades of experience in general policy making and not from the fast-moving worlds of science and innovation. New models are needed to ensure that governments take advantage of technological breakthroughs able to address SDGs faster and more effectively. More is needed in relation to tobacco harm reduction.

Nasheed also stressed the importance of supporting the likely “losers” in the energy change process – coal miners. For tobacco control, the analogous losers are tobacco farmers, especially individuals in poor rural communities of Africa and Asia where smallholder women farmers are common. The demand for tobacco is decreasing and will affect already vulnerable populations. The tobacco farmers know this and so do their governments. Increased support for ways to transition smallholder tobacco farmers to alternative livelihoods makes both economic and ethical sense.

These discussions took place 25 years after the genocide ended in Rwanda. Back then, the future looked bleak. Today, what was deemed unthinkable, is happening. The economy is thriving. Women are in many leadership positions. Science, technology, innovation, and entrepreneurship are activating and exciting young people.

These ingredients apply to what is needed to transform the tobacco industry. But such transformation starts with a clear vision of what is possible and desirable – something still missing among the legacy leadership of global tobacco control.