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

    1

    2007 Johns Hopkins Bloomberg School of Public Health

    Section B

    Tobacco Control Experiences in Developing Countries

    2007 Johns Hopkins Bloomberg School of Public Health

    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

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

    2

    2007 Johns Hopkins Bloomberg School of Public Health

    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

    2007 Johns Hopkins Bloomberg School of Public Health

    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

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

    3

    2007 Johns Hopkins Bloomberg School of Public Health

    Source: van Walbeek. (2003).

    Cigarette Price and Consumption: South Africa

    2007 Johns Hopkins Bloomberg School of Public Health

    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)

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

    4

    2007 Johns Hopkins Bloomberg School of Public Health

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

    Tobacco Control Experiences: Thailand

    Health warnings in Thailand

    2007 Johns Hopkins Bloomberg School of Public Health

    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

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

    5

    2007 Johns Hopkins Bloomberg School of Public Health

    Recommendations for FCTC Implementation

    Establish a national coordination mechanism, involving multiplestakeholders, for implementation of policies towards fullcompliance with FCTC provisionsensure 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

    2007 Johns Hopkins Bloomberg School of Public Health

    Recommendations for FCTC Implementation

    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

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

    6

    2007 Johns Hopkins Bloomberg School of Public Health

    Recommendations for FCTC Implementation

    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

    2007 Johns Hopkins Bloomberg School of Public Health

    Recommendations for FCTC Implementation

    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

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

    7

    2007 Johns Hopkins Bloomberg School of Public Health

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

    Recommendations for FCTC Implementation

    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

    2007 Johns Hopkins Bloomberg School of Public Health

    Recommendations for FCTC Implementation

    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

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

    8

    2007 Johns Hopkins Bloomberg School of Public Health

    Recommendations for FCTC Implementation

    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

    2007 Johns Hopkins Bloomberg School of Public Health

    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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