Health Bridge Indonesia TC Report 07

8/3/2019 Health Bridge Indonesia TC Report 07

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Supporting the FCTC Process in Indonesia

Final Narrative and Financial Report

April 2007

Prepared for: International Health Division, International Affairs Directorate, HealthPolicy Branch, Health Canada

Prepared by: HealthBridge (formerly known as PATHCanada)

Agreement Number: 6808-06-2006/6800063


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SUPPORTINGTHEFCTCPROCESSININDONESIA: FINALREPORT 1

HEALTHBRIDGE

SupportingtheFCTCProcessinIndonesia

FinalNarrativeReport

Background

Indonesiais

currently

experiencing

atobacco

epidemic.

With

asmoking

prevalence

rate

of

31.5%(andmorethan60%inruralareas),thecountryhasthefifthhighesttobaccoconsumption

rateintheworld.Inaddition,tobaccoconsumptionhasincreasedsteadilysincethe1970s.For

example,smokingprevalenceamongadults15yearsandolderincreasedfrom26.9%in1995,to

31.5%in2001.Indonesiaisalsothe7thlargesttobaccoproducingcountry.

MostofthecountrieslocatedinWHOsSouthEastAsianRegion(SEAR)havedemonstrateda

strongcommitmenttotheWHOFrameworkConventiononTobaccoControl(FCTC).

Indonesia,however,isanexceptionthereismuchapathyonthepartoftheGovernmentto

accedetotheFCTCandimplementtobaccocontrolpolicies. Asaverypopulouscountrywith

virtuallynotobaccocontrolactivitiesinplace(orevenplanned),substantialgovernment

supportfor

tobacco

production

and

trade,

and

no

strong

NGOs

able

to

counter

the

tobacco

industry,Indonesiaisakeycountrytosupport.

InordertobuildthecapacityofNGOstoadvocatefortobaccocontrolinIndonesia,the

IndonesianPublicHealthAssociation,theSouthEastAsiaTobaccoControlAlliance(SEATCA),

andHealthBridgehostedanadvocacytrainingworkshopforpotentialpartnersinIndonesiain

May2006. Theobjectiveofthetrainingwastoenableadvocatestoidentifyandunderstand

prioritytobaccocontrolissuesinIndonesia,providethemwithbasicadvocacyskills,identify

costeffectiveresourcesthatcouldbeutilizedforadvocacy,anddevelopaconcreteissue

specificactionplanforfutureadvocacyinitiatives.

Theparticipantswereselectedusingcriteriadevelopedcollectivelybylocalandinternational

resourcepersons.Participantsrepresentedorganizationstraditionallyinvolvedintobacco

controlaswellasnewplayersinthefield.Organizationsattendingthetrainingincludedthe

HeartFoundation,CancerFoundation,IndonesiaWomenAgainstTobacco,JakartaCitizen

Forum,NationalScoutOrganizationanduniversitystudentbodies.

Followingthetraining,theIndonesianparticipantorganizationssubmittedadvocacyproposals.

SEATCAcollaboratedwithHealthBridgetosupportfouroftheseproposalsthroughsmall

grants.HealthBridgesProgrammeDirectorprovidedtechnicalassistanceasrequiredbythose

grantees.


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HEALTHBRIDGE

GoalsandObjectives

Theoverallpurposeofthisprojectwasto improvethecapacityofIndonesiantobaccocontrol

advocatestocontributetothedevelopmentoftobaccocontrolpoliciesinIndonesia.Itsspecific

objectiveswere:

1. Tostrengthen

policy

efforts

in

Indonesia

by

ensuring

the

creation

and

carrying

out

of

concise,strategicplansforthecountrytoaccedetoandimplementtheFCTC.

2. Tosupportasmall,targetednumberofNGOstoworkdirectlywithgovernmentandmedia

ontheFCTC.

ActivitiesandOutputs

Thefollowinghighlightstheprimaryactivitiesundertakenandoutputsandoutcomesachieved

throughthisproject.

Objective1:StrengthenpolicyeffortsinIndonesiabyensuringthecreationandcarryingoutofconcise,strategicplansforthecountrytoaccedetoandimplementtheFCTCActivity

11:

Assist

advocates

in

fine

tuning

their

plans

to

meet

project

objectives.

Activity12:Helpadvocatestoturntheiractionplansintoconciseproposals.

Activity13:Reviewproposalsandselectgrantrecipients.

ThesmallgrantapplicationandreviewprocessledbySEATCAandHealthBridgetookplaceas

planned,followingtheoriginallyscheduledtimeline.Unfortunately,thismeantthatthereview

andselectionprocesswascompletedbeforeHealthCanada fundingwasofficiallyconfirmed.

Therefore, all Health Canada funding, and HealthBridge technical assistance supportedby

HealthCanada,wasreallocatedtosupportactivitiesundertakeninsupportofObjective2.This

didnot,however,affecttheultimateoutcomesoftheproject.

Objective2:Supportasmall,targetednumberofNGOstoworkdirectlywithgovernmentandmediaontheFCTCActivity21:Provide small grants to selectedprojects that strategically facilitate Indonesia to

accedetoandimplementtheFCTC.

Activity22:ProvideongoingtechnicalassistanceandcapacitybuildingtoIndonesianpartners.

Activity23:Supervisegrantprojects.

Activity24:Organizeafollowupreview/monitoring/trainingmeetingforIndonesiantobacco

controladvocates.

