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Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy
Tobacco Control Experiences in Developing Countries
Several developing countries had started putting in place tobaccocontrol policies before the FCTC negotiations began
The FCTC negotiations process gave momentum to the tobaccocontrol efforts in such countries and encouraged those without anymeasures to initiate policies and activities for tobacco control
Whereas developing-country parties can learn from “best-practicemodels” in the developed world, there are some success storiesfrom the developing-country parties
Efforts should be made to encourage south-south cooperation inscientific, technical, and legal fields
Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy
A party to the FCTC, Brazil has had a national tobacco controlprogram since 1989
This program has achieved important positive results− Smoking prevalence among adults (age 18+) decreased from
34.8% in 1989 to 22.4% in 2003: a 35% decrease
In 2003, motivated by the FCTC negotiation process, the presidentof Brazil created the National Commission for the Implementationof the FCTC and its Protocols− A formal governmental forum that convenes the
representation of 13 different ministries− Its main goal is to build a state agenda for the FCTC
Incorporated tobacco control as a key component of its overallhealth promotion strategy
Serves as a best-practice example in tobacco control policies− Strong pictorial health warnings on tobacco products− Progressive taxation policy on tobacco products
There are dedicated funds available for health promotion andtobacco control programs through earmarked tobacco and alcoholtaxes (Health Promotion Foundation Act, 2001)
Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy
In 2003, adopted a comprehensive legislation on tobacco control:The Cigarettes and Other Tobacco Products Act
Elaboration of rules for implementation of various measures of theAct is ongoing; several challenges related to implementationremain
A growing network of NGOs working on tobacco control and strongpartnerships are being established between governmental andNGOs at various levels of governance for FCTC implementation
Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy
Establish a national coordination mechanism, involving multiplestakeholders, for implementation of policies towards fullcompliance with FCTC provisions—ensure its freedom from tobaccoindustry influence
Develop a comprehensive national tobacco control legislation inline with the provisions and obligations under the FCTC
Conduct a situation analysis of tobacco control in the country toanalyze existing policies and develop new policies along withstrengthening of existing measures, in accordance with the FCTCprovisions
Integrate tobacco control into existing health systems, at all levelsof governance (federal, state, provincial, local) to ensuresustainability of tobacco control interventions
Strengthen human and institutional infrastructure forimplementation of tobacco control measures (this may be done byestablishing a national tobacco control program)
Ensure coordination between different governmental agenciesinvolved with tobacco control at national, provincial, andmunicipal levels
Strengthen NGOs, especially those working on health anddevelopment issues, so that tobacco control can be integratedwithin a broad civil society agenda in the country
Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy
Train personnel engaged in tobacco control in monitoring andevaluation of tobacco control measures
Conduct appropriate communication and public awarenesscampaigns to build a critical mass of public opinion in support ofFCTC implementation and compliance with tobacco controllegislation
Develop locally appropriate cessation programs to support tobaccousers in quitting tobacco use
Build national and regional capacity for tobacco product testingand disclosure of constituents and emissions− Essential for compliance with the provisions related to
regulation of contents of tobacco products and disclosures
Establish a national regulatory authority to regulate tobaccoproducts− Revenue-generating models for such regulatory bodies exist
For example, Brazil: ANVISA (the National Agency forSanitary Surveillance) is mandated to collect $35,000USD* as annual registration fee for each brand from thetobacco companies
Mobilize resources for FCTC implementation− Conduct needs assessment, in light of total obligations to the
FCTC, to identify program priorities as well as technical andfinancial needs for FCTC implementation
− Seek support from bilateral and multilateral fundingmechanisms and international agencies such as the WHO
− Explore funding opportunities through mechanisms such as theBloomberg Initiative to reduce tobacco use
Actively participate in sessions of the Conference of the Parties tothe FCTC for relevant matters, including the negotiation andadoption of protocols and guidelines for implementation ofselected provisions
Implementing the FCTC in Developing Countries: Dr. Poonam Dhavan and Dr. K. Srinath Reddy
Be vigilant of tobacco industry strategies to counter efforts atFCTC implementation− As countries attempt to implement comprehensive advertising
bans, the tobacco industry might use surrogate advertising andpromotion strategies such as product placement in electronicmedia and movies
− As taxation policies are put in place, governments need tomonitor and curb possible increase in illicit trade (in whichthe tobacco industry might be complicit)
Identify and promote economically viable alternatives for tobaccoworkers, growers, and sellers
The success of the FCTC will be determined by the politicalcommitment and resources applied for its implementation
Several developing countries are parties to the FCTC and are nowfaced with the challenges of implementation
There are existing best-practice models, from both developed anddeveloping countries, on effective tobacco control implementation
This lecture identifies challenges faced by developing countries intobacco control and recommends strategies for effectiveimplementation of the FCTC in a developing-country context