As cigarette smuggling in Southern Africa becomes big business, researchers have expressed concern that tobacco consumption is increasing in younger people and developing countries. Credit: Ignatius Banda/IPS

By Ignatius Banda
BULAWAYO, Zimbabwe , Jun 21 2022 (IPS)

Cigarette smuggling has emerged as one of the most lucrative enterprises between Zimbabwe and South Africa, with border authorities seizing contraband worth millions of dollars in recent years.

Last month, South African police confiscated cigarettes worth ZAR1,7 million (about USD105,000) from Zimbabwean smugglers who have taken advantage of porous border controls between the two southern African countries for years.

In November last year, another Zimbabwean was nabbed as he attempted to smuggle cigarettes worth ZAR30 million (about USD1,850,000) into South Africa, where there is a ready and expanding market for cigarettes.

The following month, another Zimbabwean was caught attempting to smuggle cigarettes worth ZAR2,6 million (USD160,300) into South Africa. The escalation of the movement of contraband highlights the complexity of not just border controls but how cigarettes and tobacco are proving to be the new gold for criminal syndicates.

As a global anti-tobacco lobby grows amid concerns of unabated tobacco-related deaths, researchers are training the spotlight on tobacco consumption and its toll on public health and national economies.

In a new report by the University of Chicago, researchers who have created a Tobacco Atlas after surveying 63 countries say global smokers now exceed 1.1 billion people.

While, according to researchers, global smoking prevalence is dropping, from 22.6 percent in 2007 to 19.6 in 2019, Africa and other developing parts of the world are recording an increase in tobacco consumption, the report says.

The findings will likely concern African governments where public health services are already struggling. The Tobacco Atlas researchers raise concerns about tobacco-related diseases and deaths in developing countries.

Tobacco-related diseases are expected to increase in future years in countries with low Human Development Index scores, the Tobacco Atlas researchers predict.

“Some African countries are seeing an increase in adult and youth smoking. What we’ve seen in Africa is the slowest decline in smoking prevalence of any region,” said Professor Jeffrey Dope, lead author of the Tobacco Atlas and a professor of public health at the University of Illinois.

“The tobacco industry is aware of this. They are working very hard to convince governments that tobacco is very important for the economy. Unfortunately, they’re having some success,” Dope said during a Zoom report launch early this month.

Further findings noted that more young girls than boys are taking a puff, with the ubiquity of social media “influencers” being a driver of the trend.

“Global progress is threatened by growing smoking rates among children aged 13 to 15 in many countries and by tobacco industry tactics such as targeting poor countries with weak regulatory environments,” the researchers said.

“We have countries where female teens smoke more than male teens and adult females, which is happening in different parts of the world,” said Violeta Vulovic, senior economist at the Institute for Health Research and Policy at the University of Chicago.

“The tobacco industry aggressively markets to children, especially through flavour products. And through social media, especially influencers, the industry clear understanding that the peer-to-peer effect is perhaps the most effective way to get kids to try smoking,” Vulovic said.

The World Health Organisation (WHO) says tobacco causes more than 8 million global deaths annually. More than “7 million of those deaths resulting from direct tobacco use, while around 1.2 million are the result of non-smokers being exposed to second-hand smoke.”

Covid-19 has only added to global health challenges that have pushed the tobacco agenda to the periphery, researchers say.

“In the wake of Covid-19, countries are prioritising public health and investing in strategies to support health and economic growth,” said Nandita Murukutla, one of the contributors to the Tobacco Atlas research.

“For countries that want to recover, tobacco control should be high on their agenda,” Murukutla said.

However, with African countries continuing to rely on tobacco for forex earnings, findings contained in the Tobacco Atlas are not likely to persuade governments to slow down the production of what across the continent has been called “green gold.”

One way to deal with the increase in smoking, the University of Chicago researchers say, is to “raise taxes on tobacco.”

“This is so that kids cannot afford to smoke. We know from decades of research that young people are extra sensitive to price,” Vulovic said.

The researchers say this has worked in other African countries to stem the illicit cigarette trade.

“Countries should look to Kenya as an example of a country that is keeping its tobacco taxes high and controlling its supply chain – little illicit trade – successfully,” Dope told IPS. “These modest investments in tax administration in Kenya have reaped huge rewards in terms of increased tax revenues, which they then reallocate to social programmes such as health and education, among others.”

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A cigarette vendor in Manila sells a pack of 20 sticks for less than a dollar. Credit: Kara Santos/IPS

By Lyndal Rowlands
UNITED NATIONS, Jan 13 2017 (IPS)

Low and middle-income countries have far fewer tobacco regulations than high-income countries and are paying the price – with bigger health and economic impacts.

Yet, according to new wide-ranging research published by the World Health Organization (WHO), tobacco companies are misleading governments, telling them that tobacco regulations will potentially harm their economies.

The research was compiled in a new monograph titled The Eonomics of Tobacco and Tobacco Control, published jointly by the WHO and the National Cancer Institute of the US-based National Institutes of Health.

Frank Chaloupka, who edited the monograph, told IPS that when low and middle income countries do implement regulations, there is usually a much bigger pay off.

“We present some new evidence in the monograph on tobacco advertising bans that shows they have a bigger effect in low- and middle-income countries than they do in high-income countries,” said Chaloupka who is also Distinguished Professor of Economics & Public Health at the University of Illinois.

“I think it’s partly because of the fact that in a lot of low- and middle-income countries they haven’t been exposed to the same information about the health consequences of tobacco use, people are more susceptible to the industry(’s positive) portrayals of tobacco,” noted Chaloupka.

For example, says Chaloupka, graphic warning labels have proven more effective in low- and middle-income countries.

“People can really see the damage caused by tobacco through the graphic warnings.” For those who have had less exposure to these warnings from other sources of information, the warnings have an even bigger impact.

Taxes on tobacco sales in low and middle countries also have a bigger impact than in high-income countries, Chaloupka added.

“Given people’s lower incomes, people are more responsive to changes in the price,” he said.

There are several reasons why low- and middle-income countries have less tobacco regulations than high-income countries, said Chaloupka, but one problematic cause is misleading arguments made by the industry:

“The industry’s arguments around things like illicit trade, impact on jobs and the broader economic impact, the impact on the poor, the impact on their tax revenues, really the economic arguments that the industry uses against tobacco control are really misleading, and for the most part, false.”

This has contributed to a widening gap between regulations in low and middle-income versus high-income countries. The gap has also widened because of how quickly high-income countries moved to implement control measures:

“We’ve seen governments get serious and really take action, and adopt strong tobacco control measures, push up taxes, ban smoking in public places, ban tobacco marketing as a result we’ve seen tobacco use falling for at least a few decades in most high-income countries.”

While some low and middle-income countries may lack the capacity to implement complex regulations, Chaloupka noted that often simpler policies can be more effective.

“The Philippines (had) a complicated tax system where we had different rates on different brands,” he said. “Over time they moved toward a significant reform in their system and they’re in the process of moving to a single uniform tax which is a lot easier to administer and much better at deterring tax avoidance and tax evasion.”

However although so-called excise taxes on tobacco products can act as a deterrent worldwide they are far from helping governments recoup the costs of tobacco use to economies and society.

“The estimate we have for the global cost is about $1.4 trillion, and less than $300 billion being generated in tax revenues,” said Chaloupka, adding that less than $1 billion of tobacco-related tax revenues is being used for tobacco control.

Chaloupka also pointed to Turkey as an example of a middle-income country that has successfully regulated tobacco use.

“If you go back a few decades the Turkish government used to be the tobacco industry in Turkey. They used to be one of the biggest growers of tobacco leaf in the world, and over time they’ve completely moved in the other direction.”

“They privatised their tobacco industry (and) they didn’t make any promises to the tobacco companies that moved into their markets, and really then did move forward with strong tobacco control policies.”

Correction: An earlier version of this article referred to “$300 million being generated in tax revenues” and “$1 million of tobacco-related tax revenues…” it should have read billion(s) not million(s).

Credit: Bigstock

By Germán Velásquez
GENEVA, Aug 22 2016 (IPS)

In a landmark decision that has been hailed as a victory of public health measures against narrow commercial interests, an international tribunal has dismissed a claim by tobacco giant company Philip Morris that the Uruguay government violated its rights by instituting tobacco control measures.

The ruling had been much anticipated as it was the first international case brought against a government for taking measures to curb the marketing of tobacco products.

Philip Morris had started proceedings in February 2010 against Uruguay at the International Centre for Settlement of Investment Disputes (ICSID) under a bilateral investment treaty (BIT) between Uruguay and Switzerland. The decision was given on 8 July 2016.

Under the BIT, foreign companies can take cases against the host state on various grounds, including if its policies constitute an expropriation of the companies” expectation of profits, or a violation of “fair and equitable treatment” These investment treaties and arbitration tribunals like ICSID have been heavily criticised in recent years for decisions favouring companies and that critics argue violate the right of states to regulate in the public interest.

