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The World’s largest tobacco control conference- ‘Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control (WHO- FCTC)’ kick-started in Greater Noida, New Delhi, last Monday (Nov. 7) drawing more than 1,300 delegates from 180 countries. The seventh session (COP7) of this six-day conference sought to find means to curb the tobacco epidemic which claims the lives of more than six million people globally every year. WHO-FCTC was adopted by the World Health Assembly in May, 2003 and came into force on February 27, 2005. It has since become one of the most rapidly and widely embraced treaties in the history of United Nations.
Sri Lanka’s success story
The COP is the governing body of the Convention which meets regularly to review its implementation and take decisions necessary to promote its effective implementation. During the opening day it was announced that Mozambique is to become the 181st Party to the Convention and Zimbabwe was welcomed as the most recent Party to accede to the Convention. Delivering the keynote address at the inauguration, President Maithripala Sirisena brought under the spotlight the strides Sri Lanka has taken as a country in fighting the tobacco epidemic. This was globally applauded. He reminded the international audience that we were among the first few countries in the South East Asian region to sign the FCTC and to later ratify it. In line with the FCTC,our own Tobacco and Alcohol Act was passed in 2006 which led to the birth of the Tobacco and Alcohol Authority (NATA). Applauding the good work of NATA, President remarked, “I believe our NATA is rather unique because it is perhaps the only such organization that covers both tobacco and alcohol.”
While referring to the recent increase in tobacco taxes by nearly 10%, President Sirisena also mentioned the country’s ambitious plans to move for plain packaging, drawing inspiration from other countries where the measure is already in place. Among the notable strides the country has taken, the President cited pictorial warnings which cover 80% of the surface of cigarette packs and the completion of the Global Youth Tobacco Survey earlier this year.
Embracing a shared ambition
Bringing the much discussed topic of illicit trade of tobacco products under the spotlight, the President urged more parties to ratify the convention so that it can become law. Drawing attention to the equally pressing concern on ‘smokeless tobacco’ both at home and in the region, President noted, ” a large body of scientific evidence shows the strong link between smokeless tobacco use and several serious outcomes, mainly, mouth cancer. I would urge the FCTC to address the issue of smokeless tobacco also very seriously in the years to come. The cost of neglect can be very high.”
He also asserted that Sri Lanka is also very concerned with the wider issues related to health, therefore take Sustainable Development Goals very seriously. His concluding observations, “our shared ambition should be to ensure the full implementation of the FCTC to see its powers tapped fully to eliminate the harm from tobacco and passive exposure to tobacco smoke everywhere in the world,” undoubtedly resonated a robust global message.
Graphic warnings on the rise
It is significant that a few days after President Sirisena’s keynote address at COP 7, the Canadian Cancer Society has released a status report which ranks Sri Lanka as the sixth in the world with graphic warnings covering 80 percent of tobacco packages. The report finds that more than 100 countries around the world have required graphic warning labels on tobacco products – a lifesaving measure that now impacts more than half the world’s population. The number of countries requiring graphic warning labels has steadily increased over the past two years.
The Canadian report which ranks 205 countries and territories based on the size of warning labels required, demonstrates the tremendous progress that is being made in addressing the world’s leading cause of preventable death. Around the world, tobacco companies depend on package design to build brand recognition and promote sales.
Packaging establishes brand imagery that is often completely opposite to the realities and dangers associated with tobacco product use. But the new report shows that countries are largely acting to limit the tobacco industry’s use of packaging to lure new users.
Challenges for India
The Indian Minister of Health and Family Welfare, J.P. Nadda, addressing the gathering at the inauguration noted that the challenges faced by India in the exercise of controlling tobacco are “formidable, both in their number and in their complexity.” The Indian Health Minister also called for a multi-pronged approach supported by international collaborations to counter not only health costs but also social and economic costs the tobacco epidemic entail. Reiterating the urgency to counter tobacco menace, the Minister said that it costs India a colossal amount of state funds to treat tobacco-related diseases.
The photographic exhibition at the conference venue which mirrored the health and social toll the tobacco menace has on the community, finely personified the words of the Indian Health Minister. Images of little girls as young as five years, engaged in rolling of beedi (which is a deep-seated industry in India) with their mothers to meet the ends meet, pregnant women and adolescent girls with their tobacco-stained palms, spoke volumes of this global health hazard which not only snuffs out over six million lives every year in their most productive years but also impedes sustainable development.
More support for low and middle income countries
Among the highlights of the preliminary sessions of the Conference was the launching of a project by the Convention Secretariat to strengthen the implementation of the global tobacco control treaty. Under this initiative which is to be delivered by WHO FCTC Secretariat in collaboration with UNDP and other partners, a number of low- and middle-income countries (LMICs) will be eligible to receive direct support to implement tobacco control strategies and policies. The project will bring together support from across the UN to accelerate the implementation of the Convention.
