With Kemo Cham
Tobacco is one of the leading causes of preventable deaths in the world.
The World Health Organization (WHO) has been at the forefront of the fight to prevent tobacco related deaths. It seeks to achieve this through the WHO Framework Convention on Tobacco Control (FCTC).
Andrew Black, the Team Lead for Development Assistance at the FCTC Secretariat in Geneva, Switzerland, has been instrumental in helping to set up Sierra Leone’s tobacco policy. Recently he was at the head of an FCTC delegation in the country to preside over the launch of a major report dubbed: the ‘Investment Case for Tobacco Control for Sierra Leone.’
In this edition of The Interview, Mr Black explains what that report means and Sierra Leone’s overall implementation of the FCTC treaty.
Politico: What is the Investment Case for Tobacco Control in Sierra Leone about?
Andrew Black: The Investment Case for Tobacco Control is a full economic analysis of the cost of tobacco to the economy of Sierra Leone as well as an overview of what the economic benefits are likely to be if Sierra Leone was to implement a number of the key measures that are set out in the Framework Convention on Tobacco Control (FCTC).
The FCTC is an international treaty that has the objective to end the global tobacco epidemic and it essentially acts as blueprint for what governments need to do to tackle tobacco in their own countries.
There are a lot of players in the making of this report. What role is the Secretariat playing?
The Convention Secretariat is playing a coordinating role, in terms of bringing support to Sierra Leone to accelerate the implementation of effective tobacco control measures.
There is a development assistant project that is being run by the Convention Secretariat in close partnership with UNDP and the WHO to be able to bring a coordinated set of support to 15 countries that we are working intensively with. Sierra Leone is one of the 15 countries that was selected to be a part of this development assistance project called the FCTC 2030 Project.
How important is this report to Sierra Leone’s implementation of the FCTC treaty?
I think the important thing to say is that there has been very little implementation of the FCTC in Sierra Leone, for a range of different reasons. And what we wanted to do is work closely with the government to be able to start implementing the key measures for tobacco control that are set out in the FCTC. The government wants to take action, and that’s been very clear from our visit this week. The government is enthusiastic and energetic for tobacco control action.
And also it’s important for us to say, having met with many parliamentarians - parliament is also ready to introduce strong tobacco control measures in the country.
The Investment Case is critically important because it brings new information to Sierra Leone about the economic cost of tobacco. This is information that hasn’t ever been provided to policy makers, because the research hasn’t ever been done. So we think the investment cases are really important piece in the puzzle for governments, because it brings new information that can be used to justify the implementation of the FCTC. This is information that has been developed or research that’s been made on the basis of global data relating to health, as well as relevant national data. So it provides an unbiased view of the cost of tobacco.
You spoke about the 2030 Project. Why is Sierra Leone part of these 15 countries?
Sierra Leone is part of the FCTC 2030 Project because the government applied to be part of it. There were almost 60 countries that applied to be part of it. We could only select 15 countries and on the basis of a strong political commitment in Sierra Leone and the need for action, Sierra Leone was selected.
Earlier you mentioned something about political willingness. But at the launch of the report, the civil society representative lamented the lack of political will. He noted that 10 years after Sierra Leone signed to the FCTC treaty there has been no law on tobacco use. That doesn’t suggest that the government is willing. What has changed?
I think we have to reflect that the past 10 years has been a challenging period for Sierra Leone and many things that have occupied the time of the government. With that in mind, the important thing is that the government today is giving us a very clear signal that tobacco control is important, that the people of Sierra Leone need to be protected from the menace of tobacco.
And the government is very clear with us from applying to be part of the project, through the engagement we have had, that they are very keen to do more to protect people in Sierra Leone from tobacco, and importantly to protect young people, to protect children from taking up the use of tobacco in the first place.
At the launch of the report a number of speakers recognized the fact that Sierra Leone had increased its tax on tobacco imports. Yet among the recommendations of the report is that there should be more tax increase. How much must the country go?
WHO recommends that 75 percent of the retail price of a packet of cigarette should be taxes and the majority of those taxes should be tobacco excise tax. Specific taxes. Not VAT, not import tax or anything, but specific excise taxes on tobacco. And Serra Leone is one of the few countries up until recently that had no tobacco tax in place. And I think it’s very good news that tobacco taxes have been increased. And the Ministry of Finance should be congratulated for that.
But of course there is significant scope for tobacco taxes to be increased to make WHO’s minimum recommendation of 75 percent. And of course the benefit of tobacco tax is that it is good for public health because it acts as a way of discouraging people from using tobacco. And also it’s a source of new revenues for governments and revenue generation these days is something that we hear a lot from governments as being a priority.
I haven’t read the whole report. But I have seen snippets of it: the number of deaths, the amount of money the country is losing. So we know that about the need to fight tobacco use.
But we don’t know much about the tobacco industry in Sierra Leone. I was wondering if that’s captured in the report. What do we know about them?
I think that there is a lot more that we need to know about how the tobacco industry operates in Sierra Leone. I think that there is a fairly unique situation in this country. We know that tobacco products are not manufactured locally. They are imported. It’s the importation of tobacco products that we need to be focused on, because there are two ways, I understand, that tobacco comes into the country. Through the legal importation of tobacco products from abroad and also through illicit channels, illegal tobacco products that haven’t had tobacco taxes paid coming into the country through illicit means, mainly across land borders, we are told.
