FCTC and developing countries
By Riaz Missen
Email: riazmissen@yahoo.com
Oct 22 - 28, 2001
An ever growing realization prevails in the
corridors of World Health Organization (WHO) that untimely death of
individuals affected by cardiovascular diseases and cancer is a great
loss of and threat to mankind. "There are numerous factors that
influence this 'new epidemic' of noncommunicable diseases, but one is
overshadowing all others: tobacco," Dr. Brundtland, the
Director-General of WHO said in her address to 'Third International
Conference on Priorities in Healthcare' last September. True to her
conviction, she has aligned with her a worldwide network of NGO's to
lobby with the governments to eliminate the industry. The cause is
noble but ground realities must also be faced. One is that there are
millions who depend on it for their livelihood.
Relating smoking with cardiovascular diseases and
cancer, she said tobacco deaths were more than those caused by malaria
and HIV/AIDS. "Besides the terrible human cost, these deaths
present huge economic costs to societies," she told the
participants of the Conference. As a physician, she strongly believes
that 4 million people die in the world due to tobacco-related diseases
annually and that this number is to rise to 10 million by 2030. The
figures she reveals are interesting: "Cardiovascular diseases
accounted for about one in ten deaths in Africa in 1999; three in ten
deaths in South East Asia; 33 percent of all deaths in America, as
well in WHO's Eastern Mediterranean and Western Pacific region; and 50
percent deaths in all European region". Similarly, to her,
another tobacco related disease is cancer that accounts for one in 20
death in Africa; one in 14 death in South East Asia and in the Eastern
Mediterranean region; and one in five deaths in Americas, Europe and
the Western Pacific. "That is why I declared global tobacco
control as a priority," is her conclusion.
The WHO has planned to get signed from the states,
'Framework Convention on Tobacco Control' (FCTC) by 2003. The
implementation of the Convention would mean increased excise duty on
cigarettes making the product unaffordable for the consumers; bans on
tobacco advertising, marketing, and sponsorship; tough counter
advertising; and, tight control on smuggling of cigarettes. Going by
the logic of FCTC, higher the GST on cigarette, on the one hand, would
diminish the purchasing power of the consumers and, on the other hand,
raise the revenue of the governments that it could use on providing
better healthcare facilities to their subjects. The Governments would
be obliged, as signatories to FCTC, ban the advertisements of tobacco
products to prevent the youth adopting the habit. To prevent the
availability of cheaper brands in the market, an international regime
would be established to check smuggling of the goods from the
neighbouring countries. All this would mean loss of profit to sustain
the industry. And the farmers would switch to alternate crops for
their livelihood. This is her basic logic.
Notwithstanding the loss to human health, as
projected by WHO, the governments in tobacco producing countries are
critical about any efforts of the international body to curb the
industry that has become backbone of their economy. These governments
become very cagey while responding to the call of WHO to curb their
major source of foreign exchange. For Kenya, it would mean the loss of
jobs to its 600,000 people. The implementation of FCTC will render 47%
labourers in Malawi jobless and will deprive the country of more than
70% of foreign currency earnings from tobacco. Similarly, tobacco
industry earns 35-40% foreign exchange for Zimbabwe, employs 1.6
million people, 47% of the labour force of the country. According to a
Reuters' report, The UN, European Union, and Waterhouse Coopers
researchers findings suggest that there is no possibility of
diversifying Malawi's economy to sugar, tea and coffee for the next
ten years. On the other hand an international ban on smoking would
exacerbate situation in Malawi whose 90% of the budget is dependent
upon donor handouts.
The underlying assumption of the whole plan of WHO
is that through increasing the price of cigarettes, the revenues of
the government would be increased and through checking the smuggling
the consumers would be prevented from availing themselves the
alternate cheaper brands that would reach the market. Gradually, the
demand of cigarettes would die down, as the consumers would not be
able to withstand the price hike and thus the industry would be wiped
out. The farmers would resort to alternate crops to sustain
livelihood. The WHO, interestingly, recommends excluding producers,
manufacturers and consumers from the negotiation process in the
execution of the agenda.
As far as Pakistan is concerned tobacco cultivation
covers 80,000 acres and Tobacco Industry provides directly and
indirectly jobs to 3,12,500 people in an era of economic depression.
And this number is likely to go up as farmers in NWFP and Northern
areas are being increasingly attracted towards tobacco cultivation
instead of poppy farming. Moreover, the industry's annual
contributions to the government revenue in the form of taxes are to
the tune of Rs.18 billion per annum. Thus, any hasty legislation would
not be without its socio-economic repercussions. The tobacco growers
in NWFP, mostly small landholders, have had replaced poppy farming
with it only for the reason that the crop delivers a handsome amount
of money within a short time. The farmers also have no access to the
policy-making circles of the state as well as the opinion leaders in
the press. But realizing the implications of WHO's proposal, the
farming communities are increasingly turning towards political
activism Afro - Asian countries, an important economic source is
tobacco industry.
Given the low level of industrial development in
these countries, the only source is the tobacco industry. Thousands of
families associated with the business find no alternate source of
income. The fact that most of the farmers are small landholders,
alternate crops that could yield the same earning within such a short
time are no option for them. The number of deaths in these societies
is comparatively lower than in the countries with no such industry —
majority of Malawians don't smoke.
The developed countries are the major contributors
to the funds of WHO. The organization is a large bureaucratic set up.
And it costs it a lot: to spend $2 on a health project it has to spend
$7 on management. And the burden is borne by no other than the
developed countries. Let Dr Brundtland proceed with her top priority
of tackling noncommunicable diseases caused by tobacco to scale down
the economic cost of its rich donors. But the tobacco producing
countries will have to think twice before supporting her cause.
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