In this particular case, the tribunal gave a ruling that dismissed the tobacco giant’s claims and upheld that the Uruguayan pro-health measures were allowed.

President Tabaré Vázquez of Uruguay, responding to the ruling, stated on 8 July:: “We have succeeded to prove at the International Centre for Settlement of Investment Disputes that our country, without violating any treaty, has met its unwavering commitment to defend the health of its people… From now on, when tobacco companies try to undermine the regulations adopted in the context of the framework tobacco convention with the threat of litigation, they (countries) will find our precedent.”

Germán Velásquez

Philip Morris International (PMI) started legal proceedings against Uruguay’ government at the International Centre for Settlement of Investment Disputes (ICSID), based at the World Bank, in February 2010. This was the first time the tobacco industry challenged a state in front of an international tribunal.

Philip Morris claimed that the health measures imposed by the Ministry of Health of Uruguay violated its intellectual property rights and failed to comply with Uruguay’s obligation under its bilateral investment treaty (BIT) with Switzerland.

Two specific measures were contested by Philip Morris. The first measure was the Single Presentation Requirement introduced by the Uruguayan Public Health Ministry in 2008, where tobacco manufacturers could no longer sell multiple varieties of one brand. Philip Morris had to withdraw 7 of its 12 products and alleged that the restriction to market only one variety substantially affected its company’s value.

The second measure contested by Philip Morris was the so-called “80/80 Regulation”. Under a presidential decree, graphic health warnings on cigarette packages should cover 80 percent instead of 50 percent, of the packaging, leaving only 20 percent for the tobacco companies’ trademarks and advertisement.

Uruguay adopted strict tobacco control policies to comply with the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC), in light of evidence that tobacco consumption leads to addiction, illness, and death.

According to the Ministry of Health, since Uruguay introduced its tobacco control programme in 2003, its comprehensive tobacco control campaign has resulted in a substantial and unprecedented decrease in tobacco use.

From 2005 to 2011 per person consumption of cigarettes dropped by 25.8 %. Tobacco consumption among school-going youth aged 12­17 decreased from over 30 percent to 9.2 percent from 2003 to 2011. Ministry of Health data also indicate that since smoke-free laws were introduced, hospitalization for acute myocardial infarction has reduced by 22 percent.

Since this was the first international litigation, the case is highly important for similar debates taking place in other forums, like the World Trade Organization, where some states are being challenged by other states for their tobacco control measures. It is a significant victory for a state facing commercial threats by tobacco companies fighting control measures.

The decision is supportive of states that choose to exercise their sovereign right to introduce laws and strategies to control tobacco sales in order to protect the health of their population.

This is a David against Goliath victory. The annual revenue of Philip Morris in 2013 was reported at $80.2 billion, in contrast to Uruguay”s gross domestic product of $55.7 billion. The international lawyer and practitioner in investment treaty arbitration Todd Weiler stated in a legal opinion that: “the claim is nothing more than the cynical attempt by a wealthy multinational corporation to make an example of a small country with limited resources to defend against a well-funded international legal action.”

An important aspect of the case was that the secretariats of the World Health Organization and the WHO Framework Convention on Tobacco Control (WHO FCTC) submitted an amicus brief during the proceedings.

The brief provided an overview of global tobacco control, including the role of the WHO FCTC. It set out the public health evidence underlying Uruguay’s tobacco packaging and labelling laws and detailed state practice in implementing similar measures.

This is a David against Goliath victory. The annual revenue of Philip Morris in 2013 was reported at $80.2 billion, in contrast to Uruguay''s gross domestic product of $55.7 billion
The Tribunal accepted the submission of the amicus brief on the basis that it provided an independent perspective on the matters in the dispute and contributed expertise from “qualified agencies”. The Tribunal subsequently relied on the brief at several points of the factual and legal analysis in their decision.

In accepting submission of the amicus brief the Tribunal noted that given the “public interest involved in this case”the amicus brief would “support the transparency of the proceeding”.

The Tribunal ruling upheld that Uruguay could maintain the following specific regulations:

Prohibiting tobacco companies from marketing cigarettes in ways that falsely present some cigarettes as less harmful than others.

Requiring tobacco companies to use 80% of the front and back of cigarette packs for graphic/pictures of warnings of the health danger of smoking.

According to expert Chakravarthi Raghavan there are several specific legal findings of the panel ruling, including:

1. Uruguay did not violate any of its obligations under the Switzerland/Uruguay Bilateral Investment Treaty, or deny Philip Morris any of the protections provided by that Treaty.

2. Uruguay’s regulatory measures did not “expropriate” Philip Morris’ property. They were bona fide exercises of Uruguay’s sovereign police power to protect public health.

3. The measures did not deny Philip Morris “fair and equitable treatment” because they were not arbitrary; instead, they were reasonable measures strongly supported by the scientific literature, and had received broad support from the global tobacco control community.

4. The measures did not “unreasonably and discriminatorily” deny Philip Morris the use and enjoyment of its trademark rights, because they were enacted in the interests of legitimate policy concerns and were not motivated by an intention to deprive Philip Morris of the value of its investment.

This is a landmark ruling because it supports the case that it is the sovereign right not only of Uruguay but of States in general to adopt laws and regulations to protect public health by regulating the marketing and distribution of tobacco products.

It is hoped that many other countries, which have been awaiting this decision before adopting similar regulations, will follow Uruguay’s example.President Vázquez said it is time for other nations to join Uruguay in this struggle, “without any fear of retaliation from powerful tobacco corporations, as Uruguay has done.”

Nevertheless, there is still a lot of public concern worldwide about the role that bilateral investment treaties has played in curbing the policy space of countries, including for health policies. There have also been serious concerns about the rulings made by other tribunals of ICSID and other arbitration centres, which have favoured the claims of companies and imposed high monetary awards against states. In the case of Philip Morris versus Uruguay, the tribunal’s ruling was correct in supporting the state’s right to regulate in the interest of public health. But the concerns in general are still valid. Other tribunals in other cases may or may not be so sympathetic to the public interest.

This is a reduced version of the article published in www.southcentre.int.

Excerpt:

A woman smokes a cigarette branded ‘Fortune’ at a campaign rally for Philippine President Benigno Aquino III, a smoker who has said he has no intention of quitting the habit. The Philippines has the second highest number of smokers in South-east Asia. Credit: Kara Santos/IPS

By Katie Dain
NEW YORK, May 26 2015 (IPS)

Governments are in the midst of tough talks in New York over the text of the Addis Ababa Accord, which is scheduled to be adopted at the end of the Third Conference on Financing for Development (FfD) , to be held in Ethiopia in July.

However at last report, negotiators continued to downplay a powerful mechanism that governments could use to help achieve and finance the Sustainable Development Goals (SDGs) that will replace the Millennium Development Goals (MDGs) in September: tobacco taxes.Tobacco use killed 100 million people in the 20th century and, if trends do not change, it will kill one billion people this century.

According to a recent estimate, increasing specific excise taxes on tobacco worldwide, in order to double prices, would raise about 100 billion dollars per year in revenues, in addition to the approximately 300 billion that the World Health Organization (WHO) estimates governments already collect on tobacco.

Tobacco use is the world’s leading preventable cause of death, and the one risk factor common to four major non-communicable diseases (NCDs): cancers, cardiovascular and lung disease, and diabetes.

Tobacco use killed 100 million people in the 20th century and, if trends do not change, it will kill one billion people this century. The proposed SDGs recognise the devastating impact of NCDs and the tobacco use risk factor, and set targets for reducing the deadly impacts of both.

Fear of trampling on governments’ right to decide on taxation is reportedly at the heart of the negotiators’ reluctance to recommend taxation in general as a way to generate funding for sustainable development.

Yet, 180 of the world’s governments have already agreed that tobacco taxation is an important tool to both generate revenue and save lives. Meeting as the Parties to the WHO Framework Convention on Tobacco Control (FCTC), these governments have even agreed on guidelines that set out how to tax tobacco as effectively as possible.

Notably, these guidelines, to the FCTC’s Article 6, represent the first time that governments have agreed on what makes – and what doesn’t make – good tobacco tax policy.

Raising tobacco taxes, and subsequently tobacco prices, is good for health because it reduces the amount of tobacco consumed in three ways:

• Some existing smokers quit entirely;
• Some people, mostly teenagers, are deterred from starting to use tobacco;
• Some people continue to use tobacco, but reduce how much they use each day.

As a result, tobacco sales decline; however the revenue generated by the higher taxes on the remaining products sold more than makes up for lower sales. That is why increasing tobacco taxes is a win-win for governments: good for health and good for the bottom line.

