In the 2014 document, Sustainable Funding Models for Tobacco Control: A Discussion Paper, by The International Union Against Tuberculosis and Lung Disease, sustainable funding is identified as crucial to curtailing the projected harms caused by tobacco use.
The Union proposed various funding options for countries implementing tobacco control policies with particular emphasis on Taxes from tobacco; Taxes on other 'health-damaging goods such as alcohol; Treasury appropriation; Value added tax (VAT); Health/sickness or universal health cover insurance levy; Philanthropic donations; and Funds collected through penalties for violations of legislation, among others.
The body was categorical that any approach to create sustainable funding for tobacco control must complement and enhance government initiatives and strategies; and must also bring together government, non-government, and community sectors, among others, to work collaboratively in the fight against tobacco.
Experience in the last two decades of uptick in global tobacco control efforts has shown that in the absence of funding mechanisms tobacco control efforts will falter and unintentionally open the doors for the tobacco industry to open channels of interacting with agencies of government and public officials. Ultimately, the goal of the industry is to frustrate any form of regulation of the tobacco business.
Lessons from the publication is relevant for Nigeria as it grapples with tobacco interference in subtle and in some cases, brazen forms. Though Nigeria's National Tobacco Control (NTC) Act 2015 has a provision setting up the Tobacco Control Fund, the operationalization of the fund has not yet happened, and the public health community is growing apprehensive.
Section 8 (2) of the NTC Act 2015 and Sections 23 and 26 of the National Tobacco Control Regulations 2019 provide those annual budgetary allocations, gifts. donations, testamentary dispositions, subventions, license fees, and proceeds of sale of forfeited items shall go into the Fund. Unfortunately, six years after the NTC Act came into force, most of the relevant agencies of government are still handicapped in ensuring that the Fund is operational.
One thing remains certain: The tobacco industry in Nigeria is not unmindful of the lacuna in funding to government agencies to carry out their statutory monitoring, surveillance, and enforcement activities. Because of this, the industry continues to forge working relationships with various ministries and departments to ultimately compromise and complicate the work of the enforcement agencies.
For instance, a leading tobacco company in Nigeria practically calls the shots in the Federal Ministry of Agriculture and has signed MOUs with virtually all the state governments in the implementation of their FADAMA projects. Such projects are scattered across Abia, Benue, Kwara, Kogi, Lagos, Niger, Ogun, and Osun States. In Lagos State, the same tobacco company has been training fish farmers and various cooperatives on so-called Capacity Building engagements. The yearly Lagos Farm Fair is also bankrolled by the same tobacco company.
To wean the agencies of government off the allure of tobacco industry funds, they must independently have access to the needed resources to be able to carry out timely and proactive interventions required for the successful implementation of tobacco control policies in the country.
A Tobacco Control Fund regime will not only prevent tobacco industry financial interventions, but it will also make funds readily available for the relevant government agencies to carry out all public health sensitization activities, cessation program, alternative cropping, and other important activities. It will eliminate the reliance of government on donor and foreign funding and aid the setting up of structures across the country to help people who want to quit and monitor compliance.
As Nigerians continue the long wait for the fund to be operationalized, the Nigerian government must also identify other ways of raising funds to prosecute the tobacco war. The Nigeria Tobacco Control Alliance (NTCA) recently recommended that funding can come from heavily taxing tobacco products and earmarking the taxes to fund tobacco control and health coverage for all Nigerians. This recommendation is in sync with the WHO strategy of reducing consumption of tobacco products and at the same time providing funding for government policies aimed at prosecuting the tobacco war.
From the foregoing, Nigeria as a nation is not short of options to address the dearth of funding currently delaying effective tobacco control in the country. Until this effective funding mechanism is put in place to match the war chest of the tobacco industry, ongoing tobacco control efforts may not yield the desired results and Nigerians will be the worse for it.
James Imasogie wrote from Makurdi