WithadministrativesupportfromSEATCA,HealthBridgefundedthreeadvocacyprojectsand

theupdatingofatobaccocontrolsourcebook.

No Organization ProjectTitle ProjectSpecificObjectives

1 NationalCommission

forChildProtection

(NCCP)

AdvocacyforYouth

ProtectionMeasures

intheTobacco

ControlLaw

Enactmentoftobaccocontrollawwithprovisionson:

1.Comprehensivebanontobaccoadvertising

2.Prohibitionofthesaleofcigarettesinsinglesticks

andkiddypacks

3.Prohibitionofsaleoftobaccoproductsbyminors

4.Childrensrighttosmokefreepublicareas


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2 IndonesianForumof

Parliamentarianson

Populationand

Development(IFPPD)

Facilitatingyouth

interfacewith

Parliamentariansfor

enactmentof

tobaccocontrollaw

1.To increaseyouthunderstandingof tobaccocontrol

policyscenario

2.Togetcommitment fromyoungpeople tourge the

parliamentininitiatingtobaccocontrollaw

3.Todevelopyouthabilityforpolicyadvocacy

3Indonesian

Planned

Parenthood,West

Jawa(IPP)

Advocacy

for

smoke

freeschool

regulationin

Bandung

1.

Increase

Stakeholder

awareness

to

stop

tobacco

consumptionamongstudentsinBandungWestJava

andmobilizetheirsupportinadvocatinglocal

governmenttomakesmokefreeschoolspolicy.

2.Supportaregionalpolicyonsmokefreeschools.

4. IndonesianPublic

HealthAssociation

(IPHA)

UpdatingTobacco

ControlSource

BookforIndonesia

1.ToupdateIndonesiaTobaccoSourceBook2004

2.Todisseminatethesourcebooktotobaccocontrol

workersandrelatedagenciesinIndonesiaandrelated

internationalorganizations

SpecificProjectOutputs

Project1:

Advocacy

for

Youth

Protection

Measures

in

the

Tobacco

Control

Law

Objective:Advocate for inclusionofyouthprotectionmeasures in thenational tobaccocontrol

lawandenlistmentofthedraftbillfordiscussionintheNationalLegislationProgramof2007of

theIndonesianParliament

Activities Outputs

Roadshowsin10schools Youth gained acknowledge about the misleading marketing

practicesofthetobaccoindustry.

Youth were motivated and inspired to get involved in tobacco

controladvocacy.

CapacityBuildingfor

motivatedyouth

leaders

Youth learned about the tobacco control scenario in Indonesiaand

advocacystrategies

for

policy

change

YouthwerepreparedtorepresentIndonesiasfuturegenerationand

advocatetobaccocontrolpoliciestolegislators

EstablishmentofTobaccoFreeYouthForum

Representationto

CommissionVIIIof

Parliamentdealingwith

Childprotection

Legislators of Commission VIII signed the youth petition and

affirmedtheirsupporttoprotectchildrenfromtobaccosharm

Mediacoverage(printandelectronic)(Appendix1)

Representationto

CommissionXof

Parliamentdealingwith

environmentalconcerns

Legislators of Commission X signed the youth petition to protect

childrenfromtobacco

Mediacoverage(printandelectronic)

YouthMeetings Prepared for advocacy events, presentations and petitions to the

Parliamentarians

Youthrepresentative

presentedtheirdemands

toParliamentariansat

IFPPDsseminar

Chairman of House of Representatives was movedby the youth

presentationand further calledon theLegislationBody (Baleg) to

include TC Law in National Legislation Program (Prolegnas)

immediately.(Appendix2)

MeetingwithChairmanof ChairmancalledontheLegislationBody(Baleg)toincludeTCLaw


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HEALTHBRIDGE

HouseofRepresentatives

(AgungLaksono)

inNationalLegislationProgram(Prolegnas)of2007

StreetRally&Press

Conference

Mediacoverage

PreparationofaNational

Childrens

Congress

YouthcalltothePresidentofIndonesiatoenactTCDraftLaw.

Project2:FacilitatingyouthinterfacewithParliamentarianstoenacttobaccocontrollaw

Objective:Tomobilizeparliamentarianstolistdrafttobaccocontrolbillinthelegislationplanfor

2007andthuspreventyouthexposuretoindustrytacticsandsmoking.

Activities Outputs

YouthCoreGroup

Meeting

Commitmentfromtheyouthtoinfluencetheparliamentariansinorder

toprotect them from theharmcausedby tobaccoproductsand tobe

peeradvocates

YouthSeminar

at

the

Parliamentopenedby

SpeakerofParliament

(Appendix2)

1.Inputsfrom

youth

to

strengthen

Parliamentarians

initiative

on

the

draftbilltobelistedintheLegislationPlanfor2007.

2.Youth commitment to advocate their peers in support of tobacco

controleffortatschools/universitiesandtheirsurrounding.

3.Signatures from youth and Parliamentarians on commitment to

tobacco control legislation Fact sheets produced for the

Parliamentariansandmedia(Appendix6)

Pressconferences Responding to theyouthvoice,LegislationBodyand factions (political

parties)urgedtogiveseriousattentionandacceleratethediscussionon

the Bill on Controlling the Impact of Tobacco Products on Health. In

addition, increased awareness of tobacco industry manipulation of

reportingon

tobacco

control

Project3:AdvocacyforsmokefreeschoolregulationinBandungObjective:Toinfluencethelocalgovernmenttodevelopasmokefreeschoolspolicy.