Most of the revenue would initially be generated in rich countries, as taxes and prices there are much higher to begin with, but developing countries could still raise substantial revenue.

For example, the Philippines hiked specific excise taxes in 2013, raising the average price per cigarette pack by 48 percent. Sales declined and the number of smokers dropped from 28.3 percent of adults in 2009 to 25.4 percent in 2013, while government revenue from tobacco taxes more than doubled from 702 million dollars in 2012 to 1.5 billion in 2013 .

To be effective, tobacco tax increases must be accompanied by other measures, as FCTC Article 6 guidelines point out. Governments should also:

• Implement the simplest, most efficient tax systems;
• Make regular adjustments so that tobacco products become less affordable over time;
• Tax all tobacco products consistently to avoid substitution;
• Phase out tax-free and duty-free products; and,
• Set long-term policies, which could include a tax target.

Parties to the FCTC are not alone in recognising the potential of tobacco taxation. In their recent paper on financing for sustainable development, Jeffrey Sachs and Guido Schmidt-Traub praise tobacco taxes:

“Consumption taxes on tobacco products have been shown to have a very positive impact on reducing tobacco use and improving health. Higher tobacco taxes are particularly effective at reducing consumption by vulnerable populations, particularly youth. In many countries, tobacco taxation is also an important source of government revenue and is dedicated to tobacco control activities, hospital services and other health prevention or promotion services.”

The authors also refer to a 2011 report that Bill Gates presented to a meeting of G20 leaders.

In the executive summary Gates wrote: “Among the revenue proposals I have examined, tobacco taxes are especially attractive because they encourage smokers to quit and discourage people from starting to smoke, as well as generate significant revenues. It’s a win-win for global health.”

Gates continued: “Tobacco taxes are already ubiquitous. Ninety percent of countries have some form of them. And they work. In Thailand, as cigarette taxes rose from 1994 to 2007, revenues doubled even though the number of smokers went down significantly.”

The Sustainable Development Goals provide the roadmap for creating a healthier, more equitable and prosperous world, and as such are extremely ambitious. Considerable resources will be needed for these goals to be realised in the next 15 years.

Already endorsed by a large majority of the world’s governments, and with a clear road map for implementation, tobacco taxation should be highlighted in the Addis Ababa Declaration as an effective domestic tool for financing sustainable development.

Edited by Kitty Stapp

Excerpt:

Tobacco pickers carry leaves to one of the sheds where they are cured on the Rosario plantation in San Juan y Martínez, in Vuelta Abajo, a western Cuban region famous for producing premium cigars. Credit: Jorge Luis Baños/IPS

By Ivet González
SAN JUAN Y MARTÍNEZ, Cuba , Feb 28 2015 (IPS)

“We have to wait and see,” “There isn’t a lot of talk about it,” are the responses from tobacco workers in this rural area in western Cuba when asked about the prospect of an opening of the U.S. market to Cuban cigars.

“If the company sells more, I think they would pay us better,” said Berta Borrego, who has been hanging and sorting tobacco leaves for over 30 years in San Juan y Martínez in the province of Pinar del Río, 180 km west of Havana.

The region of Vuelta Abajo, and the municipalities of San Juan y Martínez, San Luis, Guane and Pinar del Río in particular, combine ideal climate and soil conditions with a centuries-old farming culture to produce the world’s best premium hand-rolled cigars.

In this area alone, 15,940 hectares are planted every year in tobacco, Cuba’s fourth top export.

While continuing to hang tobacco leaves on the Rosario plantation, Borrego told IPS that “there is little talk” among the workers about how they might benefit if the U.S. embargo against Cuba, in place since 1962, is eased, as part of the current process of normalisation of bilateral ties.

Borrego said “it would be good” to break into the U.S. market, off-limits to Cuban cigar-makers for over half a century. And she said that raising the pay of day workers and growers would be an incentive for workers, “because there is a shortage of both female and male workers since people don’t like the countryside.”

Cuban habanos, rum and coffee represent a trade and investment opportunity for Havana and Washington, if bilateral ties are renewed in the process that on Friday Feb. 27 reached the second round of talks between representatives of the two countries.

Habanos have become a symbol of the thaw between the two countries since someone gave a Cuban cigar to U.S. President Barack Obama during a Dec. 17 reception in the White House, a few hours after he announced the restoration of ties.

Berta Borrego in the shed where she hangs green tobacco leaves to dry. For over 30 years she has dedicated herself to that task and to selecting the dry leaves for making cigars, on the Rosario plantation in the Cuban municipality of Juan y Martínez. Credit: Jorge Luis Baños/IPS

Among the first measures approved by Washington to boost trade and ties between the two countries was the granting of permission to U.S. tourists to bring back 100 dollars worth of cigars and rum from Cuba.

But the sale of habanos in U.S. shops, where Nicaraguan and Dominican cigars reign, is still banned, and U.S. businesses are not allowed to invest in the local tobacco industry here.

Furthermore, the lifting of the U.S. embargo depends on the U.S. Congress, not the Obama administration.

But when it happens, annual sales of habanos in the U.S. market are expected to climb to at least 250 million dollars, according to estimates by the only company that sells Cuban cigars, Habanos SA, a joint venture between the state-run Tabacuba and Britain’s Imperial Tobacco Group PLC.

The corporation estimates that 150 million cigars from the 27 Cuban brands could be sold, once the U.S. market opens up.

The new permission for visitors to take home 100 dollars worth of cigars was called “symbolic” by Jorge Luis Fernández Maique, vice president of the Anglo-Cuban company, during the 17th Habanos Festival, which drew 1,650 participants from 60 nations Feb. 23-27 in Havana.

“The increase in sales in Cuba won’t be big,” the businessman forecast during the annual festival, which includes tours to tobacco plantations and factories, visits to auctions for humidors – a specially designed box for holding cigars – and art exhibits, and combined cigar, wine, rum and food tastings.

In its more than 140 locations worldwide, La Casa del Habano, an international franchise, sells a pack of 20 Cohiba Mini cigarrillos for 12 dollars, while a single habano cigar costs 50 dollars.

Premium cigars are the end result of a meticulous planting, selection, drying, curing, rolling and ageing process that involves thousands of humble, weathered hands like those of day worker Luis Camejo, who has dedicated eight of his 33 years to the tobacco harvest.

During the October to March harvest, Camejo picks tobacco leaves and hangs them in the shed on the Rosario plantation. Like the others, he is reticent when asked how he and his fellow workers could benefit from increased trade with the United States. “I wouldn’t know,” he told IPS.

A benefit auction for humidors in the Habanos Festival. The festival drew 1,650 participants from 60 countries to the Cuban capital this year. Credit: Jorge Luis Baños/IPS

He said he earns 1,200 Cuban pesos (50 dollars) a month during harvest season, and a bonus in convertible pesos after the plantation owner sells the tobacco to the state-run companies.

That is more than the average of 19 dollars a month earned by employees of the state, by far the largest employer in this Caribbean island nation. But it is not enough to cover people’s needs, given that food absorbs 59 to 75 percent of the family budget, according to the Centre of Studies on the Cuban Economy.

“To reach a dominant position in markets, we have to grow from below, that is, in quality and yield, because Vuelta Abajo isn’t growing,” said Iván Máximo Pérez, the owner of the 5.4-hectare Rosario plantation, which produces 2.5 tons of tobacco leaves per hectare. “In terms of production, the sky is our limit,” he told IPS with a smile.

In his view, “tobacco is profitable to the extent that the producer is efficient.”

“The current harvests even allow me to afford some luxuries,” he admitted.

He said he continues to plant tobacco because “it’s a sure thing, since the state buys everything we produce, at fixed prices based on quality.”

Pérez, known as “El Gallego” (the Galician) among his people, because of his northern Spanish ancestry, is using new technologies on his farm, where he employs 10 men and eight women and belongs to one of the credit and services cooperatives that produce for the tobacco companies.

He has his own modern seedbed, is getting involved in conservation agriculture, plants different varieties of tobacco, uses organic fertiliser, and has cut insecticide use to 30 percent.

“I never thought I’d reach the yields I’m obtaining now,” he said. “Applying science and different techniques has made me see tobacco in a different light.”

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

By Laurent Huber
GENEVA, Feb 18 2015 (IPS)

February 27 will mark the 10th anniversary of the World Health Organisation Framework Convention on Tobacco Control (FCTC), the first global public health treaty.

Today the FCTC has 180 Parties, making it among the most widely-adopted international instruments. About 90 percent of the world’s population falls under the FCTC’s protections.

The creators of the Convention were bold in their intentions – “to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption.”

An anniversary is an opportunity to look back and reflect, and to look forward and plan. Has the FCTC lived up to its lofty goals? Are we on track to end the tobacco epidemic? Is it too soon to judge?

1 billion deaths ahead?

