From Tobacco Info No. 4 - February 2011
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Without a strong network of mutual support, Africa is at the mercy of Big Tobacco
After Montreal and Paris, Niamey hosts the international French-language anti-tobacco conference
By Louis Gauvin
The third conference for tobacco control among French-speaking countries (CIFCOT-III) welcomed approximately 120 participants, including health professionals, non-government organization (NGO) workers, journalists, activists, government officials, development partners and policy makers.
Capacity building for French-speaking anti-tobacco advocates
Before the first conference in Montreal (2002) and the second in Paris (2005) — together attracting just over 1,000 participants — anti-tobacco activists in the French-speaking world worked in complete isolation from one another and from their English-speaking counterparts, with whom it was difficult or even impossible to communicate. The fight against smoking has seen more success overall in the English-speaking world, which is better organized on the matter, especially in terms of sharing, networking and support. One goal of this conference was to extend these elements to the global fight against the tobacco industry.
In Niamey, Niger, from September 25 to 28, 2010, participants from 26 countries, including 22 in Africa, gathered with three main objectives in mind: to examine the issues surrounding smoking; to prepare for the next Conference of the Parties (COP) to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in Uruguay in November; and to propose ways to maintain these relationships on a more permanent basis.
One of the major difficulties facing francophone Africa is the lack of knowledge about smoking among front-line health workers. Dr. Mohamed Ould Sidi, a young general practitioner in Ouagadougou, Burkina Faso, complained that his colleagues routinely refer all smokers to him because they don’t know how to help them. To complicate matters, tuberculosis is a concern in Africa. At a pneumology service in Bamako, Mali, an estimated 25% of consultations and 30% of hospitalizations are due to tuberculosis, a disease that is aggravated by smoking. It’s believed that nearly 20% of tuberculosis deaths could be avoided if individuals didn’t smoke.
The meeting began with the delegates drawing a comprehensive picture of the nature and extent of the diseases caused by smoking, for smokers and those around them, as well as the very strong dependence smoking creates.
Some of the same tactics used with individuals also apply when advocating tobacco control to elected officials. Not only is their basic health knowledge often lacking, many are convinced that tobacco is a creator of wealth — a positive contributor to the economic growth of their countries — when in fact it contributes to the impoverishment of the people and is an obstacle to development.
Tobacco, poverty and development
Of the 22 African countries represented, 18 figure on the United Nations (UN) Low Human Development Index, which is based on life expectancy, education and quality of life. According to the most recent UN report, “most people today are healthier, live longer and are more educated” as compared with 1990 (see footnote 1). However, as Daouda Elhadj Adam of the Chadian Association for the Defense of the Rights of the Consumer explains, approximately 300 million people (60% of the population) in Africa still live on less than US$1 per day: “That is why a large number of citizens face recurring food shortages or nutritional problems. The high cost of living makes access to essential goods and services very difficult, especially for the smoker who sometimes must spend up to a half a day’s wages on a pack of 20 cigarettes.”
Most African countries have adopted poverty reduction strategies. Unfortunately, these strategies fail to take smoking into account.
Inoussa Saouna, president of SOS Tabagisme-Niger, a Nigerien anti-smoking group, believes that tobacco control could help eradicate poverty. If less money were spent on smoking, more could be allocated to health and education.
Getting ready for COP-4
The Conference of the Parties to the WHO FCTC gathers delegates from the 171 ratifying countries. Their job is to establish guidelines for the implementation of the treaty’s 21 provisions. Also in attendance are members of the Framework Convention Alliance (FCA), a group representing NGOs from nearly every country of the world. They advocate for strong guidelines that promote health. All discussions are simultaneously translated into the six official WHO languages (see footnote 2).
In 2009, the African NGOs arrived at COP-3 without having agreed in advance on a platform — a missed opportunity to make collective gains in health. With the COP-4 scheduled for November of this year in Uruguay, the CIFCOT-III conference made preparation on the part of the African delegations a priority.
They agreed upon the most pressing issues, including taxation, health warnings on packages, education and training, cessation support, environmental protection and industry accountability. Workshop organizers expressed confidence that the African delegation would be well equipped to represent their continent at negotiations in November.
The latest advances in Africa
There is still a long way to go before Africa wields better control over the tobacco industry. However, at the end of the CIFCOT-III, it was felt that an international French-language movement against tobacco had finally truly been born. Since then, online exchanges of support and information have increased significantly. In addition, the Prime Minister of Niger has publicly committed to enacting the final decrees for the Nigerien law on tobacco. For its part, the National Assembly of Burkina Faso adopted a tobacco control law on November 25, 2010. Chad is expected to follow suit soon.
Footnote 1: Human Development Report 2010, United Nations Development Programme (UNDP).
Footnote 2: French, English, Russian, Chinese, Spanish and Arabic.
Tobacco industry strategies in Africa
Many CIFCOT-III delegates spoke offstage about tobacco industry practices in their countries.
On Comoros, a tiny archipelago between Africa and Madagascar, an activist, in favour of tobacco control legislation modelled on the WHO Framework Convention, was offered the equivalent of C$75,000 (25 million Comorian francs) by the country’s largest importer to drop the project.
“The speeches by the speaker of the National Assembly, the Minister of Health and the head of Employment and Social Services seemed threatening and there was no dialogue between us. (…) They have also reproached us for how we speak to the media and our various writings with which they disagreed, and said that, in any case, it is they who are in power and that the law will be adopted without changes.” This is how one citizen described the situation in Burkina Faso after a recent campaign by anti-tobacco activists in the country to have its laws conform to the Framework Convention (written testimonial).
The tobacco industry denies that it uses children, but it is common practice in Africa for children to resell cigarettes. The ‘advantage’ of this for the tobacco companies is that it attracts other youths to smoking, turning them into loyal, dependent customers. In Malawi and Zimbabwe, young children work long hours in the fields, without any protection against pesticides or fertilizers.
In a workshop on the relationship between tobacco companies and children, participants used one word to describe the situation: “dangerous.” They recommended the consistent, equitable application in all cases of international conventions and treaties for the rights of children and referred in particular to the international principles on child labour upheld by the International Labour Organization.