Activities Outputs

YouthMeeting Recommendation andpetitionfromyouthdemandingsmokefree

schools

Stakeholder&

CommunityMeeting

Recommendation&supportfrom10institutionsthatareinfluencialfor

smokefreeschooladvocacy.

Regulations

on

smoke

freeschools Draft

regulation

will

be

produced

Mediaadvocacykit Promotionalandinformationmaterialswillbeproduced

Meetingswithallies

andgovernment

representatives

Supportgainedfromalliesandgovernmentfordraftregulation


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HEALTHBRIDGE

Project4:Tobaccocontrolsourcebook

Objective:Toupdatethe2004IndonesiaTobaccoControlSourceBook

1.Establishateamtoupdatethebook

Writingteam:WidyastutiSoerojo,WidyastutiWibisana,AbdilahAhsan,SriNurwati,

SoeharsonoSoemantri

LocalPartnerscontributedinputandtechnicalassistance:CoordinatorofNationalHealth

Survey(danDwiHapsari)fromtheNationalInstituteofHeathResearchand

Development,MinistryofHealthandSunaryo,astaffmemberoftheDirectorateof

Customs,MinistryofFinance

Overallreview:ShobaJohn,HealthBridgeProgramDirector,BungonRittiphakdee,

SEATCACoordinator,andMenchiVelasco,SEATCAResearchCoordinator.

2.Outlineofthebookdeveloped(Appendix3)

3.Chapterdraftscompleted

4.Chaptersfinalizedwithinputsfromreviewers(ExecutivesummaryattachedasAppendix4)

5.Dissemination

a)Electronicversion(followingfinalediting)willbeputontheIndonesiantobaccocontrol

websiteandwillbeavailableinPDFformatforfurtherusebyMinistryofHealth,media,

andthetobaccocontrolcommunity

b)Hardcopieswillbeproducedanddistributedtorelevantagenciesatthelocal,national,

andinternationallevels.

TechnicalAssistanceProvidedbyHealthBridgetotheProjects

HealthBridgesProgrammeDirectorbasedinIndia(ShobaJohn)maintainedongoing

communicationwiththegranteesandprovidedregulartechnicalassistancetotheprojects,

onsiteandoveremailsandvoiceoverinternetcommunication.ShevisitedJakartainNovember

2007,two

months

into

project

implementation,

to

assess

progress

and

assist

implementation

of

advocacyplans.Aonedaymonitoringmeetingwiththegranteeswasorganizedandwork

planswererevisited,challengesidentified,andalternativestrategiesdeveloped.Thegrantees

werehelpedtomodifytheirworkplansinlinewiththerevisedstrategies.

Ms.JohnalsoassistedIFPPD&NCCPtorecognizethesynergicgoalsoftheirindividual

projectsinacceleratingtheenactmentofnationallawandfacilitateddevelopmentofjointwork

plansandsharingresources.Thishelpedtoincreasethereachoftheprojecttotheirrespective

constituenciesandavoiddelaysandduplicationofefforts.

InameetingwithIFPPDmanagementandstaff,Ms.Johnfacilitatedtheidentificationof

strategies

to

counter

tobacco

industrys

attempt

to

legitimize

its

opposition

to

the

draft

tobacco

controlbillbycollaboratingwiththeUniversityofIndonesia. Shepersonallyattendedand

supportedawalkoutfromtheUniversityseminarchallengingthedraftbill.Shealsoprovided

inputstoIPPasitrefineditsplanstomatchlocalneedsandtimelines. Itprovidedconceptual

clarityonkeycomponentofsmokefreepolicies.

Ms.JohnassistedtheTobaccoSourceBookteamtodevelopitsframeworkandfinalizethe

outline.TheChapterauthorswerethendirectedtopotentialsourcesofinformationrelevantfor


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theupdate. Thedraftswerereviewedandfeedbackprovided.AlongwithSEATCA,Ms.John

metthechapterauthorsinJakartaandfinalizedthechapters.Shemaintainedregular

communicationwiththeProjectCoordinatorandauthorsthroughouttheprocessandoffered

helptodealwithhumanresourceanddatarelatedchallenges.

Ms.

John

organized

a

second

meeting

with

the

project

implementers

in

Jakarta

in

March

2007,duringwhichsheassessedtheprojectsprogressinmeetingtheirobjectives,

helpedtheteamidentifyandsharethelessonslearned,anddiscussedtermination

plans.Inaddition,asacapacitybuildingmeasure,shehelpedrefineNCCPsstatement

onPhilipMorrissdeceptionofIndonesianyouthattheAltriashareholdersmeeting.

HealthBridgealsolinkedmembersoftheprojectteamstointernationalnetworksand

resourcessuchasatGlobalinkandGlobalSmokefreePartnership.

Atthesametime,Ms.JohnvisitedandworkedwiththetobaccocontrolfocalpointintheNon

CommunicableDiseasesDivisionoftheIndonesianMinistryofHealthandhiscounterpartin

theWHOcountryoffice.HealthBridgesaccesstotheGovernmentwasutilisedinseeking

informationand

support

from

the

Government

for

local

tobacco

control

policies.

Ms.

John

persuadedtheWHOAssistantDirectorGeneraltoutiliseherimpendingvisittospecifically

seekIndonesianGovernmentssupportforaccessiontoFCTCandenactmentofnational

tobaccocontrollaw.

OutcomesAchieved

Thekeyoutcomesachievedthroughthisprojectwere:

1.Pressurebuiltfornationalandlocaltobaccocontrolpolicies

The seed grants with focused and strategic policy goals helped to build momentum and

environments

conducive

to

moving

forward

with

the

development

and

implementation

of

local

andnationaltobaccocontrolpolicies.