It is no accident that the first global, legally-binding public health effort targeted tobacco. In the absence of action, the world gloomily looked ahead to one billion deaths from tobacco consumption in the 21st century.

In addition to that depressing figure, tobacco has profoundly negative consequences for the wealth of nations and individuals, for human rights, for development and for the environment. In 10 years, have we made a dent?

Yes. The FCTC came into being at a critical time in the history of the tobacco epidemic. Consumption was moving swiftly from the developed to the developing world, and growing overall.

Everywhere, tobacco addiction was becoming a burden on the poorest, most marginalised populations.

Tobacco industry profits were staggering, dwarfing the gross domestic products of most of the countries in which they operated.

This wealth was poured back into marketing, litigation and public influence to ensure the addiction of future generations.

In 2005, when the FCTC came into force, the tobacco industry was put on notice that the world had united against it.

Numerous victories

The public health community can point to specific victories. In 2004, Ireland became the first country to ban smoking in all public and work places. They have been followed by dozens more.

Several countries have struck at the core of the industry’s business model by banning marketing – including the display of products in stores – and corporate social responsibility schemes (Mauritius), and by requiring plain packaging (Australia).

Scores of countries have introduced graphic warning labels on packaging, and there have been large tobacco tax increases in countries not previously known for their strong tobacco control policies, such as Chile and the Philippines, to name just two.

There is a protocol to address the massive problem (often perpetrated by the industry itself) of illicit trade. An increasing number of governments are using litigation to hold the industry accountable for the consequences of its products.

Mainly health ministries

But – and you knew there was going to be a “but” – sober reflection is also called for. The number of tobacco users and deaths continues to rise. The tobacco industry, the vector of the epidemic, is not on its heels: the profit of the four biggest firms was over US$36 billion in 2013.

While we have succeeded in convincing health ministries of the importance of tobacco, other government sectors lag far behind.

The implementation of the all-important FCTC Article 5.3, calling for governments to refuse to cooperate with the tobacco industry in formulating health policy, is failing miserably in all but a few countries.

And when governments bravely move forward with cutting-edge tobacco control measures, they can expect an avalanche of tobacco industry lawsuits, both domestically and through international trade agreements, chilling the political will of other governments.

Mixed results, to be certain. Should we celebrate? Absolutely! No one expected the FCTC to be an instant cure. At the outset, the curve of the epidemic was simply too steep to believe that, in 10 years’ time, it could be reversed.

We’ve made great strides.

On 27 Feb, if you have been involved in this historic endeavour, take a moment to congratulate yourself and a colleague. And then on the 28th, let’s move forward with purpose to fill in the gaps. The FCTC is the beginning, not the end, of a long and purposeful journey.

Edited by Roger Hamilton-Martin

Excerpt:

Uncontrolled woodcutting in remote areas of Zimbabwe like Mwenezi district has left many treeless fields. Credit: Jeffrey Moyo/IPS

By Jeffrey Moyo
HARARE, Feb 6 2015 (IPS)

There’s a buzz in Zimbabwe’s lush forests, home to many animal species, but it’s not bees, bugs or other wildlife. It’s the sound of a high-speed saw, slicing through the heart of these ancient stands to clear land for tobacco growing, to log wood for commercial export and to supply local area charcoal sellers.

This, despite Zimbabwe being obliged under the United Nations’ Millennium Development Goals (MDGs) to ensure environmental sustainability by the end of this year.

“The rate at which deforestation is occurring here will convert Zimbabwe into an outright desert in just 35 years if pragmatic solutions are not proffered urgently and also if people keep razing down trees for firewood without regulation,” Marylin Smith, an independent conservationist based in Masvingo, Zimbabwe’s oldest town, and former staffer in the government of President Robert Mugabe, told IPS.“The rate at which deforestation is occurring here will convert Zimbabwe into an outright desert in just 35 years if pragmatic solutions are not proffered urgently” – Marylin Smith, independent conservationist based in Masvingo, Zimbabwe

According to the United Nations Environment Programme (UNEP), Zimbabwe lost an annual average of 327,000 hectares of forests between 1990 and 2010.

Smith blamed Zimbabwe’s deforestation on the growing numbers of tobacco farmers who were cutting “millions of tonnes of firewood each year to treat the cash crop.”

According to the country’s Tobacco Industry Marketing Board, Zimbabwe currently has 88,167 tobacco growers, whom environmental activists say are the catalysts of looming desertification here.

“Curing tobacco using huge quantities of firewood and even increased domestic use of firewood in both rural and urban areas will leave Zimbabwe without forests and one has to imagine how the country would look like after the demise of the forests,” Thabilise Mlotshwa, an ecologist from Save the Environment Association, an environmental lobby group here, told IPS.

“But really, it is difficult to object to firewood use when this is the only energy source most rural people have despite the environment being the worst casualty,” Mlotshwa added.

Zimbabwe’s deforestation crisis is linked to several factors.

“There are thousands of timber merchants who have no mercy with our trees as they see ready cash in almost every tree and therefore don’t spare the trees in order to earn money,” Raymond Siziba, an agricultural extension officer based in Mvurwi, a district approximately 100 kilometres north of the Zimbabwean capital Harare, told IPS.

According to the Zimbabwe National Statistics Agency (ZimStat), there were 66,250 timber merchants nationwide last year alone.

Deforestation is a complex issue. A recent study by the Food and Agriculture Organization (FAO) reported that during the decade from 1980 to 1990, the world’s tropical forests were reduced by an average of 15.4 million hectares per year (an 0.8 percent annual rate of deforestation).

The area of land cleared during the decade is equivalent to nearly three times the size of France.

Developing countries rely heavily on wood fuel, the major energy source for cooking and heating. In Africa, the statistics are striking: an estimated 90 percent of the entire continent’s population uses fuelwood for cooking, and in sub-Saharan Africa, firewood and brush supply approximately 52 percent of all energy sources.

Zimbabwe is not the only sub-Saharan country facing a crisis in its forests. A panel run by the United Nations and the African Union and led by former South African President Thabo Mbeki found that in Mozambique thousands more logs were exported to China than were legally reported.

Disappearing forest cover is a particular problem in Ghana, where non-timber forest products provide sustenance and income for 2.5 million people living in or near forest communities.

Between 1990 and 2005, Ghana lost over one-quarter of its total national forest cover. At the current rate of deforestation, the country’s forests could completely disappear in less than 25 years. Current attempts to address deforestation have stalled due to lack of collaboration between stakeholders and policy makers.

In west equatorial Africa, a study by Greenpeace has called logging the single biggest threat to the Congo Basin rainforest. At the moment, logging companies working mostly in the Democratic Republic of the Congo (DRC) are busy cutting down trees in over 50 million hectares of rainforest, or an area the size of France, according to its website.

An estimated 20 to 25 percent of annual deforestation is thought to be due to commercial logging. Another 15 to 20 percent is attributed to other activities such as cattle ranching, cash crop plantations and the construction of dams, roads, and mines.

However, deforestation is primarily caused by the activities of the general population. As the Zimbabwe economy plummets, indigenous timber merchants are on the rise, battling to eke a living, with environmentalists accusing them of fuelling deforestation.

For many rural dwellers, lack of electricity in most rural areas is creating unsustainable pressures on forests in Zimbabwe.

“Like several other remote parts of Zimbabwe, we have no electricity here and for years we have been depending on firewood, which is the main source of energy for rural dwellers even for the past generations, and you can just imagine the amount of deforestation remote areas continue to suffer,” 61-year-old Irene Chikono, a teacher from Mutoko, 143 kilometres east of Harare, told IPS.

Even Zimbabweans with access to electricity are at the mercy of erratic power supplies from the state-owned Zimbabwe Electricity Supply Authority (ZESA), which is failing to meet electricity demand owing to inadequate finances to import power.

“With increasing electricity outages here, I often resort to buying firewood from vendors at local market stalls, who get this from farms neighbouring the city,” 31-year-old Collina Hokonya, a single mother of three residing in Harare’s high density Mbare suburb, told IPS.

Government claims it is doing all it can to combat deforestation but, faced with this country’s faltering economy, indigenous timber merchants and villagers say it may be hard for them to refrain from tree-felling.

“We are into the timber business not by choice, but because of joblessness and we therefore want to make money in order to survive,” Mevion Javangwe, an indigenous timber merchant based in Harare, told IPS.

“A gradual return of people from cities to lead rural life as the economy worsens is adding pressure on rural forests as more and more people cut down trees for firewood,” Elson Moyo, a village head in Vesera village in Mwenezi, 144 kilometres south-west of Masvingo, told IPS.

“Politicians are plundering and looting the hardwood forest reserves since they own most sawmills, with their relatives fronting for them,” Owen Dliwayo, a civil society activist based in Chipinge, an eastern border town of Zimbabwe, told IPS.

