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Africa/Global: Tobacco Industry Targets Africa Markets
AfricaFocus Bulletin
October 9, 2017 (171009)
(Reposted from sources cited below)
Editor's Note
"British American Tobacco (BAT) and other multinational tobacco firms have threatened
governments in at least eight countries in Africa demanding they axe or dilute the
kind of protections that have saved millions of lives in the west, a Guardian
investigation has found. ... The giant tobacco firms hope to boost their markets in
Africa, which has a fast-growing young and increasingly prosperous population." - The
Guardian
Tobacco is the iconic case of the conflict of public health and industry power. With
its growth in the 20th century supercharged by advertising, it lost ground to a a
broad public health campaign in the last decade of the twentieth century,
particularly in the United States. It resisted that campaign with a powerful campaign
to dispute scientific data on the health consequences of smoking.
Worldwide, the World Health Organization has led an effect to counter tobacco use,
based on the WHO Framework Convention on Tobacco Control, adopted in 2003, to which
181 countries are parties (http://www.who.int/fctc/cop/about/en/). But implementation
is inconsistent, and the industry is particularly targeting new younger consumers in
countries without strong measures to curb the use of tobacco. According to the WHO,
"Tobacco use is the leading single preventable cause of death worldwide, killing over
7 million people each year."
In Africa, the WHO-linked Center for Tobacco Control in Africa, based in Kampala,
Uganda at the Makerere University School of Public Health, has taken the lead (
http://ctc-africa.org/index.php/company/about-us). But the industry is fighing back,
as documented in the lead article excerpted in this issue of AfricaFocus Bulletin.
That excerpt is accompanied by a short press release from WHO on their annual tobacco
control report, and an open letter in the British Medical Journal Tobacco Control
Blog, denouncing the new smokescreen organization launched by Philip Morris
International (misleadingly titled "Foundation for a Smoke-free World", see
http://tinyurl.com/yb6or524 for more details).
Another rising threat to health in Africa, parallel to that posed by tobacco, is the
rapid expansion of fast food consumption, fueled both by multinational corporations
and local rivals. See two recent articles:
"Obesity Was Rising as Ghana Embraced Fast Food. Then Came KFC," New York Times,
October 2, 2017
http://tinyurl.com/ydhqz46r
"Fast food is fueling an obesity epidemic in Africa,"
Quartz Africa, October 4, 2017
http://tinyurl.com/y9eqhjec
For previous AfricaFocus Bulletins on health, visit
http://www.africafocus.org/intro-health.php
For those wishing to explore these topics in greater depth, AfricaFocus has also
compiled this short list of relevant books.
Naomi Oreskes and Erik M. Conway, Merchants of Doubt: How a Handful of Scientists
Obscured the Truth on Issues from Tobacco Smoke to Global Warming. 2010
http://amzn.to/2xrLbLx
"Naomi Oreskes and Erik Conway have demonstrated what many of us have long suspected:
that the "debate' over the climate crisis--and many other environmental issues--was
manufactured by the same people who brought you "safe' cigarettes. Anyone concerned
about the state of democracy in America should read this book." - Former Vice
President Al Gore
David Kessler, A Question of Intent: A Great American Battle with a Deadly Industry.
2002. http://amzn.to/2xsaRMC
Carrick Mollenkamp et al., The People Vs. Big Tobacco: How the States Took on the
Cigarette Giants. 1998. http://amzn.to/2z70Ul7
Mark Wolfson, The Fight Against Big Tobacco: The Movement, The State and the Public's
Health. 2001. http://amzn.to/2xrbQb8
Books on the public health campaign against the tobacco companies in the 1990s. The
short lesson is that the victories came from a convergence of actions by health
advocates, public officials, and industry insiders who exposed lies by the companies.