So there is certainly the need to understand more about the way that the tobacco industry operates here.
I was just in the car coming to the WHO building where we are having our discussion and I have seen many bill boards of tobacco products with brand names I have not seen before. So there is something happening in Sierra Leone with tobacco advertising and promotion.
The problem with tobacco advertising is that it’s a way of bringing in new smokers, appealing especially to young people, and our key recommendation to the government is to introduce a new tobacco control bill that includes a comprehensive ban on all tobacco advertising, promotion and sponsorship, as a way of protecting young people from tobacco.
There are a lot of people who are skeptical about the effectiveness of increasing tobacco taxes, especially in a country like Sierra Leone where we import rather than produce. They say it will create a room for the illegal importation. What do you say to this?
There is never a straight forward answer when it comes to matters concerning tobacco. But we know that tobacco products (cigarettes) are very cheap in Sierra Leone, even when you look at the comparison of prices with other countries. So putting up tobacco taxes just by a little bit, may not have much of an impact on price. So we think that there is a significant scope to increasing tobacco taxes to make a meaningful impact on the price of tobacco and of course our FCTC treaty suggests that tobacco taxation and price measures should be used for the benefit of public health. So the government can certainly increase tobacco taxes, in a way that it would have a substantial impact on the purchase price of tobacco products.
You are recommending to the government to increase taxes. But we are saying there is a problem in that. Do you have a recommendation? Have you been thinking about this? How to handle the problem at the ports, where the illegal imports come in?
I think the problem with illegal imports might be more to do with land borders rather than them coming through the ports. That’s what we have been told. We will be meeting the NRA to be talking about measures that can be taken, for example putting tax stamps on packets of tobacco is one measure that can be taken. Tax stamps that can’t be easily replicated, that show that a packet of cigarettes has had the necessary tax payments as a legal product for sale in the market.
But also, what we would say is that if Sierra Leone is to implement new laws that would for example require picture health warnings on packets, that would be another way you could differentiate between legal and illegal products. And of course illegal products can be confiscated from the people that are selling them. That’s why we are encouraging the government to implement a new strong tobacco control law that includes provisions relating to the way the packs should look.
And also discussion about plain packaging of cigarettes and other tobacco products, which means that branding would be entirely removed from packets, with the exception of the brand name, as a way of making both health warnings more prominent. But also removing the enticing branding as a way of protecting young people from tobacco.
Again, at the launch of the report, you made the comment that the situation in Sierra Leone was getting worse. I was wondering on which basis you said so.
We know that tobacco is very popular with young people – 11 to 15 years old for example. We have data on that, and we are seeing very worrying trends that tobacco is becoming more and more popular, especially among young girls.
If you did a study targeting youths, it must mean that there is a major problem, not just in Sierra Leone but globally, I mean in terms of youths consuming tobacco.
The problem is that most tobacco users start using tobacco when they are still children and they become addicted to tobacco before they become adult. All around the world we have seen the tobacco industry targeting children because that’s who they want to have as customers. To replace the people who are dying from tobacco related diseases at the other end, they need to continue to get people into their market and so young people, children, are ideal customers for the tobacco industry. That’s why we need to remove influences like tobacco advertising and promotion. And also some are calling for the areas around schools to become tobacco free zones as well.
How is Sierra Leone doing compared to the other 14 countries in the FCTC 2030 Project?
I think Sierra Leone is quite unique in the word as one of the few countries that currently has no tobacco control restrictions or laws in place. So Sierra Leone is at a different place in terms of tobacco control policy, compared to the other countries that we are working with. Each of the other 14 countries at least has some tobacco co ntrol law in place. In many of the countries the tobacco control laws that are in place might not be strong enough, or might not fully implement the convention of tobacco control, but at least there is a law.
So our challenge here is to support the Ministry of Health to develop a draft tobacco control law that will make the treaty obligations within the FCTC and then to support the government to be able to get the law made and then critically to get the law implemented.
So it’s a bit difficult to compare Sierra Leone to other countries because this country is in quite a unique position. We are hoping that through the [FCTC 2030] Project we can give all the support to Sierra Leone to get this law made and implemented.
We are just talking about tobacco advertising, increase taxes... Why aren’t we saying ban tobacco use altogether?
I think that it’s difficult to ban products that so many people use. Around the world, there are about a billion smokers. And if we were to ban tobacco around the world, you would instantly criminalize a billion people, and it’s not as simple as that.
We need to remember that tobacco users tend to be highly addicted people. And it just wouldn’t be right to, at the stroke of the pen, take away the product that they are addicted to without giving them a lot of help and support to be able to beat the addiction.
We think that the best way forward is to work with communities to get them to reject tobacco altogether in the first place and then to provide support to those tobacco users who want to quit.
The history of prohibition of alcohol, for example, provides us with an idea of what might happen if we try to ban tobacco altogether.
And maybe Cannabis too…Marijuana…?
Well, I can’t talk about cannabis…
I mean the fact that there is a debate about legalizing it, even though we say it’s harmful.
There are many different questions that arise when it comes to Cannabis. What we know is that tobacco is very harmful to health, it’s very harmful to sustainable development of countries. And I am not sure whether cannabis has the same impact. It certainly has some benefits, possibly for the use in medicines, for example. So as far as I am concerned cannabis is a completely different plant, different substance altogether, and it’s very difficult to compare tobacco and cannabis, apart from saying people who use cannabis tend to smoke tobacco.
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