NCCP successfullybuilt a formidable youth pressure group, which in limited time gained

mediaandGovernmentattention.Thisgroup inturnhasunlimitedpotentialasastakeholder

group in keeping youth concerns on the agenda of the legislators and accelerating the

parliamentarylegislativeprocess.

IFPPD (the Parliamentarians initiative on developmental issues), through this project, has

managed to mobilize increased support from key leaders in the Parliament for the tobacco

controlbillitispilotingintheParliament.

IPPsstrengthisintheprovincesandinworkingwithchildren,parentsandtheschoolsystem.

ThisgivestheminroadstotheEducationalBoardthathastoformulatetheSmokefreeSchool

decree. Having branches in several provinces, IPPs efforts to make smokefree school

regulationsinWestJavacouldpotentiallybecomeamodelforotherprovincesinIndonesiato

initiatelocalsmokefreeinitiatives,evenasthenationallawisyettobecompleted.

TheTobaccoControlSourcebook thathasbeenupdatedwill serveasa resource forvarious

mediaandpolicyefforts. It isbeing referred to in the local tobaccocontroldiscussions,even


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HEALTHBRIDGE

beforeitsformalpublication;thisindicatesitspotentialtobeacredibleinformationsourcefor

localandinternationalagencies.

2.EmergingleadershipinIndonesiantobaccocontrolfostered

Theseedgrantsenabledtherecipients,allrecententrantsinIndonesiantobaccocontrol,togain

greatervisibility

with

the

media

and

the

Government

and

within

the

development

community.

Thiswillenhancetheirplanstofurtherimprovetobaccocontrolpoliciesinthecountry.Thefact

that youth from NCCP were invited to address the media alongside Parliamentarians

exemplifiesthelongertermimpactoftheproject.TobaccocontrolmovementinIndonesiahas

beenabletoidentifyintheChairoftheHouseofRepresentativesanadvocateforitscause.This

couldhelpinmobilisingfurthersupportinensuringthatthetobaccocontrolbillishighlighted

intheParliamentslegislativeprogrammeforthecomingyear.

3.CollaborativepartnershipscreatedinIndonesiantobaccocontrol

NCCPandIFPPDworkedcollaborativelytowardstheirsynergeticgoals.Theirworkplanswere

developed and implemented in a consultative manner. Resources were shared to maximize

their efficiencyand toavoidpotentialduplication.Theorganisationsand theirconstituencieshave developed a trusting relationship that could stimulate further collaborative efforts in

tobaccocontrol.

4.Contributionsmadetointernationaltobaccocontrol

Activities supported through the Health Canadafunded small grants have improved the

capacity of the grant implementers and increased their visibility in international tobacco

control.This in turncouldhelp them tobe resourcesandmodels forother similar initiatives

whilealsoattractingadditionalresourcesfortheirownwork.

The NCCPs Project Officer has come to be closely connected with Essential Action, an

internationaltobacco

control

network

that

challenges

industry

manipulations.

She

was

selected

bythenetwork torepresentglobalandIndonesianyouth inraisingtheirconcernsatthe2007

Altria(formerlyPhilipMorris)ShareholdersMeetinginEastHanover,NewJersey.

IFPPDeffectivelyutiliseditsmembershipinGlobalinktoseekinformationfromcountriesthat

have evaluated the impact of FCTC ratification on tobacco farming and employment, for

movingthetobaccocontrolbillintheirParliamentsagenda.(Appendix5)

TheleadauthoroftheTobaccoControlSourcebookfromIPHAhasbeeninvitedtoparticipate

ontheSteeringCommitteeoftheGlobalSmokeFreePartnership.

Conclusion

Overall the small grants for advocacy projects havebeen a success and have facilitated the

trainingandequippingofanewgroupofconfidentadvocatesinIndonesia.Moreimportantly,

they have initiated advocacy activities that contribute to tobacco control policies atboth the

localandnational levels. It is important that theadvocacyefforts thatwere startedcontinue.

Hence continued support to this group is also important. HealthBridge and SEATCA are

committed to work closely with the Indonesian tobacco control network to support and

strengthentheseadvocatestobeactivecontributorstotobaccocontrolpoliciesinIndonesia.


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SUPPORTINGTHEFCTCPROCESSININDONESIA: FINALREPORT

HEALTHBRIDGE

Appendix 1:Media CoveragefromAdvocacyfor Youth ProtectionMeasures in the

TobaccoControlLawProject


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activist urges ban on sale (2552x3352x24b jpeg)


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12/26

batasi peredaran rokok (2552x3368x24b jpeg)


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anti tobacco-jakarta post (1352x2052x24b jpeg)


14/26

activist urges ban on sale2 (1496x2336x24b jpeg)


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Appendix2:PhotographsfromAdvocacyforYouthProtectionMeasuresintheTobacco

