Tobacco Control in Africa: Advocating Through Videos

In 2007, IDRC, Canada, analysed tobacco situation in Africa. Evidence indicated that the majority of countries in sub-Saharan Africa were in the early stages of the tobacco epidemic. In recent years tobacco consumption in Africa has increased faster than in the developing world as a whole. 

Between 1995 and 2000, tobacco consumption was estimated to have risen by 2.7% in the developing world as a whole, but in Africa by 3.2%, during the same period. The majority of governments in the region were aware of the looming epidemic and its potential for thwarting the development process. 

Under a research project ‘Research for International Tobacco Control (RITC)’ funded by IDRC, Canada, in partnership with the Bill & Melinda Gates Foundation, the initiative aimed at understanding the critical determinants of success for tobacco control in Africa. The initiative aimed at a situation analysis to assess tobacco use, the dynamics of tobacco farming and tobacco control policies (including their level of implementation) in 10 to 14 sub-Saharan African countries. 

The project also aimed to build the technical capacity of African researchers to gather, synthesize and analyze data at the country and the regional level, and the result was used for weighing opportunities and obstacles to tobacco control, assess country readiness and capacity for action, and guide action for tobacco control in Africa. A key element was to ensure the engagement of African stakeholders and global partners in the effort.

WHO’s tobacco control efforts in Africa

 

The World Health Organization (WHO) increased its attention to tobacco control in Africa in 2009, with the overall goal of preventing tobacco use from becoming as prevalent there as it is in other parts of the world.

 

The focus of the programme was on strengthening countries' ability to implement the WHO Framework Convention on Tobacco Control (WHO-FCTC), the international health treaty that guides national efforts to counter the tobacco epidemic, and the establishment of a regional centre of excellence to support the development of countries' capacity to resist the spread of tobacco use. 

Tobacco use is the most preventable cause of illness and death. It is now common knowledge that if unchecked, it will kill several million people per year by 2030, with more than 80% of those deaths occurring in developing countries. Tobacco use is a risk factor for the major non-communicable diseases – heart attacks, strokes, cancers, diabetes and asthma and other chronic diseases – which together account for 60% of all deaths in the world. In the 46 countries of WHO's Africa region (AFRO), non-communicable diseases are expected to account for 46% of deaths by 2030, up from 25% in 2004.

For the African region, tobacco use is more than a health problem, because of its effect on countries' development. Tobacco breeds poverty, killing people in their most productive years. It consumes family and health-care budgets. The money spent on tobacco products is equal to money not spent on essentials like education, food and medicine, according to experts in the area.

The importance of tobacco lies in its association as the leading preventable cause of death in the world. Actions for tobacco control will prevent young people from starting its use and help current tobacco users to quit, and protect unwilling non-smokers from exposure to second-hand smoke or passive smoking.

Strengthening the implementation of the WHO Framework Convention on Tobacco Control (WHO-FCTC) is ratified by about 40 out of the 46 countries in the African region, and its implementation through comprehensive tobacco control legislation and capacity building for its effective enforcement is a major challenge for the member states in the African region.

The fast growth of the population in Sub-Saharan Africa is leading to larger and more accessible markets and an increase in purchasing power of the African consumers. Intensive efforts by the tobacco industry to expand African markets has had an effect on tobacco consumption. According to reports, countries in the African region are experiencing an increasing rate of tobacco use. The prevalence of tobacco use in African countries is between 8 to 43% for boys and 5 to 30% for girls. 

Observance of No-Tobacco Day in the African Region

Prevention of diseases is clearly the most cost-effective measure. The world over ' World No-tobacco Day' is observed on 31st May to develop mass awareness about tobacco, its harmful effects and necessity to control it. The last year theme for the event was 'The WHO Framework Convention on Tobacco Control' held around the world on 31 May 2011. In the African Region, the event was organised in several countries; reports on events organised in thirteen countries (Benin, Burkina Faso, Burundi, Cape Verde, Gambia, Kenya, Mali, Mauritania, Mozambique, Niger, Senegal, Sierra Leone, Tanzania) are enlisted in the WHO site.

Tobacco in Africa Video Series 

The African region is a new frontier for tobacco companies and the region is witnessing a smoking epidemic. However there is a major effort to promote harmful effects of smoking and tobacco control, and counter tobacco companies’ promotional efforts through videos. These short videos provide an introduction to tobacco use in Africa, some of the successes in addressing the devastating effects of tobacco use, and the challenges to progress, including tobacco industry influence.

The videos have been made in conjunction with the African Tobacco Situation Analysis Project (ATSA), an initiative supported by IDRC in partnership with the Bill and Melinda Gates Foundation. The project helped African advocates and researchers identify barriers and opportunities to tobacco control in their countries. They achieved groundbreaking success by focusing their efforts on key advocacy, policy, and legislative strategies.

These short videos provide an introduction to tobacco use in Africa, successes in addressing the devastating effects of tobacco use, and the challenges to progress, including tobacco industry influence. African advocates and researchers describe the tactics used by tobacco companies to undermine tobacco control efforts.

