Africa: Multilateral Approaches to Improve Population Health: How Can the Public and Private Sectors Work Together?

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12 October 2020

In parallel to the 75th United Nations General Assembly which was held from September 22nd 2020, a round of Conversations on Leadership organized by the Wall Street Journal was held on September 29th. One of the session's themes dealt with the lessons that could be learned from the Covid-19 pandemic and how the scientific community can better work with the public and private sectors to mitigate threats to population health in the future.

André Calantzopoulos is the CEO of Philip Morris International (PMI), the world's largest transnational tobacco company, that employs more than 73,000 people around the world and has affirmed for a couple of years now a firm commitment to a "smoke free world".

During the discussion, he stressed the importance of science, transparency and the collaboration of governments, regulators, health community and the private sector to drive progress: "It's about being pragmatic: it is a global economy. It is not going to change whether we like it or not and we need to work together. Governments need to sit down with the private sector and discuss how to address all of these things. If we learn from the Covid 19 pandemic, we can prepare for worse things. If we forget all that happened and we go back to normal, I think we will certainly miss an enormous opportunity. I think companies have two advantages; they can innovate and they have access to people who are their consumers. If we want to have significant change, governments alone cannot do it. Companies alone cannot do it. I think the first and most important thing is to factually explain to people what are the problems we are facing. Not demagogically, not based on politics, but factually. We are trying to move people out of cigarettes and make them switch to less harmful non-combustible alternatives. The governments have to create a conducive science- based regulatory environment to enable this to happen in orderly and collaborative manner."

One of the biggest adversaries of PMI's non-combustible products is the World Health Organization (WHO) and according to PMI their tobacco control policies are not adequate to address the reality of the market and the consumers' needs and will. For the UN agency, PMI's agenda is fundamentally opposed to public health: "Strengthening implementation of the WHO Framework Convention on Tobacco Control for all tobacco products remains the most effective approach to tobacco control. Policies such as tobacco taxes, graphic warning labels, comprehensive bans on advertising, promotion and sponsorship, and offering help to quit tobacco use have been proven to reduce demand for tobacco products. These policies focus not just on helping existing users to quit, but on preventing initiation. If PMI were truly committed to a smoke-free world, the company would support these policies. Instead, PMI opposes them. PMI engages in large scale lobbying and prolonged and expensive litigation against evidence-based tobacco control policies such as those found in the WHO Framework Convention on Tobacco Control."

However, André Calantzopoulos stated that science and technology used by companies needs to be bounded: "Science and technology have to be framed. We need to be transparent. Whatever we do has potential impact on humans and the environment. There is no service or product which delivery has no impact on the planet or humans or both. Our product being cigarettes has the highest impact known and that is why we do everything to change this equation"

Economist and researcher Julia Coronado is President and Founder of independent research agency MacroPolicy Perspectives. She believes that public and private sectors should definitely work together in a balanced way, always keeping in mind the target: a better public health for all: "Global business has been able to use technology and lower cost energy to fully take advantage of opportunities and markets. The public private partnership and communication and working relationships is more important than it has ever been.  It is a matter of protecting the interest of the consumer and making sure companies behave responsibly and at the same time allowing the kind of innovation and delivery of what businesses and consumers need. There is always a sort of negotiation and a democratic process around that."

What role can digitalization play in helping move collaboration forward?

For the CEO of PMI, Andre Calantzopoulos, the most important things are facts and data and digitalization can provide both efficiently, in particular in low-income countries: "Digitalization gives you access to facts and data and the ability to process them in an unprecedented way…65% of the people who smoke believe that vape products are worse than cigarettes and they continue smoking! Somebody has to be accountable for that misinformation. And the confusion for a variety of reasons is even bigger in developing countries because it is more hearsay as there is less access to factual information and they suffer more from that because their social support systems and health systems are often substandard so hey are disproportionately negatively impacted."

Finally, Julia Coronado pointed out that during this pandemic African and Asian countries have had innovative approaches that advanced economies should be inspired by: One of the really interesting things about the Covid-19 pandemic is that some the less "developed" countries, in Africa and South-East Asia mainly actually had some of the most innovative approaches and did very well in containing the virus, much better than expectations and much better than some "advanced" economies. Those countries have had experience with SRAS and Ebola before. It was very tangible and real. They have fought through some of these challenges. They innovated and some of the "developed" countries ended up following."

In fact, the capacity of countries in Africa to carry out sustainable public-private sector partnerships is often questioned. However, the pandemic has raised countless opportunities on the continent to alleviate the social and economic consequences of the crisis and create and implement long-term solutions for the population.

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