http://www.who.int/fctc/mediacentre/opedsdgs/en/
Halting the Tobacco Epidemic in the post-2015 development agenda, July 2015
By Dr Vera Luiza da Costa e Silva Head of the Convention Secretariat WHO Framework Convention on Tobacco Control
The doctor who sees Mario and diagnoses terminal lung cancer is depressed by the outcome, but there’s nothing he can do. He tells the father-of-four, a factory worker, to go home and get some rest. In reality, he’s sent away to die. Much the same happens to Maria, a single mother of two children who’s also the sole provider for her parents. She has emphysema.
It’s 2030 and both Mario and Maria have been smoking for three decades, like millions of others in their homeland in a low-income country. Now the tobacco epidemic has arrived with a vengeance and the healthcare system just can’t cope. Hospital wards are full to overflowing with people suffering from tobacco-related diseases including cancer, heart disease, emphysema and stroke. The country can’t afford enough treatments, or even palliative care.
It’s a very different story in the developed world of 2030, where tobacco consumption has been falling for decades and where expensive new drugs and treatments are showing success. As a result, wealthier countries see tobacco consumption and illness as yesterday’s problem, requiring little attention.
Right now, in 2015, forecasts of the coming epidemic are stark, even frightening. About 100 million deaths were caused by smoking in the 20th century, more than in the two world wars combined.
At current rates, the number of deaths from tobacco will rise to 1 billion in this century. While tobacco consumption is falling in the developed world, it is rising in poorer countries.
This tragedy, aggravated by the unregulated supply of tobacco products, can be stopped. It’s possible to help smokers in developing countries who are being targeted by transnational tobacco companies seeking to lure new consumers. Cost-effective tobacco-control measures would help smokers to quit and dissuade potential addicts, especially children and women, from taking up tobacco use. It could save the lives of some of the 8 million people who by 2030 will be dying annually from tobacco-linked illness. But governments have to act now.
This year sees two crucial conferences which could reinvigorate the battle against tobacco. In September, the United Nations General Assembly will agree on Sustainable Development Goals (SDGs), a critical series of worldwide metrics for the world to reach by 2030. And later this month, methods of funding the SDGs will be discussed at the Third International Conference on Financing for Development (FfD) in Addis Ababa.
These meetings present an unmissable opportunity. And that’s why the Secretariat of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is working with its partners to push tobacco onto the SDG agenda and to keep it there.
Failure would be a huge setback. Issues excluded from the SDGs may well be relegated from the international agenda, or forgotten altogether. We can’t let that happen.
So the FCTC Secretariat, employing a mandate from the Conference of the Parties, has taken steps to revitalise the campaign. We have contacted Parties to the Convention and sought action on two fronts.
Firstly, we need to ensure that the reference to the Convention remains in the final SDGs. At the moment, paragraph 3.a underlines the need “to strengthen implementation of the Framework Convention on Tobacco Control in all countries as appropriate.” There is also a commitment that by 2030 there should be a one-third reduction in premature mortality from non-communicable diseases, which includes tobacco-related illness.
Of course, in order to have some effect, it is also important to have a metric. So we’re pressing for an indicator monitoring the number of people aged 15 and over using tobacco products. Likewise we are advocating an indicator measuring the probability of death from cardiovascular disease, cancer, diabetes, or chronic respiratory disease between the ages of 30 and 70.
But none of this will have any effect unless there are funds to finance the implementation of the treaty provisions and that’s why we’re also seeking changes at the Addis Ababa Ffd Conference, where UN Member States will finalise their decisions on how to fund the SDGs.
The campaign against tobacco needs money and there’s one obvious source – taxation (It’s worth noting that this approach has the support of the World Bank.) So we’re promoting the explicit inclusion of such pledges in the Addis Ababa Outcome Document.
Here’s why. Research indicates that a 10% rise in price leads to a decline in tobacco consumption of more than 5% in low- to middle-income countries like China and South Africa. And it’s been shown to work – Turkey cut smoking by 13% from 2008 to 2012, a time when excise duties were sharply increased.
This is a virtuous process, allowing revenues to be reinvested. Most national tobacco control programmes are poorly staffed and under-resourced, especially in low- to middle-income countries which account for 80% of worldwide tobacco-related deaths. Communication and advocacy campaigns, research and monitoring activities and even funding to defend countries from tobacco industry litigation, need resources at all levels.
Achieving the goals set out here will, I believe, re-energise the worldwide tobacco control movement. And it will help all the Marios and Marias, throughout the world, who might otherwise face a bleak diagnosis in a doctor’s office in the years ahead.
Tobacco taxes can be used to finance the Sustainable Development Goals
Joint position of the WHO and WHO FCTC on the new SDGs and Financing for Development