11 June 2017

Africa: Integrity First - How Tobacco Politics Impacts On Human Development

Photo: The Citizen
lthough the WHO warns against tobacco farming and use, the crop is still grown in some parts of Tanzania.
analysis

Tobacco is the most controversial cash crow amongst the main cash crops Tanzania has been depending on for its economy for many centuries. It's the only cash crop that its consumption by human beings is hundred per cent harmful.

Despite this obvious and genuine fact, that tobacco is harmful to human health, it has remained on the list of cash crops that the country promotes for its economic advantages. Thus, there are two different and contradictory approaches, when the world is marking World No Tobacco Day on every May 31 each year.

This year's theme on May -World No Tobacco day was: 'Tobacco is a threat to development'. Why it should be a threat to development, while it is has been supporting the country's economy for many years? Why tobacco should be a threat to development, while it has been sustaining the livelihood of many people, particularly in those areas, where it is grown? For many years political leaders of almost all countries in which tobacco is grew and marketed never entertain facts that tobacco is harmful to health.

Economic advantages of tobacco and its products have been promoted, while playing down its negative effects on human health. According to the World Health Organisation (WHO), about 7.2 million people die every year due to tobacco related diseases. In Tanzania alone, about 16,000 people die every year and about 83 die every week due to tobacco related diseases. From these facts is there any reason to continue promoting tobacco farming?

According to WHO, action to stamp out tobacco use can help countries prevent millions of people from falling ill and dying of tobacco-related disease, combat poverty and reduce large-scale environmental degradation. Because of these obvious health problems caused by tobacco use, WHO calls on governments to implement strong tobacco control measures.

These include banning marketing and advertising of tobacco, promoting plain packaging of tobacco products, raising excise tax and making indoor public places and the workplace smoke-free, things, which are not done by our government. While WHO leads in urging countries to make sure they reduce or if possible stamp out tobacco use, Tanzania promotes tobacco farming despite its harmful effects on human health.

According to Ocean Road Cancer Institute (ORCI) and Muhimbili National Hospital (MNH) data, 32 per cent of cancer cases are linked to smoking tobacco. A study by the Ministry of Health in collaboration with National Institute for medical Research (NIMR) and WHO, 17.5 per cent people in households did not actively smoke tobacco were exposed to the substance by other smokers and 24.9 per cent are exposed to tobacco in the workplace.

These statistics are really shocking and logically it could be anticipated that tobacco be stamped out and be substituted for other crops, which are consumer-friendly. We are told by physicians that tobacco contains about 2,000 toxins - that is why no wonder that tobacco is one of causes of diseases like cancer, diabetes, heart and lung diseases.

Tobacco's health and economic costs

"Tobacco is a major barrier to development globally;" says Dr Douglas Bettcher, Director of WHO's Department for the Prevention on non-communicable diseases (NCDs). "Tobacco-related deaths and illness are drivers of poverty, leaving households without breadwinners, diverting limited household resources to purchase tobacco products rather than food and school materials, and forcing many people to pay for medical expenses."

Studies by Sokoine University of Agriculture (SUA) suggest that the country loses about 61, 000 hectares of forests every year due to tobacco farming. It's also estimated that about 12,389 cubic metres of trees are felled annually in Tabora Region by tobacco growers/farmers. In terms of economic advantages, it is said that tobacco earns the country of about $150 million per year.

Globally, tobacco costs households and governments over $1.4 trillion through healthcare expenditure and lost productivity. "Tobacco threatens us all," says WHO Director-General, Dr Margaret Chan. "Tobacco exacerbates poverty, reduces economic productivity, contributes to poor household food choices, and pollutes indoor air." Dr Chan adds: "by taking robust tobacco control measures, governments can safeguard their countries".

From these costs, which are detrimental to health, tobacco farming doesn't pay off. Tanzania is able to substitute tobacco farming for other crops like sunflowers, cotton, maize and save the lives of many people from tobacco related diseases. Since tobacco is a threat to development, it can reasonably be likened to the use of narcotic drugs and negative effects of corruption on the country.