++++++++++++++++++++++end editor's note+++++++++++++++++
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Threats, bullying, lawsuits: tobacco industry's dirty war for the African market
by Sarah Boseley in Nairobi
The Guardian, July 12, 2017
https://www.theguardian.com Direct URL: http://tinyurl.com/yc83jmeh
British American Tobacco (BAT) and other multinational tobacco firms have threatened
governments in at least eight countries in Africa demanding they axe or dilute the
kind of protections that have saved millions of lives in the west, a Guardian
investigation has found.
BAT, one of the world's leading cigarette manufacturers, is fighting through the
courts to try to block the Kenyan and Ugandan governments' attempts to bring in
regulations to limit the harm caused by smoking. The giant tobacco firms hope to
boost their markets in Africa, which has a fast-growing young and increasingly
prosperous population.
In one undisclosed court document in Kenya, seen by the Guardian, BAT's lawyers
demand the country's high court "quash in its entirety" a package of anti-smoking
regulations and rails against what it calls a "capricious" tax plan. The case is now
before the supreme court after BAT Kenya lost in the high court and the appeal court.
A ruling is expected as early as next month.
BAT in Uganda asserts in another document that the government's Tobacco Control Act
is "inconsistent with and in contravention of the constitution".
The Guardian has also seen letters, including three by BAT, sent to the governments
of Uganda, Namibia, Togo, Gabon, Democratic Republic of Congo, Ethiopia and Burkina
Faso revealing the intimidatory tactics that tobacco companies are using, accusing
governments of breaching their own laws and international trade agreements and
warning of damage to the economy.
BAT denies it is opposed to all tobacco regulation, but says it reserves the right to
ask the courts to intervene where it believes regulations may not comply with the
law.
Later this month, BAT is expected to become the world's biggest listed tobacco firm
as it completes its acquisition of the large US tobacco company Reynolds in a $49bn
deal, and there are fears over the extent to which big tobacco can financially
outmuscle health ministries in poorer nations. A vote on the deal by shareholders of
both firms is due to take place next Wednesday, simultaneously in London at BAT and
North Carolina at Reynolds.
Professor Peter Odhiambo, a former heart surgeon who is head of the government's
Tobacco Control Board in Kenya, told the Guardian: "BAT has done as much as they can
to block us."
Experts say Africa and southern Asia are urgent new battlegrounds in the global fight
against smoking because of demographics and rising prosperity. Despite declining
smoking and more controls in some richer countries, it still kills more than seven
million people globally every year, according to the WHO, and there are fears the
tactics of big tobacco will effectively succeed in "exporting the death and harm" to
poorer nations.
There are an estimated 77 million smokers in Africa and those numbers are predicted
to rise by nearly 40% from 2010 levels by 2030, which is the largest projected such
increase in the world.
Cigarette ad targeting African women.
Image from article in
Cincinnati Inquirer, March 4, 2003.
In Kenya, BAT has succeeded in delaying regulations to restrict the promotion and
sale of cigarettes for 15 years, fighting through every level of the legal system. In
February it launched a case in the supreme court that has already halted the
imposition of tobacco controls until probably after the country's general election in
August, which are being contested by parliamentarians who have been linked to
payments by the multinational company.
In Uganda, BAT launched legal action against the government in November, arguing that
the Tobacco Control Act, which became law in 2015, contravenes the constitution. It
is fighting restrictions that are now commonplace in richer countries, including the
expansion of health warnings on packets and point-of-sale displays, arguing that they
unfairly restrict its trade.
The court actions are brought by BAT's local affiliates, BAT Kenya and BAT Uganda,
but approved at Globe House, the London headquarters of the multinational, which
receives most of the profits from the African trade. In its 2016 annual report, BAT
outlined the "risk" that "unreasonable litigation" would be brought in to control
tobacco around the world. Its response was an "engagement and litigation strategy
coordinated and aligned across the Group".
'Focus on emerging markets'
At its annual meeting in March, chairman Richard Burrows toasted a "vintage year" for
BAT, as profits rose 4% to £5.2bn after investors took their cut their dividend had
increased by 10%. When asked about the legal actions in Africa, he said tobacco was
an industry that "should be regulated ... but we want to see that regulation is
serving the correct interests of the health mission and human mission which should
lie behind it".
