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Activists speak on challenges, successes in Africa’s fight against tobacco use

July 23, 2020

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Tobacco control advocates across Africa on Wednesday brainstormed on the challenges and gains recorded in the fight against the use of the product on the continent.

They spoke at a webinar co-hosted by the Africa Tobacco Control Alliance (ATCA), Centre for Tobacco Control in Africa (CTCA), and the Kenya Tobacco Control Alliance (KETCA).

The panellists, who are the WHO 2020 World No Tobacco Day awardees, highlighted the efforts of activists in their respective countries and proferred solutions to combat increased tobacco use.

Rachel Devotsu, a Kenyan advocate, said Africa has recorded a measure of success in the fight against tobacco use.

“We have some countries that have done things that I will call groundbreaking,” said Ms Devotsu, a lawyer and the regional coordinator for Africa, McCabe Centre for Law and Cancer, Kenya.

“For example, if you look at Kenya and Uganda, their sections in the law Article 5.3 are some of the best in the world. And, of course, we have paid the price by being taken to court, for those measures have been challenged.

“When I learnt about tobacco control, I was told about something called the scream test. And, basically, any time the tobacco industry screams, it’s a sign that your tobacco control measure is really good. Any time they take you to court, it’s a sign you’ve done something good.

“So, Kenya has been taken to court severally, Uganda is currently in court and I think one of the reasons they are being fought so hard is because of those provisions in Article 5.3.”

Ms Devotsu noted that countries such as Mauritius, Seychelles, Burkina Faso, Chad, Niger had made progress in terms of graphic health warnings.

“Of course, Kenya’s track and trace system is one of the best in the world, several people have come over to learn from us,” she said.

“And so we have some countries that have done some very groundbreaking moves, but then, unfortunately, there is a large number of countries that are doing the bare minimum.”

Wondu Bekele, an Ethiopian activist, said 52 per cent of Africans are dying from non-communicable diseases mainly due to tobacco and other risk factors.

“Non-communicable disease is no longer a health issue, it’s becoming a development issue and I’m sorry to tell you that Africa is the least prepared. Our people are needlessly dying from the tobacco epidemic,” said Mr Bekele, executive director, The Mathiwos Wondu-YeEthiopia Cancer Society, Ethiopia.

He said African governments are not giving enough attention and commitment to the fight against tobacco use.

“If they are committed, they have to give us something like 15 per cent of our national budget for health,” he said.

“Otherwise, if you take Ethiopia 30 per cent of our national budget is from overseas, only 70 per cent is coming from the government.

“The money we are getting from our donors, I’m not under-estimating their generous support but we want money from our national budget, that is how we can make a meaningful intervention towards the challenge of growing tobacco in Africa.”

Another panellist, Robinah Kaitiritimba, described Uganda’s tobacco control law as, perhaps, one of the strongest in the region. The law, among other provisions, bars designation of smoking areas and puts the age of smoking at above 21. Also, the pictorial warning on cigarette packs is 65 per cent.
“I think that, legally, for Uganda, we are not doing badly,” said Ms Kaitiritimba, executive director, Uganda National Health Users’/Consumers Organisation.

“The lessons that we see here is that there is very little support for tobacco control. The link between tobacco and non-communicable diseases has not been highlighted. We have a lot of work to do to demonstrate the relationship between tobacco and non-communicable diseases.

“I know we talk about it, it is in the figures but it is different from going to people and explaining to them. I saw that the information that we gave parliament in Uganda, for instance, that you look at your children at 18, they are at university years, in secondary years but whose money are they smoking? Why are we allowing them?

“And parliament saw that evidence, although it was already out there but we gave it such force that parliament eventually began to look at their own children.”

Africa’s ‘weak measures’

According to Ms Devotsu, the African region still struggles with putting strong measures against tobacco use.

“We are one of the regions that still have very low tobacco taxes, we’ve not yet met the threshold set by the WHO 70 per cent tax,” she said.

“We still have so many countries that still have designated smoking areas in their smoking laws. So we pat ourselves on the back we’ve passed a smoking law, but if it is got a designated smoking area then it is really not 100 per cent smoke-free.

“We have very few countries putting dedicated funding for tobacco control, either in terms of earmarking of tobacco taxes which, as a continent, we are not doing very well.”

Ms Devotsu said although several African countries have begun passing laws on warnings for tobacco packagings, a lot still do the bare minimum which, according to her, is 50 per cent graphic health warnings.

“My challenge to the African region is, can we try and be groundbreaking? Can we do something that’s going to shake the world? Can we stop passing laws with designated smoking areas? Can we go for 60, 70, 80 per cent graphic health warnings?

“Who is going to be the first African country to do plain packaging? I know South Africa has got a law on its books that is in parliament that contains plain packaging? But I will love to see more African countries making laws in that direction.”