Legal framework in controlling tobacco use

In realising harmful effects caused by tobacco users, WHO in 2005 initiated the Framework Convention on Tobacco to control and reduce the prevalence of tobacco uses and its exposure to tobacco non-smokers. Despite this convention, which requires signatory countries to make sure tobacco use is extremely controlled to reduce its effects, still 600,000 people die each year from exposure to second hand smoke, while only 30 countries meet best practices for pictorial warning against tobacco consumers. This means many countries, including Tanzania, do not adhere to WHO's convention.

According to the WHO report first ever published, only 16 per cent of the world's population is protected by comprehensive national smoke free laws. Although tobacco farming and factories processing tobacco, the Tobacco Production (Regulations) Act, 2003, are in the country for many decades before and after independence, Tanzania's legal framework on controlling tobacco use was enacted in 2003. Ironically, the law is weak and very ineffective, when it comes to tobacco use control in the country.

On World No Tobacco Day, minister of Health Ummy Mwalimu promised us new tobacco control legislation, which will discourage both tobacco farming and use as a way forward to having Tanzania without tobacco. We hope this won't be a mere political statement. All countries, including Tanzania, have committed to the 2030 Agenda for Sustainable Development (SDG 2030), which aims at strengthening universal peace and eradicating poverty. Key elements of this agenda include implementing the WHO Framework Convention on tobacco control and by 2030 reduce by one third premature deaths from NCDs. Tanzania must comply with the SDG 2030, for the health of its people.

Tobacco threat cuts across all social lives

According to the WHO report, tobacco threatens all people, national and regional development, in many ways, including:

Poverty: Around 860 million adult smokers worldwide live in low- and middle-income countries. Many studies have shown that in the poorest households, spending on tobacco products often represents more than 10 per cent of total household expenditure - meaning less money for food, education and healthcare.

Children and education: Tobacco farming stops children attending school. About 10-14 per cent of children from tobacco-growing families miss classes because of working on tobacco farms.

Women: About 60-70 per cent of tobacco farm workers are women, putting them in close contact with often hazardous chemicals.

Health: Tobacco contributes to 16 per cent of all NCD deaths.

These harmful effects of tobacco also are prevalent in Tanzania as well. While many governments in western countries are taking action against tobacco use, from banning advertising and marketing, to introducing plain packaging for tobacco products, and smoke-free work and public places, but Tanzania has been reluctant to enforce these measures for fearing to lose both political and economic advantages of tobacco. Tanzania's tobacco use control is in small-scale. Cigarette companies are almost free to brand and market tobacco products. According to WHO, governments worldwide collect nearly $270 billion in tobacco excise tax revenue each year, but this could increase by over 50 per cent, generating an additional $141 billion, simply from raising taxes on cigarettes by just $0.80 per pack (equivalent to one international dollar) in all countries. Increased tobacco taxation revenues will strengthen domestic resource mobilisation, creating the fiscal space needed for countries to meet development priorities under the 2030 Agenda.

According to the WHO's report, tobacco-related illness is one of the biggest public health threats the world faces, killing more than 7 million people a year. But tobacco use is one of the largest preventable causes of NCDs. Tobacco control represents a powerful tool in improving health in communities and in achieving the SDGs. SDG target 3.4 is to reduce premature deaths from NCDs by one third by 2030, including cardiovascular and chronic respiratory diseases, cancers, and diabetes.

Another SDG target 3.a. calls for the implementation of the WHO Framework Convention for Tobacco Control (WHO FCTC). The WHO FCTC entered into force in 2005 and its parties are obliged to take some steps to reduce demand and supply for tobacco products. Actions addressed in the convention include protecting people from exposure to tobacco smoke, banning tobacco advertising, promotion and sponsorship, banning sales to minors; requiring health warnings on tobacco packaging, promoting tobacco cessation, increasing tobacco taxes; and creating a national coordinating mechanism for tobacco control. There are 180 parties to the WHO Convention.

From what the convention highlights, it is my belief that Tanzania has no reason to continue and promote tobacco farming, rather our politicians must now change their mindset in persuading tobacco farmers to substitute tobacco farming for other crops. Health is source of wealth.

The author is a lawyer/journalist based in Dar es Salaam.

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