So, "from time to time it's necessary for us to take legal action to challenge new
regulation" which he said was led by "the local board".
BAT says it is "simply not true that we oppose all tobacco regulation, particularly
in developing countries". Tobacco should be appropriately regulated as a product that
has risks to health, it said, but "where there are different interpretations of
whether regulations comply with the law, we think it is entirely reasonable to ask
the courts to assist in resolving it". It was opposed to only a handful of the issues
in Kenya's regulations, not the entirety, it said in a statement.
Although most countries in Africa have signed the World Health Organisation (WHO)
treaty on tobacco control, none has yet fully implemented the smoking restrictions it
endorses.
The WHO predicts that by 2025, smoking rates will go up in 17 of the 30 Africa-region
countries from their 2010 level. In some countries a massive hike is expected in
Congo-Brazzaville, from 13.9% to nearly half the population (47.1%) and in Cameroon
from 13.7% to 42.7%. In Sierra Leone it will be 41.2% (74% among men) and in Lesotho
36.9%.
In contrast, research showed last year that just 16.9% of adults smoke in the UK; and
last month new figures showed UK heart disease deaths had fallen 20% since that
country's indoor smoking ban.
"The tobacco industry is now turning its focus toward emerging markets in sub-Saharan
Africa, seeking to exploit the continent's patchwork tobacco control regulations and
limited resources to combat industry marketing advances," said Dr Emmanuela Gakidou
and colleagues at the Institute for Health Metrics and Evaluation at the University
of Washington in Seattle, publishing an analysis of smoking prevalence around the
world in the Lancet in April.
Africa's growing numbers of children and young people, and its increasing wealth,
represent a huge future market for the tobacco industry. The companies deny targeting
children and cannot sell packs smaller than 10, but a new study carried out in
Nairobi by the Johns Hopkins school of public health in the US and the Kenya-based
Consumer Information Network found vendors selling cigarettes along the routes
children take to walk to primary schools.
Stalls sell single Dunhill, Embassy, Safari and other BAT cigarette sticks, costing
around 4p (5 cents) each, alongside sweets, biscuits and fizzy drinks. The vendors
split the packets of 20 manufactured by BAT. "They are targeting children," said
Samuel Ochieng, chief executive of the Consumer Information Network. "They mix
cigarettes with candies and sell along the school paths."
BAT said that its products were for adult smokers only and that it would much prefer
that stalls sold whole packets rather than single sticks, "given our investment in
the brands and the fact there are clear health warnings on the packs.
"Across the world, we have very strict rules regarding not selling our products to
retailers located near schools. BAT Kenya provides support to many of these
independent vendors, including providing stalls painted in non-corporate colours, and
providing youth smoking prevention and health warnings messages. We also educate
vendors to ensure they do not sell tobacco products near schools."
Links with politicians
The Kenya case, expected to be heard after the elections on 8 August, is seen as
critical for the continent. If the government loses, other countries will have less
appetite for the long and expensive fight against the wealthy tobacco industry.
BAT has around 70% of the Kenyan market; its Kenyan competitor, Mastermind, has
joined in the legal action against the government.
...
Tih Ntiabang, regional coordinator for Africa of the Framework Convention Alliance
NGOs that support the WHO treaty said the tobacco companies had become bolder. "In
the past it used to be invisible interference, but today it is so shameful that it is
so visible and they are openly opposing public health treaties like the case in Kenya
at the moment
Today they boldly go to court to oppose public health policy. Every
single government is highly interested in economic growth. They [the tobacco
companies] know they have this economic power. The budget of tobacco companies like
BAT could be as much as the whole budget of the Africa region.
"Our health systems are not really well organised. Our policy makers can't see
clearly what are the health costs of inaction on tobacco control because our health
system is not very good. It puts the tobacco industry at an advantage on public
health."