According to a recent press release of the Convention Secretariat, if current tobacco use patterns persist, tobacco will kill about one billion people in the 21st Century. By 2030, over 80 percent of the world’s tobacco-related mortality will be in LMICs. The treaty is an evidence-based ‘blueprint’ for tobacco control policies. Tobacco use will be reduced if a country has a high level of WHO FCTC implementation, it notes. The Secretariat observes that the significant harms of tobacco use on developing countries are usually understood primarily as health issue.
‘This overlooks the extensive impact of tobacco on social, economic and environmental progress. Tobacco control is a development issue and its success relies on the work of other sectors such as commerce, trade, finance, justice and education. This is why the international community agreed to include the implementation of the WHO FCTC in the UN’s new Sustainable Development Goals (SDGs)’, it notes.
Under this initiative, countries will be offered support to create and strengthen coordination mechanisms and action across sectors to implement the WHO FCTC, including treaty obligations to ban tobacco advertising and promotion, ensure tobacco packaging entails health warnings, end smoking in enclosed public and workplaces, increase tobacco taxes and protect public health policies from tobacco industry interference. The five-year project will open call for expressions of interest inviting LMIC governments wishing to join implementation from 2017.
The project will be backed by UK’s development funding. The project aspires to help countries set national priorities, scale-up effective investments, strengthen policy coherence, and develop institutional capacities for fully-fledged tobacco control efforts.
Championing sustainable development
In promoting the new project, the Head of the FCTC Secretariat Dr Vera Luiza da Costa e Silva said: “The implementation of the WHO FCTC is critical in advancing sustainable development. Through the new project, we will take implementation of the WHO FCTC to a new level by providing support and guidance to developing country Parties.”
Douglas Webb, Team Leader on Health and Innovative Financing at the UN Development Programme, welcoming the project, noted: “there is a growing recognition that current tobacco trends and sustainable development cannot coexist. As a committed partner, UNDP welcomes this opportunity to advance tobacco control through better support to national planning, good governance and protection against tobacco industry interference in policy making.”
Tobacco taxation and plain packaging
Applying the global experience to the local terrain, particularly in the realms of tobacco taxation and plain packaging, it is worth navigating through latest literature pertaining to them. The Executive Summary of the WHO Report on the Global Tobacco Epidemic, 2015 (Raising Taxes on Tobacco) notes ‘increasing taxes to a sufficiently high level is an extremely effective – including cost-effective intervention.’ The Report further notes that ‘increased taxes reduce tobacco use, costs government relatively little to implement and increases government revenues, sometimes substantially.’
Referring to the ‘spurious claims’ the industry makes of economic harm caused by higher taxes, the WHO Report dismisses them as those ‘not borne out by the evidence’.
Contrary to the popular claim by the industry that higher taxes lead to increased smuggling and illicit trade, evidence does not validate this, the Report says. ‘But because tobacco taxes are generally better accepted than other types of taxes, it is possible to achieve widespread public support, even among tobacco users, especially if at least some of the new tax revenues are used for tobacco control, health promotion and other public health programmes.’
In December, 2012, Australia became the first WHO Member State to implement fully tobacco plain packaging. Since then several more WHO Member States have shown increased interest in embracing the same. The High Court of Australia (which is country’s apex court) in 2012, dismissed the tobacco industry’s constitutional challenge to tobacco plain packaging on the basis that the scheme did not effect an “acquisition” of its property, the relevant test under the Australian Constitution. The WHO publication titled, ‘Plain packaging of tobacco products- Evidence, Design and Implementation’ notes ‘legal challenges to plain packaging are an example of the tobacco industry’s broader strategy of using litigation to contest regulation, rather than a new phenomenon’.
Citing the findings of several studies, the WHO Report point out that plain packaging ‘reduces the attractiveness of tobacco products, restricts the use of the package as a form of advertising and promotion, limits misleading packaging and increases the effectiveness of health warnings.’
Fortifying the national commitment
As the curtain falls on COP7, WHO Member States are undoubtedly driven to revisit their anti-tobacco policies, seeking means of giving them more teeth to fight this global threat. This global forum becomes very relevant to us as a nation placed in a decisive backdrop of pushing for ambitious policies to counter a global health hazard entailing colossal economic and social loss as well. It is even more relevant to us as a developing nation globally applauded for progressive anti-tobacco policies. Yet, at this juncture we need to remind ourselves that although national strides have been taken, we cannot afford to be complacent but continue to take the baton forward.