“For all the forests that politicians plunder, they don’t pay a cent to council authorities and truly how do people get motivated to play a part in conserving hardwood forests?” Dliwayo asked.

“We will only manage to fight deforestation if government brings electricity to our doorsteps because without electricity we will keep cutting down trees for firewood,” said Chikono.

Edited by Lisa Vives/Phil Harris   

Markets are critical to the success of Zimbabwe’s smallholder farmers. Credit: Busani Bafana/IPS

By Busani Bafana
BULAWAYO, Zimbabwe, Jan 29 2015 (IPS)

With agriculture as one of the drivers of economic growth, Zimbabwe needs to invest in the livelihoods of smallholder farmers who keep the country fed, experts say.

Agriculture currently contributes nearly 20 percent to Zimbabwe’s gross domestic product (GDP), due largely to export earnings from tobacco production. More than 80,000 farmers have registered to grow the plant this season.

But, even as tobacco harvests expand, food shortages continue to plague Zimbabwe, most dramatically since 2000 when agricultural production missed targets following a controversial land reform that took land from white farmers and distributed it to black Zimbabweans.Food shortages continue to plague Zimbabwe, most dramatically since 2000 when agricultural production missed targets following a controversial land reform that took land from white farmers and distributed it to black Zimbabweans

Depressed production has been blamed on droughts, but poor support to farmers has also contributed to food deficits and the need to import the staple maize grain annually.

Last year, the World Food Programme (WFP) reported that “hunger is at a five-year high in Zimbabwe with one-quarter of the rural population, equivalent to 2.2 million people, estimated to be facing food shortages …”

The report was dismissed by Zimbabwe’s deputy agricultural minister, Paddington Zhanda, who said that “the numbers [of those in need] are exaggerated. There is no crisis. If there was a crisis, we would have appealed for help as we have in the past. We are in for one of the best harvests we have had in years.”

WFP had planned to reach 1.8 million people out of the 2.2 million hungry people during the current period, but funding shortages meant that only 1.2 million were helped.

Last year, the government stepped in with maize bought from neighbouring countries. That year, Zimbabwe topped the list of maize meal importers, with imports from South Africa at 482 metric tons between July and September 2014. Only the Democratic Republic of Congo imported more maize meal during that time.

Agricultural economist Peter Gambara, who spoke with IPS, estimated that over one billion dollars is required to reach a target of two million hectares planted with maize.

“It costs about 800 dollars to produce a hectare of maize, so two million hectares will require about 1.6 billion dollars,” he said.

“However, the government only sponsors part of the inputs required, through the Presidential Inputs Scheme, the rest of the inputs come from private contractors, the farmers themselves, as well as from remittances from children and relatives in towns and in the diaspora.”

These inputs include fertilizer and maize seed. Zimbabwe Commercial Farmers’ Union president Wonder Chabikwa said he was worried that many farmers could fail to purchase inputs on the open market due to liquidity problems. Totally free inputs were ended in 2013.

Linking agriculture to the reduction of poverty was one of the first Millennium Development Goals (MDGs) with a target of cutting poverty in half by 2015. In fact, all MDGs have direct or indirect linkages with agriculture. Agriculture contributes to the first MDG through agriculture-led economic growth and through improved nutrition.

In low-income countries economic growth, which enables increased employment and rising wages, is the only means by which the poor will be able to satisfy their needs sustainably.

Smallholder farmers in Zimbabwe need adequate and appropriate inputs to improve their productivity. Credit: Busani Bafana/IPS

“Government should invest in irrigation, infrastructure like roads and storage facilities,” Gambara told IPS. “By supplying inputs through the Presidential Inputs Scheme, Government has done more than it should for small-scale farmers. This scheme resulted in the country achieving a surplus 1.4 million tonnes of maize last year.”

The surplus was linked, explained Agriculture Minister Joseph Made, to good rainfall.

Marketing of their produce is the biggest challenge facing farmers, said Gambara, who recommended the regulation of public produce markets like Mbare Musika in Harare through the Agricultural Marketing Authority (AMA).

Gambara maintains that the government should provide free inputs to the elderly, orphaned and other disadvantaged in society and consider loaning the rest of the small-scale farmers inputs that they will repay after marketing their crops.

“That will help the country rebuild the Strategic Grain Reserve (SGR), managed by the Grain Marketing Board,” he said. “However, the government has not been able to pay farmers on time for delivered produce and this is an area that it should improve on. It does not make sense to make farmers produce maize if those farmers fail to sell the maize.”

In the Maputo Declaration on Agriculture and Food Security in Africa of 2003, African heads of state and governments pledged to improve agricultural and rural development through investments. The Maputo Declaration contained several important decisions regarding agriculture, but prominent among them was the “commitment to the allocation of at least 10 percent of national budgetary resources to agriculture and rural development policy implementation within five years”.

Only a few of the 54 African Union (AU) member states have made this investment in the last 10 years. These include Burkina Faso, Ghana, Guinea, Mali, Niger, Ethiopia, Malawi and Senegal.

According to Gambara, as a signatory to the Maputo Declaration, Zimbabwe should have done more to channel resources to agriculture since 2000 when the country embarked on the second phase of land reform.

“Most of these (new) black farmers did not have the resources and knowledge to farm like the previous white farmers and such a scenario would demand that the government invests in research and extension to impart knowledge to the new farmers as well as provide schemes that empower these farmers, for example through farm mechanisation and provision of inputs,” he said.

Everson Ndlovu, development researcher with the Institute of Development Studies at Zimbabwe’s National University of Science and Technology, told IPS that government should invest in dam construction, research in water harvesting technologies, livestock development, education and training, land audits and restoration of infrastructure.

Ndlovu said there were signs that European and other international financial institutions were ready to assist Zimbabwe but a poor political and economic environment has kept many at a distance.

“The political environment has to change to facilitate proper business transactions, we need to create a conducive environment for business to play its part,” said Ndlovu. “Government should give farmers title deeds if farmers are to unlock resources and funding from local banks.”

Economic analyst John Robertson asked why the government should finance farmers which would be unnecessary if it had allowed land to have a market value and ordinary people to be land owners in order to use their land as bank security to finance themselves.

“Ever since the land reform, we have had to import most of our food,” Robertson told IPS. “Government should be spending money on infrastructural development that would help agriculture and other industries.”

Before the land reform, continued Robertson, Zimbabwe had nearly one million communal farmers, a number that increased by about 150,000 under Land Reform A1 and A2 allocations.

‘A1’ farms handed out about 150,000 plots of six hectares to smallholders by dividing up large white farms, while the ‘A2’ component sought to create large black commercial farms by handing over much larger areas of land to about 23,000 farmers.

“Only a few farms are being run on a scale that would encompass larger hectarage and that is basically because the farmers cannot employ the labour needed if they cannot borrow money,” Robertson said.

“Loans are needed to pay staff for the many months that work is needed but the farm has no income, so most smallholders work to the limits of their families’ labour input. That keeps them small and relatively poor.”

Edited by Lisa Vives/Phil Harris   

In Sri Lanka’s poverty-stricken Northern Province, residents say they must stretch the few resources they have in order to survive. Credit: Amantha Perera/IPS

By Amantha Perera
ODDUSUDDAN, Sri Lanka, Aug 24 2014 (IPS)

In this dust bowl of a village deep inside Sri Lanka’s former conflict zone, locals will sometimes ask visitors to rub their palms on the ground and watch their skin immediately take on a dark bronze hue, proof of the fertility of the soil.

Village lore in Oddusuddan, located in the Mullaitivu district, some 338 km north of the capital Colombo, has it that the land is so fertile, anything will grow here. But Mashewari Vellupillai, a 53-year-old single mother, knows that rich farmland alone is not enough to ensure a viable future.

Thirty years of civil war in the Northern Province, where the separatist Liberation Tigers of Tamil Eelam (LTTE) were defeated by government forces in May 2009, are not easily forgotten, and five years of peace have not yet resulted in prosperity for many residents in this former battleground.

“You have to do things on your own otherwise there will be no money." -- Velupillai Selvarathnam, a former lorry driver from Mullaitivu
Schemes to provide relief and employment opportunities for civilians and rehabilitated combatants are few and far between, and several villagers tell IPS that survival here is dependent on creative thinking to make the most of the few income generation options available.

At least 30 percent of the population in the province derives their income from agriculture or related areas, and a 10-month-old drought is wrecking havoc on farmers who tend to focus on a single crop at a time.

After taking a 50,000-rupee (384-dollar) financial hit following a failed harvest last year, Vellupillai has diversified the two-acre plot that surrounds her half-built house and planted everything from onions and bananas to cassava, aubergines and tobacco.

In addition, she has leased out her two acres of paddy land, and hires workers intermittently to see to its harvest.

Vellupilla’s most profitable crop is tobacco; a single, good-quality leaf fetches about 10 rupees (0.77 dollars), giving her an income of about 10,000 rupees (about 76 dollars) monthly.