The African example to promote issues associated with tobacco through videos is a creative mass awareness and education campaign, leading to pressuring the tobacco industry and engaging governments to strengthen legislation. Thus African tobacco control advocates are protecting people from the harmful effects of tobacco use, and having their influence on future of NCDs in Africa.

NCDs shall receive top priority in Indonesia

Elly Burhaini Faizal has reported in The Jakarta Post that following the reported increase in deaths from non-communicable diseases overtaking deaths from infectious diseases, the government has prioritized efforts to fight non-communicable diseases this year.

The Health Ministry is planning to improve campaigns for healthy lifestyle to reduce the risks of non-communicable diseases while at the same time continuing its fight against infectious diseases.

The Health Ministry’s disease control and environmental health director general Tjandra Yoga Aditama is reported to have said that the threat of non-communicable diseases such as heart and blood-related diseases, diabetes mellitus and other degenerative and chronic diseases had greatly increased.

“Noncommunicable diseases cause more deaths in the country than infectious diseases, and problems of the heart and blood vessels are the top causes of death,” he had told The Jakarta Post.

Realization by experts that most non-communicable diseases are consequence of unhealthy lifestyles and poor living conditions, the Government contemplates to include in the disease control programs not only curative treatments but also preventative approaches.

The prevention measures would include a campaign for healthy lifestyle among people with common risk factors such as smokers, heavy drinkers, and people who are inactive or have unhealthy diets.

Tjandra has pointed out that at the centre of NCDs problem lies the modern lifestyle, characterized by increased mobility and low social activity, unhealthy eating patterns, lack of physical exercise, sedentary-behavior such as too much sitting or watching television, and harmful use of alcohol.

Obesity in current epidemic form affecting many countries comes not only from modern sedentary lifestyles but also poor diet. With unhealthy eating habits, more people are in the obese category and have high levels of cholesterol and blood glucose, resulting in a higher risk of endocrine and metabolic disorders.

Poor awareness on the dangers of smoking aggravates the problem, he added.

Basic health research study conducted in Indonesia, in 2007,  has revealed quite a high prevalence of non-communicable diseases in which hypertension accounts for 31.7 of the total disease, followed by joint problems (30.3 percent); accident-related injuries (25.9 percent); stroke (8.3 percent); heart problems (7.2 percent); cancer and tumor (4.3 percent); asthma (3.5 percent); and diabetes mellitus (1.1 percent).

 

The data reveals that stroke accounts for 15.4 percent of the total leading causes of deaths, placing it at as the most common cause of death among all age groups, followed by hypertension (6.8 percent); ischemic heart disease (5.1 percent); and other heart diseases (4.6 percent).

“We should have made non-communicable diseases a priority 10 years ago as the leading causes of death have shifted from infectious diseases to the non-infectious ones,” said Hasbullah Thabrani, a professor of public health from University of Indonesia’s School of Public Health.

With such a high incidence of deaths caused by non-infectious diseases, Health Minister Endang Rahayu Sedyaningsih is reported to have vowed in a statement to take wide-ranging measures to cut both deaths and impairments in the quality of  life caused by non-communicable diseases.

Successful campaigns in the fight against infectious diseases will be carried out along with non-communicable diseases through both health promotion and disease prevention, she is reported to have committed. The commitment is seems to be a victory for public health experts as they have long argued that tackling non-communicable diseases  due to sharp increase in deaths and disability they cause.

A very important statement made in the context of non-communicable diseases is reportedly made by Hasbullah Thabrani, a professor of public health from University of Indonesia’s  School of Public Health. He has said, “We should have made non-communicable diseases a priority 10 years ago as the leading causes of death have shifted from infectious diseases to the noninfectious ones,”. “Unlike a decade ago, cardiovascular diseases currently account for the majority of deaths, with other non-communicable diseases, such as high blood pressure, diabetes mellitus and cancer, contributing to the development of those [cardiovascular] diseases,” he has reportedly told.

The report has pointed out that in spite of NCDs related fatalities being preventable their incidence will increase unless adequate actions are taken for change in behavior. For example, the government requires implement of  “no-smoking zones” as stipulated in article 15 of Law No. 36/2009 on Health. The regulation is necessary for control of consumption of cigarettes and reducing the number of both active and passive smokers.

Like many other countries the problem seems to be similar in Indonesia where the government does not appear to have made enough efforts to educate people on the importance of healthy living habits. The danger of smoking, and its far reaching effects will only multiply given no strong measures to counter massive cigarette advertisements by tobacco companies to lure young people to start smoking.

The situation is amply summed up by Elly Burhaini Faizal in his article in The Jakarta Post report, “ Tobacco companies spend annually an estimated Rp 3-4 trillion on cigarette ads, while the ministry’s budget for health promotion and education is only about Rp 100 billion per year”.

According to a report released by the Canada-based Cameron Institute, Indonesia loses US$37.2 billion a year, about 7 percent of its gross domestic product, due to non-communicable diseases (NCDs) such as cancer, high blood pressure, heart problems and diabetes. The figure is based on healthcare costs and an estimate of lost potential household income from workers who were debilitated by illness or died prematurely.