ControlLawProject

Petition from Tobacco Free Indonesian

Children Forum, March 28, 2007 accepted by Honorable HR Agung Laksono

Seminar at Parliament BuildingMarch 28, 2007

Press Conference at Parliament Building (Honourable HR

Agung Laksono,Mrs. Aisyah H. Baidlowi, and Youth Reps, March 28, 2007


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HEALTHBRIDGE

Appendix3:TobaccoSourceBook2007Outline

CHAPTER1 SmokingPrevalence

1.1 GeneralPrevalence

1.2 TobaccoUseamongPopulationSubGroups

1.3

Ageat

Initiation

of

Smoking

1.4 PrevalenceofPassiveSmokers

CHAPTER2 MorbidityandMortalityfromTobaccoUse

2.1 Morbidity

2.2 Mortality

2.3 HealthCareCostsfromTobaccoRelatedDiseases

CHAPTER3 TobaccoProduction,TradeandIndustry

3.1 TobaccoCultivation

3.2 ProductionandTrade

3.3

TobaccoManufacturing

3.4 TobaccoEmployment

3.5 MarketShareofCigaretteManufacturers

3.6 TobaccoExciseTaxRevenue

CHAPTER4 TobaccoConsumptionandEconomicImpact

4.1 CigaretteDomesticConsumption

4.2 AnnualPerCapitaConsumption

4.3 MonthlyAverageCigaretteConsumption

4.4 CigarettePriceandTaxes

4.5

Tobaccoand

Poverty

4.6 PerCapitaIncomeandMinimumWages

4.7 TobaccoSmokingandFireHazards

CHAPTER5 TobaccoControlMeasures

5.1 TobaccoControlLaw

5.2 ControlofTobaccoProduct

5.3 ProtectionForNonSmokers

5.4 TobaccoTaxation

5.5

Health

Education

5.6 CessationServices

5.7 Organizations

CHAPTER6 ResearchonTobaccoUseandTobaccoControl

6.1 ExistingStudies

6.2 ResearchGapsandRecommendationsforFutureStudies


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Appendix4:2007TobaccoControlCountryProfile;ExecutiveSummary

Tobaccouseandhealthrisks

Morethan50millionsmokersinIndonesiaspent,onaverage11.5%oftheirmonthlyhousehold

expendituresoncigarettesin2004,20%increasefromtheyear2001;thepoorestspentmoreon

cigarettes(11%)

than

the

richest

(9.7%).

Smoking

is

estimated

to

kill

427,948

people

annually,

about1172personsperday.Halfoftobaccorelateddeathsareamongpeopleintheirmost

economicallyproductiveyears.Thenegativehealthimpactsoftobaccousehavelongbeen

establishedandlungcanceristheworldsleadingcauseofpreventabledeaths.Basedonthe

mortalitystudyoftheNationalHealthSurvey2001,therelativeriskorlungcancerswere

calculatedashighas8.17andtheestimateddeathswere36,832.

Twooutofthreemalesareactivesmokers.Sixtysevenpercentmaleswithnoeducationordo

notfinishprimaryschoolsmokecomparedto48%universitygraduated.Despiteextremelyfast

growingofcigaretteconsumption,theworryingtrendsinIndonesiaarethelargenumbersof

youngpeoplewhobegintosmokeeachyearandappeartobestartingatyoungerage.The

averageage

of

uptake

in

1995

was

18.8

years

and

continuously

declined

to

18.3

years

in

2001

and17.4yearsin2004.Thevastmajorityofsmokersstartbeforetheyreach19yearsold.The

percentageincreasedfrom68%in2001to78%in2004withthehighestincreaseoccurringinthe

youngestagegroupof59yearsfrom0.4%in2001to1.8%in2004.

Traditionallywomenhavenotsmoked,butthe2004datashowedremarkableincreaseinfemale

smokingprevalenceinallincomeandeducationgroupsfromaaverageof1.3%in2001to4.5%

in2004.Becausediseaseriskbuildsovertimewithsmoking,recentincreasesinrelativelyshort

periodwillaffecthealthoutcomesandeconomicburdeninfutureyears.

In2004,almost3in4Indonesianhouseholdshadatleastonesmokerathomeand84%smokers

15years

and

above

smoke

at

home

in

the

presence

of

family

members.

Eight

of

10

students

wereexposedtotobaccosmokeinpublicplaces.Itisestimatedthatover45millionadultsre

passivesmokersintheirhomesamongwhom37millionwerewomen,4timeshigherthanmen.

The2001datashowedthat70%children014yearswereexposedtopassivesmokeintheir

homes.Extensivestudiesonsecondhandsmokeconfirmedthatpassivesmokeisharmfulto

humanhealthandchildrenareparticularlyvulnerable.

TobaccoProduction,TradeandIndustry

Thelanddevotedtotobaccocultivationisrelativelystableat1.2%oftotalarablelandformore

than40years.With16%expansionoftheabsolutewidthofarablelandforthepast4decades,

increase

in

tobacco

farming

was

insignificantly

from

224

ha

in

1961

to

259

ha

in

2003.

This

gives

ananticipationofthemostprobablegrowthoftobaccofarmersrelativetotheincreasing

demandfortobaccoleafsuppliestosupporttheextensivetobaccoproductionduringthesame

periodof1961(35.5Billionsticks)to2003(186Billionsticks).Tobaccoleafimportistheanswer.

Beginningearly90s,thequantityofimportedtobaccoleafpassedtheexport,thensharplywent

downfrom47tonsto17tonsin19971998duetothesavingofforeigncurrencyreservesduring

theeconomiccrisis.Althoughthequantityofexportexceedingtheimport,butinmonetary


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HEALTHBRIDGE

term,thevaluewasmuchlower.In2004,thenetexportvaluereachedUS$30Mandranged

betweenUS$27MUS$54Minthepast10years.

Indonesiacontributesabout2.1%ofglobaltobaccoleafproduction;Almost67%oftheworlds

supplyoftobaccoleafcomesfromChina,Brazil,IndiaandtheUnitedStatesofAmerica.