“I can’t take a chance by depending on one source of income, I have to be sure that I have alternatives,” she tells IPS, citing cases of villagers here falling victim to a buyers’ market, as was the case in 2011 when most Oddusuddan residents grew aubergines and were forced to part with their yields for dirt cheap prices as buyers from Vavuniya Town, 60 km south, manipulated the market.

Over 400,000 people like Vellupillai have returned to the north after fleeing the last days of fighting between armed forces and the LTTE.

Since then, the government has poured over three billion dollars into massive infrastructure projects in the region, including rail-links, new roads and electrification schemes.

But despite such impressive figures, life in general remains hard. Poverty is rampant according to the latest government figures released for the first quarter of this year.

Four of the five districts that make up the province recorded rates higher than the national figure of 6.7 percent.

Three of them – Kilinochchi, Mannar and Mullaittivu – recorded poverty rates of 12.7 percent, 20.1 percent and 28.8 percent respectively, according to the latest government poverty head count released in April. Experts say this comes as no surprise, since these districts were hit hardest by the war, and are suffering the worst of its long-term impacts.

Unemployment also remains above national levels. There are no official figures for full unemployment rates in the Northern Province, but in the two districts where figures are available – Kilinochchi at 9.3 percent and Mannar at 8.1 percent – they were over twice the national rate of four percent.

Economists working in the region feel that unemployment could be as high 30 percent in some parts of the province.

A dearth of proper housing adds to the troubles of the north, with only 41,000 out of a required 143,000 houses being handed over to returning residents, while some 10,500 homes are still under construction.

According to UN Habitat, initial funding was for 83,000 units, including those already built, but no funds are available for the remaining 60,000 homes.

“Those who can make the situation work for them, or use what they have in them […] will fare better,” Sellamuththu Srinivasan, the additional district secretary for the Kilinochchi District, told IPS.

That is precisely what Velupillai Selvarathnam, a former lorry driver from Mullaitivu, has done.

Since the war’s end, he rents a small vehicle and commutes between Colombo and his hometown, covering a distance of over 300 km each week to bring ready-made garments from the capital to his small shop close to the town of Puthukkudiyiruppu.

“I can make a 25,000-rupee profit [about 192 dollars] every month,” he told IPS.

That is good money, especially if it is constant in a district that is one of the poorest five in the country and where the average monthly income is less than 4,000 rupees (about 30 dollars).

Selvarathnam, who has a deep scar on the side of his chest running down to his abdomen caused by a shell injury, tells IPS, “You have to do things on your own otherwise there will be no money.” His next aim is to travel to India to purchase garments in bulk, so that he can cut down on costs even more.

Like him, Velvarasa Sithadevi, another resident of Oddusudan has her hands full. She has to take care of a 25-year-old son who suffers from shellshock and a husband who is yet to recover from his wartime injuries.

When the family received a 25,000-rupee (192-dollar) grant from the U.N. Refugee Agency upon returning to their home village in 2011, Sithadevi invested the money in setting up a small shop. “We live in the back room, that is enough for us,” she told IPS.

Sithadevi is a good cook, and sells food products in her roadside shop. “It is a good business, especially when there are people working on roads and other construction [sites],” she stated, adding that she makes about 4,000 rupees (30 dollars) a day.

But for every single individual success story, there are thousands of others unable to break out of the suffocating cycle of poverty in the region.

Public official Srinivasan said that if assistance were to increase, the overall situation would improve. That, however, is unlikely to happen any time soon.

“The next option is to attract private sector investment […]. We are talking with companies in the south, there is some progress, but we need more companies to come in,” he stressed.

Edited by Kanya D’Almeida

By 2030, 80 percent of deaths from tobacco will be in the poorest countries in Asia, Africa and South America. Credit: Bigstock

By Laurent Huber
GENEVA, Jul 7 2014 (IPS)

Undeniably, the Millennium Development Goals (MDGs) helped lift specific health concerns onto the global agenda.

For example, maternal mortality, which is addressed in MDG 5, declined 45 percent from 1990 to 2013, while deaths of children under five (MDG 4) dropped from 12.4 million to 6.6 million worldwide from 1990 to 2012, (both statistics from the World Health Organisation).If trends do not change, by 2030 NCDs will be the leading global cause of disability.

Despite those impressive advances, the world is facing new development challenges. For this reason, the Sustainable Development Goals (SDGs) that will replace the MDGs in 2015 must expand the list of health goals to include non-communicable diseases (NCDs) – the world’s #1 killer.

NCDs account for 60 percent (35 million) of all deaths. They include cancers, cardiovascular and lung disease, and diabetes, but they are not – as many people believe – ‘lifestyle’ diseases afflicting old people in rich countries. The largest burden – 80 percent, or 28 million deaths – occurs in low-middle-income countries (LMICs), making NCDs a major cause of poverty and an urgent development issue.

If trends do not change, by 2030 NCDs will be the leading global cause of disability. In addition, between 2011 and 2031 the diseases would have cost the world economy 30 trillion dollars, the equivalent of 98,400 dollars for every person in the United States.

Tobacco is the leading risk factor for NCDs. One hundred million people died from tobacco-related disease in the 20th century, and unless the global community acts decisively, one billion people will die in the 21st century. By 2030, 80 percent of deaths from tobacco will be in the poorest countries in Asia, Africa and South America.

In 2011, world leaders assembled for the first time at the United Nations to discuss the growing NCDs epidemic. The Political Declaration they issued concluded that the burden of NCDs “undermines social and economic development throughout the world”.

It noted that NCDs strike people in LMICs during their prime working years, and that close to half of all NCD deaths in these countries occur below the age of 70, and nearly 30 percent under age 60. As well, most NCDs deaths are preceded by long periods of ill health.

These illnesses, and early deaths of families’ main income earners, result in loss of productivity, which drags down economic growth and development.

Social determinants, such as education and income, influence people’s vulnerability to NCDs and exposure to risk factors. Individuals of lower education and economic status are increasingly exposed to NCDs risks and are disproportionately affected by them. For example, in countries such as Bangladesh, India and the Philippines, tobacco use is highest among the least educated and poorest segments of the populations.

At the same time, having an NCD may also contribute to social inequalities. The financial burden associated with these diseases increases the risk that families will be unable to send children to school and, under-educated, the risk grows that those children will live in poverty for the rest of their lives.

What can be done? There are four modifiable risk factors for the main NCDs: unhealthy diets, physical inactivity, harmful use of alcohol and tobacco use. While work continues to adopt global tools to tackle the first three factors, there is consensus on how to fight the tobacco epidemic.

In 2003, the world’s governments adopted the WHO Framework Convention on Tobacco Control, the first modern-day public health treaty. It contains a number of measures that Parties commit to implement, including: smoke-free public spaces, pictorial health warnings on packages, price and tax measures to increase the price of tobacco – which discourages consumption – and complete bans on tobacco advertising.

Today the FCTC has 178 Parties, representing nearly 90 percent of the world’s population. In the battle against NCDs, “There is no other ‘best buy’ for the money on offer”, said WHO Director-General Margaret Chan in 2011.

Recognising the potential of global tobacco control, the Political Declaration of the 2011 NCD Summit:

• Urged greater efforts from countries to implement the FCTC;
• Called on countries that are not Parties to the FCTC to accede to the Convention;
• Noted the importance of tobacco taxation as a strategy at the national level;
• Recognised the irreconcilable differences between the tobacco industry and public health policy.

Building on the Declaration, in May 2013 the World Health Assembly endorsed the Global Action Plan for the Prevention and Control of NCDs, 2013-2020. It includes a target for cutting tobacco use: a 30 percent relative reduction in smoking prevalence by the year 2025.

A stand-alone goal, Attain healthy lives for all, has been proposed for the SDGs. Its sub-goals include: “By 2030 reduce substantially morbidity and mortality from non-communicable diseases (NCDs) through prevention and treatment…” and “Strengthen implementation of the Framework Convention on Tobacco Control in all countries who have ratified the Convention and urge countries that have not ratified it to ratify and implement it”.

Including NCDs and the FCTC in the development goals that will be announced by the UN General Assembly in 2015 will also ensure that battling the tobacco epidemic becomes a national priority, and prevent millions of premature deaths.

Laurent Huber is Director of the Framework Convention Alliance.

Madeline Murambwi's tobacco crops on her 32-hectare farm in Zimbabwe's Mashonaland East province. She is one of this southern African nation's emerging female tobacco tycoons. Credit: Jeffrey Moyo/IPS

By Jeffrey Moyo
HARARE, May 11 2014 (IPS)

Madeline Murambwi sits behind the wheel of her brand new Toyota Land Cruiser, threading her way through the traffic in Zimbabwe’s capital, Harare. She’s on her way back from the tobacco auction floors where she just pocketed thousands of dollars.

