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Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy

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© 2007 Johns Hopkins Bloomberg School of Public Health

Section B

Tobacco Control Experiences in Developing Countries


Tobacco Control Experiences in Developing Countries

Several developing countries had started putting in place tobaccocontrol policies before the FCTC negotiations began

The FCTC negotiations process gave momentum to the tobaccocontrol efforts in such countries and encouraged those without anymeasures to initiate policies and activities for tobacco control

Whereas developing-country parties can learn from “best-practicemodels” in the developed world, there are some success storiesfrom the developing-country parties

Efforts should be made to encourage south-south cooperation inscientific, technical, and legal fields


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Tobacco Control Experiences: Brazil

A party to the FCTC, Brazil has had a national tobacco controlprogram since 1989

This program has achieved important positive results− Smoking prevalence among adults (age 18+) decreased from

34.8% in 1989 to 22.4% in 2003: a 35% decrease

In 2003, motivated by the FCTC negotiation process, the presidentof Brazil created the National Commission for the Implementationof the FCTC and its Protocols− A formal governmental forum that convenes the

representation of 13 different ministries− Its main goal is to build a state agenda for the FCTC

implementation


Tobacco Control Experiences: South Africa

A party to the FCTC since 2005, South Africa has one of the mostcomprehensive tobacco control policies in the world

The 1993 Tobacco Products Control Act included strong measureson smoke-free public places, taxation, health warnings, andadvertising bans

The Tobacco Products Amendment Act came into force in SouthAfrica in October, 2000

Political commitment and strong tobacco control networks enabledadoption and implementation of strong tobacco control policies


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Source: van Walbeek. (2003).

Cigarette Price and Consumption: South Africa


Tobacco Control Experiences: Thailand

Incorporated tobacco control as a key component of its overallhealth promotion strategy

Serves as a best-practice example in tobacco control policies− Strong pictorial health warnings on tobacco products− Progressive taxation policy on tobacco products

There are dedicated funds available for health promotion andtobacco control programs through earmarked tobacco and alcoholtaxes (Health Promotion Foundation Act, 2001)


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Image source: The University of SydneyTobacco Control Supersite. (2006).

Tobacco Control Experiences: Thailand

Health warnings in Thailand


Tobacco Control Experiences: India

In 2003, adopted a comprehensive legislation on tobacco control:The Cigarettes and Other Tobacco Products Act

Elaboration of rules for implementation of various measures of theAct is ongoing; several challenges related to implementationremain

A growing network of NGOs working on tobacco control and strongpartnerships are being established between governmental andNGOs at various levels of governance for FCTC implementation


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Recommendations for FCTC Implementation

Establish a national coordination mechanism, involving multiplestakeholders, for implementation of policies towards fullcompliance with FCTC provisions—ensure its freedom from tobaccoindustry influence

Develop a comprehensive national tobacco control legislation inline with the provisions and obligations under the FCTC

Conduct a situation analysis of tobacco control in the country toanalyze existing policies and develop new policies along withstrengthening of existing measures, in accordance with the FCTCprovisions



Integrate tobacco control into existing health systems, at all levelsof governance (federal, state, provincial, local) to ensuresustainability of tobacco control interventions

Strengthen human and institutional infrastructure forimplementation of tobacco control measures (this may be done byestablishing a national tobacco control program)

Ensure coordination between different governmental agenciesinvolved with tobacco control at national, provincial, andmunicipal levels

Strengthen NGOs, especially those working on health anddevelopment issues, so that tobacco control can be integratedwithin a broad civil society agenda in the country


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Train personnel engaged in tobacco control in monitoring andevaluation of tobacco control measures

Conduct appropriate communication and public awarenesscampaigns to build a critical mass of public opinion in support ofFCTC implementation and compliance with tobacco controllegislation

Develop locally appropriate cessation programs to support tobaccousers in quitting tobacco use



Develop a national tobacco control research agenda that addressesnot only health effects of tobacco use but also the socioeconomicaspects

Establish and integrate a tobacco control surveillance programwithin the health systems


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*Source: da Costa e Silva, V.L. (2004).


Build national and regional capacity for tobacco product testingand disclosure of constituents and emissions− Essential for compliance with the provisions related to

regulation of contents of tobacco products and disclosures

Establish a national regulatory authority to regulate tobaccoproducts− Revenue-generating models for such regulatory bodies exist

For example, Brazil: ANVISA (the National Agency forSanitary Surveillance) is mandated to collect $35,000USD* as annual registration fee for each brand from thetobacco companies



Mobilize resources for FCTC implementation− Conduct needs assessment, in light of total obligations to the

FCTC, to identify program priorities as well as technical andfinancial needs for FCTC implementation

− Seek support from bilateral and multilateral fundingmechanisms and international agencies such as the WHO

− Explore funding opportunities through mechanisms such as theBloomberg Initiative to reduce tobacco use

Actively participate in sessions of the Conference of the Parties tothe FCTC for relevant matters, including the negotiation andadoption of protocols and guidelines for implementation ofselected provisions


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Be vigilant of tobacco industry strategies to counter efforts atFCTC implementation− As countries attempt to implement comprehensive advertising

bans, the tobacco industry might use surrogate advertising andpromotion strategies such as product placement in electronicmedia and movies

− As taxation policies are put in place, governments need tomonitor and curb possible increase in illicit trade (in whichthe tobacco industry might be complicit)

Identify and promote economically viable alternatives for tobaccoworkers, growers, and sellers


Summary

The success of the FCTC will be determined by the politicalcommitment and resources applied for its implementation

Several developing countries are parties to the FCTC and are nowfaced with the challenges of implementation

There are existing best-practice models, from both developed anddeveloping countries, on effective tobacco control implementation

This lecture identifies challenges faced by developing countries intobacco control and recommends strategies for effectiveimplementation of the FCTC in a developing-country context

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