Productionoftobaccoleavesfluctuatesovertimeindicatedthattobaccofarmingisnotastable

job.

Thenumberoftobaccofarmersremainedat1.5Mforthepast3years20002003,accountedfor

3.7%ofworkersattheagriculturalsectordespitethefactthattobaccofarmingisnotafulltime

job.Farmersdonotrelysolelyontobaccotomaketheirliving.ThenumberofFullTime

Equivalenttobaccofarmerswas647,750or1.5%ofworkersinagriculturalsectorin2003.

Cigaretteproductionin2005wasreported220Bafterdecreasesintwoconsecutiveyears2003

2004thatwasinterpretedasresultingfromrealcigarettepriceincreaseduring19982002.The

annualtaxincreasewasfrozenin20032004toboostcigaretteproduction.Concurrentlythe

MinistryofFinancefoundcounterfeitedtaxthatcausedrevenuelossamountedRp150B.

ThemarketshareofcigarettesinIndonesiawasdominatedbythreelargecompanies:GudangGaram(32%),Djarum(23%)andHMSampoerna(19%).AfterPhillipMorriestookover

Sampoernainmid2005,themarketshareshiftedwithPhillipMorrisSampoernainthesecond

rank(26%)afterGudangGaram(31.7%)andDjarumbecamethethird(17.2%).

Thenumberofworkersintobaccomanufacturingwas265,364in2002thataccountedfor1.2%

ofthetotalindustryworkers.Ironicaltotherevenuesgainedbythreegianttobaccoindustries,

theaveragemonthlywagesoftobaccoworkerswere6788%ofthemonthlywagesinfood

manufacturingand4964%ofthewagesinallindustries.Itdispelsthemyththattobacco

productionisbeneficialtotheworkersengageinit.

TobaccoConsumption

and

Economic

Implications

Indonesiaranksfifthamongcountrieswithhighestcigaretteconsumptionthatconsumed173B

stickscigarettesin2004.Inlinewiththereporteddataondecreasesincigaretteduring2003

2004,consumptiondeclinedto930percapitaperyearinthesameyears.

Theseeminglydramaticdecreasethatwasassociatedwiththepriorincreaseinrealcigarette

pricemaynotbetherealcasebecauseoftheinelasticdemandfortobaccoasanaddictive

commodityandtheaffordabilityofcigarettesinIndonesia.

CigarettepricesarecheapinIndonesia.UsingMarlboroasanindextocompareaffordability

amongcountries,Indonesiaranksthelowest.

Increasingtobacco

consumption

in

the

past

few

years

was

alarming.

The

poorest

spent

more

on

cigarettethantherichest.Proportionoftobaccoexpendituresinpoorhouseholdspersistently

increasingfrom8%in1996to13.3%in2003,whilemoneyspentoncarbohydratewere

decreasingfrom28%to19%duringthesameyears.Thishasgivenconsiderablyextraburden

forthelimitedhouseholdresourcesofthepoortocoverbasicneeds,nottomentionthecostsfor

treatingdiseasesattributedtotobaccoconsumption.


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HEALTHBRIDGE

Tobaccotaxrevenuesin2005reachedRp32,65trillionthataccountedfor6.7%oftotaldomestic

revenuesand9.8%oftaxrevenues.

Indonesiaappliestieredtaxationsystem,i.e.differenttaxratesfordifferenttypesofproducts

andproductionvolume.Beginning2007,thegovernmentappliesspecifictaxperstickranging

fromRp7,Rp5andRp3forlarge,mediumandsmallindustriesrespectivelyinadditiontothe

existingtieredtaxation.Inproportion,smallerindustrywillgethigherincrease.

TobaccoControlMeasures

Indonesiahassomeoftheweaknesstobaccocontrollegislationintheworld.Despitenostrong

regulationinplace,IndonesiaistheonlycountryinAsiaPacificRegionthatdidnotsignnor

accededtotheFCTC.

Thetobaccodraftbillfailedtobeincludedin2007nationallegislationagenda.Inspiteofthe

politicalbarriers,theleastresistancemeasuresisinplaceinsomelocalities.SmokeFreepolicyis

beginningtotakeplacealthoughwilltakelongertimetofullyimplement.

Thereis

almost

no

restriction

to

all

types

of

advertisements,

sponsorship

and

promotion.

Health

warningbecomesthesecondrelativelypromisingmeasurethantotaladvertisingbanandprice

andtaxpolicy.Preliminarystudyonpictorialwarningisunderway.

Tobaccocontrolorganizationsarebeginningtotakeshape,drivenbyexposureswithtobacco

controlalliancesoutsidethecountry.Thenewemergingnetworksareactivelyinvolvedin

advocacyforpolicychange.

Evidenceiscriticaltosupportpolicyadvocacy.Besidestheexistingresearch,thereare

identifiedinformationgapsthatrequirefurtherstudies.


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HEALTHBRIDGE

Appendix5:IFPPDs use of International Network, Globalink

From:Ms. Itsnaeni AbbasTo:General MessagesSent: Tuesday, December 26, 2006 4:24 PM

Subject: Need some data on FCTC Implementation

Next week, we will have a meeting with expert staff of Legislation Body in parliament. They will reviewour draft bill (Controlling the Impact of Tobacco Product on Health) and give comments on it. They willsubmit back to the speaker of parliament whether the draft bill should be put in National LegislationProgram for 2007.