The sale across the whole of Africa of single cigarette sticks was a serious problem
because it enabled children to buy them. "They are extremely affordable. Young
teenagers are able to purchase a cigarette. You don't need £1 for a pack of 20," he
said.
BAT has a reputation in Africa as an employer offering steady and well-paid jobs,
said Ntiabang, based in Cameroon. "When I was about 10, I was always dreaming I could
work for BAT. They have always painted themselves as a responsible company a dream
company to work for. All the staff are well-off. The young people think 'I want to
work for BAT'. They promote a lot of events and make their name appear to young
people. We grow up dreaming we can be one of them."
[see more, including several country case studies in full article at
http://tinyurl.com/yc83jmeh]
WHO report finds dramatic increase in life-saving tobacco control policies in last
decade
4.7 billion people 63% of world's population are covered by polices such as
strong graphic warnings, smoke-free public places, and other measures
http://www.who.int/ - Direct URL: http://tinyurl.com/ycfbr6x8
News Release, World Health Organization
19 July 2017 | Geneva | New York - The latest WHO report on the global tobacco
epidemic published today finds that more countries have implemented tobacco control
policies, ranging from graphic pack warnings and advertising bans to no smoking
areas. About 4.7 billion people 63% of the world's population are covered by at
least one comprehensive tobacco control measure, which has quadrupled since 2007 when
only 1 billion people and 15% of the world's population were covered. Strategies to
implement such policies have saved millions of people from early death.
However, the tobacco industry continues to hamper government efforts to fully
implement life- and cost-saving interventions, according to the new WHO report on the
global tobacco epidemic, 2017.
"Governments around the world must waste no time in incorporating all the provisions
of the WHO Framework Convention on Tobacco Control into their national tobacco
control programmes and policies," says Dr Tedros Adhanom Ghebreyesus, WHO DirectorGeneral.
"They must also clamp down on the illicit tobacco trade, which is
exacerbating the global tobacco epidemic and its related health and socioeconomic
consequences."
Dr Tedros adds: "Working together, countries can prevent millions of people from
dying each year from preventable tobacco-related illness, and save billions of
dollars a year in avoidable health care expenditures and productivity losses."
Today, 4.7 billion people are protected by at least one "best practice" tobacco
control measure from the WHO Framework Convention on Tobacco Control (WHO FCTC), 3.6
billion more people than in 2007, according to the report. This progress has been
possible because governments have intensified action to implement key measures of the
WHO FCTC.
Strategies to support implementation of tobacco demand reduction measures in the WHO
FCTC, like the "MPOWER" measures, have saved millions of people from early death, as
well as hundreds of billions of dollars in the past decade. MPOWER was established in
2008 to promote government action on six tobacco control strategies in-line with the
WHO FCTC to:
- Monitor tobacco use and prevention policies.
- Protect people from tobacco smoke.
- Offer help to quit tobacco use.
- Warn people about the dangers of tobacco.
- Enforce bans on tobacco advertising, promotion and sponsorship.
- Raise taxes on tobacco.
"One in 10 deaths around the world is caused by tobacco, but we can change that
through MPOWER tobacco control measures, which have proven highly effective," says
Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and founder
of Bloomberg Philanthropies. "The progress that's been made worldwide and
documented throughout this report shows that it is possible for countries to turn
the tide. Bloomberg Philanthropies looks forward to working with Director-General Dr
Tedros and continuing our work with WHO."
The new report, funded by Bloomberg Philanthropies, focuses on monitoring tobacco use
and prevention policies. It finds that one third of countries have comprehensive
systems to monitor tobacco use. While this is up from one quarter of countries
monitoring tobacco use at recommended levels in 2007, governments still need to do
more to prioritize or finance this area of work.