“Tobacco farming is a brisk business here. Before joining it, I didn’t realise men were making lots of money out of this leaf. I have made great economic strides in my life,” Murambwi tells IPS, adding that she now also invests in property.“Women here are fast becoming tobacco tycoons, holding their heads high in the midst of male tobacco farmers..." -- Zimbabwe Association of Women Tobacco Farmers chairperson Grace Mapuranga

“So far I have made 42,000 dollars through tobacco sales, with more sales to come,” says Murambwi, 47, who has a 32-hectare tobacco farm in Zimbabwe’s Mashonaland East Province.

In 2012, Murambwi ventured into tobacco farming and her business continues to grow each season.

“Faced with responsibilities I couldn’t avoid as a single parent, I turned to tobacco farming as a way to generate a more reliable income,” Murambwi says.

On the Zimbabwean market, a kilogram of tobacco can sell from between 2,67 and 2,91 dollars, depending on the quality.

According to independent statistics from the Zimbabwe Association of Women Tobacco Farmers (ZAWTF), 85,006 farmers, 32 percent of whom are women, registered to grow tobacco during the 2013 to 2014 season.

The government’s Tobacco Industry Marketing Board, however, estimates that there are currently 110,000 small-scale tobacco farmers, of which 39,5 percent are women.

“The increase in women tobacco farmers here is actuated by an increase in the number of single mothers, either widowed or divorced, pressed hard with financial responsibilities of looking after their children … they are fast finding tobacco growing a panacea to turning around their fortunes,” ZAWTF chairperson Grace Mapuranga tells IPS.

“Women here are fast becoming tobacco tycoons, holding their heads high in the midst of male tobacco farmers, who traditionally dominate the field of tobacco farming,” adds Mapuranga.

Elsie Msipa, 38, is one of Zimbabwe’s farmers who has seen her fortunes turned around by tobacco farming. Credit: Jeffrey Moyo/IPS

Elsie Msipa, 38, is one of those farmers who has seen her fortunes turned around by tobacco farming.

“Tobacco has changed my economic fortunes for the better. I now own clothing shops around Harare,” Msipa tells IPS.

She says her success if partly in thanks to the Ministry of Agriculture, Mechanisation and Irrigation Development, which has provided ”expert knowledge concerning growing tobacco and assistance from different tobacco experts.”

According to the agriculture ministry, the tobacco industry accounts for 40 percent of exports.

The ZAWTF estimates Zimbabwe’s 2013 tobacco exports at 771 million dollars, with women farmers contributing 25 percent of the total exported leaf. The Food and Agriculture Organisation of the United Nations ranks the country as one of the major tobacco exporters in the world. The leaf is exported to countries like China, Belgium, United Arab Emirates, South Africa, Russia, Hong Kong, Sudan and Malaysia.

Behind the success of these new tobacco barons are civic organisations.

“We provide support networks to these women, ensuring they have access to resources and skills training and development,” Phides Mazhawidza, director of Women Farmers, Land and Agricultural Trust, tells IPS.

“More often women lack support networks to assist them effectively utilise the land and market their produce. We create collaborations between women farmers and other organisations, government and private partners to enable them get the best out of their land,” adds Mazhawidza.

Independent economist Artwell Jamela tells IPS: “Women tobacco farmers are bearing positive results on the country’s struggling economy, where tobacco accounts for 10.7 percent of Zimbabwe’s GDP.”

Jamela says as the number of economically-active women in the informal sector increases, it could result in female tobacco farmers overtaking their male counterparts as more Zimbabwean men are formally employed than women.

However, the Gender Links 2013 Barometer on Zimbabwe reported that although Zimbabwe’s economic framework calls for women’s participation in key sectors of the economy, there are no gender-responsive policies in the agriculture and mining sectors.

But a government official from the Ministry of Gender and Women Affairs and Community Development told IPS on the condition of anonymity that this would soon change.

“Plans are at an advanced stage for the government to align legal frameworks that would ensure equal opportunities between men and women in agriculture and mining ahead of the looming deadline of the 2015 U.N. Millennium Development Goals,” the official said.

A patient being treated at the Regional Cancer Centre in Thiruvananthapuram, India. Credit: K.S. Harikrishnan/IPS

By Kanya D'Almeida
UNITED NATIONS, Apr 9 2014 (IPS)

Few people in the world can claim to be untouched by cancer. If not personally battling it in one form or another, millions are at this very moment sitting beside loved ones fighting for their lives, visiting friends recovering from chemo, or researching the latest treatments for their relatives.

The forecast by the world’s leading cancer research organisation predicts that things will only get worse. The World Cancer Report 2014 says we can expect a 70 percent increase in new cancer cases over the next 20 years, hitting 25 million by the year 2025.

Produced every five years by the International Agency for Research on Cancer (IARC), a specialised agency of the Geneva-based World Health Organisation (WHO), the 632-page report noted that new cancer cases rose from 12.7 million in 2008 to 14.1 million in 2012. The same year recorded 8.2 million cancer-related deaths globally.

Increasingly, the disease is gaining a foothold in low- and middle-income countries that have neither the experience nor the financial resources to deal with it.

A full 60 percent of cancer cases now occur in Asia, Africa and Central and South America, the same regions that account for 70 percent of cancer-related deaths.

Gauging the ‘Cancer Divide’

Experts from around the world say that, when it comes to cancer, developing countries are caught between the devil and the deep blue sea.

On the one hand, they continue to experience high rates of infection-related cancers like cervical, stomach and liver cancer, all of which are associated with poverty: lack of access to vaccines, an absence of screening facilities, and inadequate treatment options.

On the other hand, cancer associated with a wealthier lifestyle – such as cancers of the lung, breast and large bowel, which are linked to increased consumption of alcohol, tobacco and processed foods – are also on the rise in the ranks of these countries’ burgeoning middle classes.

For instance, the American Cancer Society reported just a few months ago that Africa is witnessing an “alarming rise” in tobacco use, with the number of adult smokers expected to skyrocket “from 77 million to 572 million by 2100 if new policies are not implemented and enforced.”

Evan Blecher, director of the international tobacco control research programme at the American Cancer Society and author of the report ‘Tobacco Use in Africa’, attributes the rise to multiple factors, economic growth being a primary one.

“African economies are growing faster and more consistently now than any time in the last 50 years,” Blecher told IPS from his native Cape Town. “Economic growth and development increases tobacco use because of higher disposable incomes.

“Some of the countries where we have seen the biggest increases include Angola, the Democratic Republic of the Congo, Ethiopia, Madagascar, Mozambique, Senegal, and Nigeria – these countries are amongst the most rapidly growing countries in Africa and the world,” he added.

This ‘double burden’ – of cancers associated with both growth and poverty – threatens to cripple healthcare systems already stretched too thin.

The International Atomic Energy Agency found that low- and middle-income countries account for 85 percent of the world’s population but possess just 4,400 megavoltage machines, less than 35 percent of global radiotherapy capacity.

Keeping in mind that roughly 50 to 65 percent of all cancer patients eventually require some type of radiotherapy, the huge dearth spells bad news for developing countries. According to the IAEA, some 23 countries – most of them in Africa – with populations of over one million people do not have a single radiotherapy machine.

Assessing inequality

R. Sankaranarayanan, special advisor on cancer control at the IARC, told IPS that the cancer divide does not only separate nations at various levels of development, but also affects different populations within countries.

“The wide disparities in survival outcomes from breast and large bowel cancer between rural and urban areas in countries such as China, India, Thailand, etc. and… breast cancer survival disparities between the black and white populations in the United States… are good examples,” he said.

The latter has been widely reported in the U.S., with researchers and medical professionals lamenting the 8.8 percent gap between breast cancer-related mortality rates for black and white women.

Data released last month by the American Cancer Society suggests that poverty fuels disparities in cancer diagnoses and mortality rates.

Given that obesity is a huge problem in African American communities, affecting roughly 50 percent of all adults compared to 35 percent of white adults, it is unsurprising that African Americans experience a higher incidence of colorectal cancer, which is associated with overconsumption of unhealthy, processed foods.

In India, where over a million new cancer cases were reported in 2012 and nearly a million people died from some form of the disease, a huge diversity of lifestyles seems to account for the gaping cancer divide.

For instance, the highest incidence of cancer was recorded in the northeastern state of Mizoram, one of the fastest growing economies in India, while the lowest incidence was reported in Barshi, a rural registry in the western state of Maharashtra, where much of the population is engaged in agricultural activity.

Silvana Luciani, advisor on cancer prevention and control in the department of non-communicable diseases and mental health at the Pan American Health Organisation (PAHO), says interregional disparities in health services also result in lopsided mortality rates.