Therefore, we need some comparative studies or success stories from other countries about FCTC(before and after implementation). Also, we need some researches on the impact of FCTC ratification

in other countries, especially the impact on employment and farming. Because they will make somelists of comparison with other countries in order to put in National Legislation Program for 2007.

Regards,Itsnaeni AbbasProgram OfficerIndonesian Forum of Parliamentarians on Population and Development (IFPPD)Nusantara I Building, 12th Floor, Room 1211DPR RIJl. Jend. Gatot Subroto, SenayanJakarta 10270Phone: +6221-5756395, 70608262, 5737422Fax: +6221-5756366, 5737422

Mobile: +6221818196072e-mail: [email protected]: http://www.ifppd.org/...

This message was sent using GLOBALink Email Platform


21/26


HEALTHBRIDGE

Appendix6:FactsheetsandPetitionsProducedbyIFPPDinBahasaIndonesia

1. KabarBurukdariNegeriTerpuruk=BadNewsfromtheHeavenofSmokers

2. TuhanSembilanSenti=TheNineCentimeterGod:DoyoupreferyourpeopleworshipIT?

3. PetisiAnakIndonesia=PetitionofIndonesianChildren

4.Politik

Cukai

dan

Kedermawanan

Industri

Rokok

=A

Twisted

Mind


22/26

KABAR BURUK DARI NEGERI TERPURUK

Bukan kereta sembarang keretaKereta ini putih sekali

Bukan berita sembarang beritaBerita ini sedih sekali

Kemarin di negeri kita 156 orang meninggal duniaTapi anehnya di koran tidak ada itu beritaTak di radio, tak di televisi, tak satu pun di media

Apakah ada pemboikotan yang begitu merata?Padahal kejadian ini sudah bertahun-tahun lamanya

Setiap hari tercatat 156 orang mati

Lebih ngeri dari bom Kuningan, bom Mariott, dan bom BaliLebih dahsyat ketimbang bencana banjir bandang dan gunung api

Yang masing-masing itu terjadi Cuma satu kaliTermasuk gempa dan gemuruh tsunamiCelakanya, tak tampak oleh mata kita korban sebanyak iniKarena dia menyebar merata di seluruh negeriDan fenomena maut yang satu iniBertahun-tahun, bertahun-tahun berlangsung setiap hari

Setiap 24 jam 156 orang, mayat menjadi

Setahunnya 57.000 *) orang Indonesia matiKorban empat tahun yang lalu sama dengan satu tsunamiKorban empat tahun depan sama dengan satu tsunami lagiKarena merokok, sebabnya pastiGara-gara dicengkeram nikotin sebagai adiksi

Bukan kereta sembarang keretaKereta ini putih sekali

Bukan berita sembarang beritaBerita ini sedih sekali

2004, 2005

*) Prof. Dr. Dadang Hawari, dalam satu makalahnya, 1998


23/26

TUHAN SEMBILAN SENTI

Indonesia adalah sorga luar biasa ramah bagi perokok,tapi tempat siksa tak tertahankan bagi orang yang tak merokok,

Di sawah petani merokok, di pabrik pekerja merokok, di kantor pegawai merokok, di kabinetmenteri merokok, di reses parlemen anggota DPR merokok, di Mahkamah Agung yang bergauntoga merokok, hansip-bintara-perwira nongkrong merokok, di perkebunan pemetik buah kopi

merokok, di perahu nelayan penjaring ikan merokok, di pabrik petasan pemilik modalnyamerokok, di pekuburan sebelum masuk kubur orang merokok,

Indonesia adalah semacam firdaus-jannatu-na'im sangat ramah bagi perokok, tapi tempat siksakubur hidup-hidup bagi orang yang tak merokok,

Di balik pagar SMU murid-murid mencuri-curi merokok, di ruang kepala sekolah ada gurumerokok, di kampus mahasiswa merokok, di ruang kuliah dosen merokok, di rapat POMG orangtua murid merokok, di perpustakaan kecamatan ada siswa bertanya apakah ada buku tuntunancara merokok,

Di angkot Kijang penumpang merokok, di bis kota sumpek yang berdiri yang duduk orang

bertanding merokok, di loket penjualan karcis orang merokok, di kereta api penuh sesak orangfestival merokok, di kapal penyeberangan antar pulau penumpang merokok, di andong Yogyakusirnya merokok, sampai kabarnya kuda andong minta diajari pula merokok,

Negeri kita ini sungguh nirwana kayangan para dewa-dewa bagi perokok, tapi tempat cobaansangat berat bagi orang yang tak merokok,

Rokok telah menjadi dewa, berhala, tuhan baru, diam-diam menguasai kita,

Di pasar orang merokok, di warung Tegal pengunjung merokok, di restoran di toko buku orangmerokok, di kafe di diskotik para pengunjung merokok,

Bercakap-cakap kita jarak setengah meter tak tertahankan abab (ansich) rokok, bayangkanisteri-isteri yang bertahun-tahun menderita di kamar tidur ketika melayani para suami yang baumulut dan hidungnya mirip asbak rokok,

Duduk kita di tepi tempat tidur ketika dua orang bergumul saling menularkan HIV-AIDSsesamanya, tapi kita tidak ketularan penyakitnya. Duduk kita disebelah orang yang dengancueknya mengepulkan asap rokok di kantor atau di stopan bus, kita ketularan penyakitnya.Nikotin lebih jahat penularannya ketimbang HIV-AIDS,