Even countries with limited resources can monitor tobacco use and implement
prevention policies. By generating data on youth and adults, countries can, in turn,
promote health, save healthcare costs and generate revenues for government services,
the report finds. It adds that systematic monitoring of tobacco industry interference
in government policymaking protects public health by shedding light on tobacco
industry tactics. These include exaggerating the economic importance of the tobacco
industry, discrediting proven science, and using litigation to intimidate
governments.
"Countries can better protect their citizens, including children, from the tobacco
industry and its products when they use tobacco monitoring systems," says Dr Douglas
Bettcher, Director of WHO's Department for the Prevention of Noncommunicable Diseases
(NCDs).
"Tobacco industry interference in government policy-making represents a deadly
barrier to advancing health and development in many countries," says Dr Bettcher.
"But by monitoring and blocking such activities, we can save lives and sow the seeds
for a sustainable future for all."
...
Note for Editors:
Tobacco use is the leading single preventable cause of death worldwide, killing over
7 million people each year. Its economic costs are also enormous, totaling more than
US$ 1.4 trillion in health care costs and lost productivity.
The WHO Report on the global tobacco epidemic will be launched on 19 July 2017 on the
side-lines of the UN High-Level Political Forum on Sustainable Development in New
York.
Controlling tobacco use is a key part of the 2030 Agenda for Sustainable Development.
The Agenda includes targets to strengthen national implementation of the WHO FCTC and
a one third reduction in premature deaths from NCDs, including heart and lung
diseases, cancer and diabetes. Tobacco use is a leading common risk factor for NCDs,
which kill 40 million people each year, equivalent to 70% of all deaths globally,
including 15 million people aged between 30 and 69 years. Over 80% of these
"premature" deaths occur in low- and middle-income countries.
...
A "Frank Statement" for the 21st Century?
British Medical Journal Tobacco Control Blog, 19 Sep, 2017
http://blogs.bmj.com/tc - Direct URL: http://tinyurl.com/ya429sh9
Ruth E. Malone, Simon Chapman, Prakash C. Gupta, Rima Nakkash, Tih Ntiabang, Eduardo
Bianco, Yussuf Saloojee, Prakit Vathesatogkit, Laurent Huber, Chris Bostic, Pascal
Diethelm, Cynthia Callard, Neil Collishaw, Anna B. Gilmore
The surprise announcement by the former head of the World Health Organization's
Tobacco Free Initiative, Derek Yach, that he would head a newly-established
organization called the "Foundation for a Smoke-free World" to "accelerate the end of
smoking" was met with gut-punched disappointment by those who have worked for decades
to achieve that goal. Unmoved by a soft-focus video featuring Yach looking pensively
off into the distance from a high-level balcony while smokers at ground level stubbed
out Marlboros and discussed how hard it was to quit, leading tobacco control
organizations were shocked to hear that the new organization was funded with a $1
billion, twelve-year commitment from tobacco company Philip Morris International
(PMI). PMI, which has been working for decades to rebrand itself as a "socially
responsible" company while continuing to promote sales of its top-branded Marlboro
cigarettes and oppose policies that would genuinely reduce their use, clearly
believes this investment will further its "harm reduction" agenda, led by its new
heat-not-burn product, IQOS. But don't worry, the Foundation assures everyone that
"PMI and the tobacco industry are precluded from having any influence over how the
Foundation spends its funds or focuses its activities."
Except that is what a broad range of industry front groups, sometimes headed by
respected and even well-intentioned leaders, have been saying since the "Frank
Statement" of 1954. The long and sordid history of the industry's funding of
"research," a major part of the mission of this new foundation, is replete with
exactly this sort of blithe reassurance, as Yach himself pointed out in an earlier
time. In reality, nothing has changed. The "research" really isn't the point anyway.
The mere fact of having landed Yach is a major public relations coup for PMI that
will be used to do more of what the industry always does: create doubt, contribute
further to existing disputes within the global tobacco control movement, shore up its
own competitive position, and go on pushing its cigarettes as long as it possibly
can.
