Tobacco control in Africa: Challenges, successes and

perspectives

Douglas WebbHIV, Health and Development Practice

UNDP New York

44th Union World Conference on Lung Health3 November 2013

Paris, France

Obstacles – Governance Challenges

6 Sub-Saharan African countries are not Parties to the FCTC

Obstacles – Governance Challenges

Nine of the 11 countries to have never submitted an FCTC report are African. One third of African parties did not submit a report in 2012.

No countries in sub-Saharan Africa have identified FCTC implementation as a priority in their UN Development Assistance Frameworks

Fewer than a quarter of WHO-Afro States reported undertaking anti-tobacco mass media campaigns during 2009-2010 – lower than any other region.

45% of parties Africa reported no attempts to counter industry interference (article 5.3)

Sources: FCTC 2012 Global Progress Report and

2011 WHO Report on the Global Tobacco Epidemic

Regional Tobacco Control Priorities

• Raising awareness about the WHO FCTC ratification/accession process and requirements ;

• Building capacity for the development of national action plan and comprehensive tobacco control policy and legislation reflecting the different provisions of the WHO FCTC such as protection from tobacco smoke, support for cessation programmes, warning about the dangers of tobacco, bans on tobacco advertising and promotion and raising taxes on tobacco products;

• Establishing a full-time national coordinating mechanism with a designed national focal point and a national multisectoral steering committee;

• Establishing a system for surveillance, monitoring and evaluation of tobacco use, tobacco control policies interventions as well as tobacco industry activities;

• Mobilizing resources for national tobacco control programmes with the participation of nongovernmental organizations and the private sector.

Obstacles – Governance Challenges

Countries that report not responding to industry interference in health policies

Obstacles – Governance Challenges

Why act now in Africa?

• Africa is a major target for tobacco industry sales and marketing.

• African governments are ill-equipped to cope with the added health burden and costs from the wave of chronic diseases that inevitably follows increased tobacco use.

• Tobacco-related illness and premature death impose high productivity costs and loss of labor.

• Lost economic opportunities resulting from tobacco use can be particularly severe since most tobacco-related deaths occur during the prime productive years.

• Tobacco is a big contributor to the factors that continue to derail governments’ efforts to attain the MDGs.

• Reducing and preventing tobacco use will improve individual health, increase available household funds for food and education, and better serve economic productivity.

UN system response; alignment with FCTC

• Context of goal of 30% reduction in prevalence of tobacco use by 2025

• UN division of labour on FCTC within newly formed UN Inter Agency Task Force on the Prevention and Control of NCDs

• ECOSOC resolution July 2012 requesting FCTC support integration into UNDAFs

• COP Working Group on Sustainable Measure to Strengthen the Implementation of the FCTC formed in October 2103; principal requests-– Better uptake and coordination of country needs

assessments– Technical support to generate evidence of micro and

macro-economic impacts of tobacco– Support to align tobacco control with development planning

instruments– Coordinated support to parties regarding counter-litigation

from the industry

Drivers for UN go beyond tobacco alone

• UN Political Declaration on NCDs 2011• WHO Global Action Plan on NCDs 2013-2020• Post 2015 Development Agenda – imperative

to link tobacco control with maternal and child health, NCDs and universal health coverage

• Momentum towards integrated health responses and financing – a grand convergence – with investment approaches

• Does tobacco control need an investment framework?

Overview of UNDP

• The UN’s global development network

• On the ground in 177 countries and territories

• Administrator of UN Resident Coordinator System

• HIV, Health and Development:– Mainstreaming, social determinants– Governance, human rights and the law– Implementation and capacity development

(Global Fund to Fight AIDS, TB and Malaria)

• Thematic areas: poverty reduction, governance, environment & energy, capacity development, gender equality and HIV

UNDP and the FCTC – political mandate

• FCTC COP decision FCTC/COP4/17

• Report of the UN Secretary General to ECOSOC – July 2012

‘UNDP to take into account Article 5 in its country-level role as convener and coordinator…and under its governance programmes’

• ECOSOC resolution RES/2012/4 – July 2012

‘… integration of the WHO FCTC implementation efforts within the United Nations Development Assistance Frameworks, where appropriate, in order to promote coordinated and complementary work among funds, programmes and specialized agencies’

‘UN funds, programmes and specialized agencies to contribute, as appropriate, to the goals of the Framework Convention, including through multisectoral assistance, public outreach and communication, in particular in the context of the prevention and control of NCDs.’

UNDP and the FCTC – substantive contributions

Current work

Other potential

contributions

• FCTC Needs Assessments and follow-up • FCTC regional implementation meetings• Trade and NCDs/tobacco in the Pacific

• Analysis of FCTC integration in development planning and assistance frameworks

• Article 5 analysis

• UN system coordination, UNDAF integration• Post-2015 development agenda• Support to NCD action plan development

• Integration into national development planning• Support to national, local governance structures

• Anti-corruption and regulatory independence

• Strengthening law enforcement, justice

• CSO and parliamentarian engagement

National Development Plan

Integration framework

FCTCPlan

NCD Plan

United Nations

Development Assistance Framework

Bilateral

Bilateral Bilateral

Emerging Lessons: FCTC inclusion in UNDAF

UNDAFs should support• achieving NDP priorities – so FCTC should be

included in NDP• delivery of international treaty obligations – so

FCTC should be listed• coordination of UN agencies actions – so

UNCTs must be sensitised to relevance and responsibilities

Wrap up - key messages

• Article 5 matters and generally needs to be accelerated

• There are ways to do it – framing tobacco as development issue, mainstreaming, evidence and political positioning

• UN has proactive and reactive (demand-driven) ways of providing support

• Country needs assessments and coordination of technical support through the COP will accelerate the UN response.

Thank you

Douglas Webb

HIV, Health and Development Practice

Bureau for Development Policy

UNDP New York

Email: douglas.webb@undp.org

Acknowledgements:

Brian Lutz, Alison Cox, Dudley Tarlton, Michelle Sahal-Estime, Roy Small