Indonesia adalah sorga kultur pengembangbiakan nikotin paling subur di dunia, dan kita yangtak langsung menghirup sekali pun asap tembakau itu, bisa ketularan kena,

Di puskesmas pedesaan orang kampung merokok, di apotik yang antri obat merokok, di pantipijat tamu-tamu disilahkan merokok, di ruang tunggu dokter pasien merokok, dan ada jugadokter-dokter merokok,

Istirahat main tenis orang merokok, di pinggir lapangan voli orang merokok, menyandang raketbadminton orang merokok, pemain bola PSSI sembunyi-sembunyi merokok, panitiapertandingan balap mobil, pertandingan bulutangkis, turnamen sepakbola mengemis-ngemismencium kaki sponsor perusahaan rokok,

Di kamar kecil 12 meter kubik, sambil 'ek-'ek orang goblok merokok, di dalam lift gedung 15tingkat dengan tak acuh orang goblok merokok, di ruang sidang ber-AC penuh, dengancueknya, pakai dasi, orang-orang goblok merokok,


24/26

Indonesia adalah semacam firdaus-jannatu-na'im sangat ramah bagi orang perokok, tapi tempatsiksa kubur hidup-hidup bagi orang yang tak merokok,Rokok telah menjadi dewa, berhala, tuhan baru, diam-diam menguasai kita,

Di sebuah ruang sidang ber-AC penuh, duduk sejumlah ulama terhormat merujuk kitab kuningdan mempersiapkan sejumlah fatwa. Mereka ulama ahli hisap. Haasaba, yuhaasibu, hisaaban.Bukan ahli hisab ilmu falak, tapi ahli hisap rokok. Di antara jari telunjuk dan jari tengah merekaterselip berhala-berhala kecil, sembilan senti panjangnya, putih warnanya, ke mana-manadibawa dengan setia, satu kantong dengan kalung tasbih 99 butirnya,

Mengintip kita dari balik jendela ruang sidang, tampak kebanyakan mereka memegang rokokdengan tangan kanan, cuma sedikit yang memegang dengan tangan kiri. Inikah geranganpertanda yang terbanyak kelompok ashabul yamiin dan yang sedikit golongan ashabus syimaal?Asap rokok mereka mengepul-ngepul di ruangan AC penuh itu. Mamnu'ut tadkhiin, ya ustadz.Laa tasyrabud dukhaan, ya ustadz. Kyai, ini ruangan ber-AC penuh. Haadzihi al ghurfatimalii'atun bi mukayyafi al hawwa'i. Kalau tak tahan, di luar itu sajalah merokok. Laa taqtuluuanfusakum.

Min fadhlik, ya ustadz. 25 penyakit ada dalam khamr. Khamr diharamkan. 15 penyakit adadalam daging khinzir (babi). Daging khinzir diharamkan. 4000 zat kimia beracun ada padasebatang rokok. Patutnya rokok diapakan? Tak perlu dijawab sekarang, ya ustadz. Wayuharrimu 'alayhimul khabaaith. Mohon ini direnungkan tenang-tenang, karena pada zamanRasulullah dahulu, sudah ada alkohol, sudah ada babi, tapi belum ada rokok. Jadi ini PR untukpara ulama. Tapi jangan karena ustadz ketagihan rokok, lantas hukumnya jadi dimakruh-makruhkan, jangan,

Para ulama ahli hisap itu terkejut mendengar perbandingan ini. Banyak yang diam-diammembunuh tuhan-tuhan kecil yang kepalanya berapi itu, yaitu ujung rokok mereka. Kini merekaberfikir. Biarkan mereka berfikir. Asap rokok di ruangan ber-AC itu makin pengap, dan ada yangmulai terbatuk-batuk,

Pada saat sajak ini dibacakan malam hari ini, sejak tadi pagi sudah 120 orang di Indonesia matikarena penyakit rokok. Korban penyakit rokok lebih dahsyat ketimbang korban kecelakaan lalulintas, lebih gawat ketimbang bencana banjir, gempa bumi dan longsor, cuma setingkat di bawahkorban narkoba,

Pada saat sajak ini dibacakan, berhala-berhala kecil itu sangat berkuasa di negara kita, jutaanjumlahnya, bersembunyi di dalam kantong baju dan celana, dibungkus dalam kertas berwarnidan berwarna, diiklankan dengan indah dan cerdasnya,

Tidak perlu wudhu atau tayammum menyucikan diri, tidak perlu ruku' dan sujud untuk taqarrubpada tuhan-tuhan ini, karena orang akan khusyuk dan fana dalam nikmat lewat upacaramenyalakan api dan sesajen asap tuhan-tuhan ini,

Rabbana, beri kami kekuatan menghadapi berhala-berhala ini.

2000, 2003


25/26


26/26

Dengarkan Suara K am i !Dengan ini kami atas nama anak dan remaja Indonesia

MEMINTA

kepada wakil rakyat Republik Indonesia untuk

memperjuangkan :

1. Melarang segala bentuk iklan, promosi dan sponsor rokok.2. Menaikkan harga rokok agar tidak terjangkau oleh anak-

anak Indonesia.

3. Melarang penjualan rokok secara batangan serta membatasitempat penjualannya.

4. Menjadikan tempat-tempat umum bebas dari asap rokok.5. Mendorong undang-undang yang secara menyeluruh

melindungi kami dari dampak produk tembakau.

Jakarta, 28 Maret 2007

Forum Remaja Indonesia Bebas Tembakau

Komisi Nasional Perlindungan Anak

Health Bridge Indonesia TC Report 07

Documents