In the video, Yach invites "everyone" to join the "movement" this new organization is
starting implicitly dismissing the past 40 years of tobacco control activism and
advocacy and 60 years of tobacco industry lies and duplicity. Leaders of active
existing civil society coalitions like the Framework Convention Alliance and the
Noncommunicable Disease Alliance were blindsided. Contrary to the video's claim,
there is no shortage of "fresh thinking" in the already-vibrant, already-existing
global movement to end the tobacco epidemic. There are many great "endgame"-
furthering ideas now being actively debated, studied, and tried out: the primary
obstacle to implementing them is the tobacco industry.
PMI hasn't stopped opposing the policies that would reduce tobacco use, has it? No:
recently leaked documents show that PMI continues to actively oppose any policy that
could genuinely reduce tobacco use. Countries around the world identify the tobacco
industry as the single biggest barrier to progress in implementing such tobacco
control policies. This "new" initiative is just more of the same lipstick on the
industry pig, but in a way it's far worse this time: by using a formerly high profile
WHO leader as a spokesperson, PMI can also accelerate its longstanding ambition to
splinter the tobacco control movement.
It's also not true, as the video suggests, that tobacco control efforts have
"plateaued." Cigarette consumption is declining and since 2003, more than 180
countries have become parties to the World Health Organization Framework Convention
on Tobacco Control (FCTC), committing themselves to implement effective policy
measures and building public support for ending the epidemic. PMI knows this, hence
its ongoing, covert and overt efforts to stymie the FCTC. For example, at the last
Conference of the Parties, the meetings where implementation of the treaty is
discussed, tobacco farmers organized by PMI demonstrated outside the venue and PMI
representatives met secretly with delegates to the meeting.
The company hasn't announced it is going to stop promoting cigarettes to kids in
Africa and Asia, has it? No: in fact, it's developing "stronger" products for some
markets, and continuing to aggressively promote Marlboro cigarettes to the young
through campaigns like "Be Marlboro". Despite decades of developing and then
abandoning so-called "reduced harm" products, cigarettes remain PMI's biggest
moneymaker, dwarfing anything else. Only the profoundly naïve will believe that PMI
is not solely promoting its self-interest in supporting this new "foundation".
In fact, the announcement came the day after a huge win for tobacco control: the
exclusion of tobacco companies (as well as makers of cluster bombs and some other
unsavory actors) from membership in the United Nations Global Compact, due to their
incompatibility with responsible business principles. Tobacco control leaders across
the globe are convincing governments to protect health policymaking from tobacco
industry influence, in line with Article 5.3 of the FCTC. PMI's response is a new
industry sponsored entity, eager to work with governments. From its inception, this
organization will constitute a challenge for Article 5.3 implementation.
The timing of the announcement was interesting in another way: just the day before, a
new global health initiative led by former US Centers for Disease Control head Tom
Frieden was announced, with $225 million in funding from Bloomberg Philanthropies,
the Chan Zuckerberg Initiative and the Bill & Melinda Gates Foundation. While this
initiative does not focus solely on tobacco, these funders know how much tobacco
contributes to disease and death worldwide. They are also funders who have
unequivocally taken positions supporting the strong policy measures that work.
What is required to end smoking isn't helping the world's leading cigarette
manufacturer in its ongoing image makeover while it continues to try to derail the
significant public health progress made to date. What is required is leaders who have
the humility to work with the movement and policymakers with the backbones of steel
needed to stand up to the industry to enact and implement strong tobacco control
measures, including high taxes, smokefree laws, effective media campaigns to
denormalize both smoking and tobacco companies, and marketing, packaging and
retailing regulations to make these deadly products less ubiquitous. The global
movement public health activists built over decades of toiling in the trenches must
stand together and not allow PMI to buy more time by executing a 21st century version
of the "Frank Statement."
AfricaFocus Bulletin is an independent electronic publication providing reposted
commentary and analysis on African issues, with a particular focus on U.S. and
international policies. AfricaFocus Bulletin is edited by William Minter.
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