“In Central America you see cervical cancer mortality rates of about 15 or 18 per 100,000 whereas in North America the cervical cancer mortality rate will be around two, which is significantly lower,” she told IPS.

“This has a lot to do with better pap smear screening programmes in North America that have been in existence for a long time and are of a much higher quality than in Central America, where healthcare systems are much more fragmented,” she said.

Sankaranarayanan says countries such as South Korea, Turkey, Malaysia, India, Ghana, Morocco, Brazil, Chile, Colombia, Costa Rica and Mexico are “increasingly introducing universal health care coverage or national insurance schemes that target the most socio-economically downtrodden populations… although the rapidly ageing populations and continued introduction of high cost technologies for cancer care are increasing pressures on these systems.”

Excerpt:

Yamilé Venero strings tobacco leaves onto long poles for natural curing on the Valle farm, in the municipality of San Juan y Martínez, the centre of production of this preeminently Cuban crop. Credit: Jorge Luis Baños/IPS

By Ivet González
SAN JUAN Y MARTÍNEZ, Cuba, Mar 6 2014 (IPS)

Near the close of the harvest , local people in the Cuban municipality of San Juan y Martínez, which boasts the finest tobacco plantations in the world, are seeing their hopes of a plentiful season dashed by unexpected winter rains.

“It’s been a bad year, a rebellious one as we call it. There was a lot of rain, which rots the plants. Tobacco needs sun during the day and cold at night,” 67-year-old Dámaso Rodríguez, a worker on the Valle plantation in this municipality, 180 kilometres west of Havana, in the province of Pinar del Río, told IPS.

“We are late with the farm chores,” said Yamilé Venero, a young tobacco worker on the same plantation. “It’s not worth planting again,” added María Teresa Ventos, a 54-year-old woman who comes every season to string the tobacco leaves onto long poles for drying in this agricultural industry which is a source of temporary jobs for women.

Since November, when the season started, there has been too much rain in the province which was expected to supply 70 percent of the 26,400 tonnes of tobacco leaf forecast for the 2013-2014 harvest. San Juan y Martínez and the neighbouring municipality of San Luis were severely affected; between them they provide 86 percent of the tobacco for the prized and costly Havana cigars.

Local sources reported the loss of 813 hectares in Pinar del Río and partial damage in a further 1,000 hectares, out of the provincial plan for 15,000 hectares. Many farms had to uproot their tobacco plants and replant three times over.

Tobacco is Cuba’s third export, after nickel and medical products.

In 2013, the country earned 447 million dollars from tobacco, eight percent more than in 2012 when the Anglo-Cuban corporation Habanos S.A. made 416 million dollars. It is the sole vendor of Cuban cigars worldwide, trading in 160 countries, with most of its business in Europe, although cigars are doing well in Asia and the Middle East.

The storm clouds over Pinar del Río, in the west of the country, may hurt sales this year, along with other problems like tough anti-tobacco laws in Europe and the economic blockade imposed by the United States on Cuba because of the of conflict between Washington and Havana that has gone on for half a century.

To weather the damage done by the downpours, plantations in Pinar extended their planting season, which usually ends in January, by 45 days, and delayed other major tasks of the current tobacco harvest. They have also resorted to harvesting “capadura” (lower quality) leaf and plant regrowth, in order to maximise production.

On the Valle plantation, 12 skilled men continue to harvest tobacco leaves and take them to a high-roofed wooden barn at one side of the estate. Inside, 12 women string the leaves in bunches and arrange them on long poles which are then hung in tiers right up to the slanted roof for traditional curing (controlled drying) in air.

“After all, the tobacco is good quality, but not as good as before,” Rodríguez said. This veteran tobacco grower, the son and grandson of peasant farmers, is concerned that the strange weather in his birthplace “is no longer the same” as it was three decades ago.

The unique combination of temperature, soil and humidity in the Vuelta Abajo region, in the west of the province, is essential for the development of the best handmade premium cigars on the planet, a process that involves close to 190 different operations.

Only here can all the types of leaf be grown that are used in making cigars, the successors to the rolled leaves smoked by native people on the island of Cuba when Spanish colonists arrived in 1492.

Dayana Hernández and Aliet Achkienazi, researchers at the state Meteorology Institute, have forecast that this territory will become warmer every decade this century, unsettling the conditions that give Cuban cigars their exclusive taste, aroma and texture and have earned them their protected designation of origin (PDO).

The PDO protects agricultural products that have a quality and characteristics fundamentally or exclusively due to geographical factors in their place of origin. In this case it is reserved for cigars of over three grams, made in Cuba according to traditional methods from varieties of Cuban black tobacco.

The study “Impacto del cambio climático sobre el cultivo del tabaco en la zona de Pinar del Río, Cuba” (Impact of climate change on tobacco cultivation in the area of Pinar del Río, Cuba) analysed particularly productive districts in the province, including San Juan y Martínez and San Luis.

On the basis of future climate scenarios, the authors forecast that rising temperatures will not cause great harm in the next few decades, but later on, as warming increases, crop yields will decline. However, in the north of the area they studied, the climate will be more stable and it is less likely that temperatures will exceed 25 degrees Celsius.

The study found that “the impact of climate change can be mitigated in conditions compatible with the sustainable development” of the delicate tobacco leaf. It recommended “further research” into the effects of imbalances in the rainfall patterns on the plantations.

The experienced eye of Francisco José Prieto, the manager of the Valle plantation, who owns 4.5 hectares that have belonged to his family since his grandfather’s days, led him to take steps ahead of the inclement weather.

He planted early, and was already harvesting “when the rains intensified,” he told IPS. “I didn’t have to replant,” said this member and president of the Tomás Valdés Credit and Services Cooperative (CCS), which groups 50 farms in Vuelta Abajo.

The CCSs were created in the 1960s as voluntary associations of small farmers who retain ownership of their land, and gain collective access to technologies, financing and sales facilities for their products.

But in spite of his efforts, Prieto doubts whether this harvest will be as good as the last, when his farm produced 158 quintals (7,272 kilos), a record result.

Prieto uses soil conservation techniques on his land. He sprays the tobacco only once, and after the harvest, he plants crop varieties that improve the soil, like maize and jack beans. “They provide shade, conserve nutrients that otherwise would be washed away by the rains, and they are dug in as a green manure,” he said.

The 44,863 people living in San Juan y Martínez, on large estates dotted with simple houses with light roofs, depend on the success of each tobacco harvest. “We are paid fixed wages, with bonuses for productivity,” union leader Celeste Muñoz told IPS.

Constantly working dry tobacco wrapper leaf from the last harvest on her roller, Muñoz, employed for the last 17 years in a centre for tobacco collection, selection and processing, said that her team of 50 women is trying to “recover as much dry leaf as possible.”

She is not sure whether it is “because of the climate, the fertilisers or the variety planted,” but she claims that the yield “is less than before. We got as many as 1,000 quintals (46,039 kilos) of dry leaf in one season,” she said nostalgically.

In the Philippines, under regulated advertising for tobacco products, cigarette brands have developed more creative products like packets of 10 sticks instead of the standard 20 to make them cheaper for consumers. Credit: Kara Santos/IPS

By Carey L. Biron
WASHINGTON, Sep 7 2013 (IPS)

Between concluding rounds of negotiations towards the Trans-Pacific Partnership (TPP), a major U.S.-proposed free trade agreement, a divisive fight has heated up over the extent to which countries should be allowed to regulate the sale of foreign – potentially far cheaper – tobacco products.

In duelling proposals offered during the latest round of negotiations, in Brunei late last month, the United States and Malaysia put forward starkly different approaches. While Washington is urging that tobacco products be given no special consideration, the Malaysian government has countered that these items should receive a special “carve-out”, exempting them from a broader lifting of trade restrictions.“When you lower tariffs on cigarettes, prices become cheaper, greater numbers of kids and poor people become addicted, and overall health gets worse.” -- Ellen R. Shaffer of the Centre for Policy Analysis

Now, critics of the U.S. proposal are hoping to emphasise the health implications of these proposals ahead of the next 12-country TPP talks, slated to take place here in Washington starting Sep. 18. The administration of President Barack Obama had initially hoped to have a final agreement text by October, but that now looks extremely unlikely.

“Under other trade agreements, tobacco companies are currently using their investment provisions to attack public health regulations,” Arthur Stamoulis, director of the Citizens Trade Campaign at Public Citizen, a Washington-based consumer watchdog, told IPS.

“For this reason, many feel there needs to be a broad carve-out in this agreement for tobacco, if public health is going to be protected. Fortunately, as negotiations get further along and the negotiators get into thornier issues, there’s a lot more people paying attention to these talks.”

New York Mayer Michael Bloomberg, a long-time proponent of greater tobacco control, recently suggested that the U.S. proposal could directly contribute to “tens of millions” of deaths globally.

The potential results of the U.S. proposal are fairly clear, with repeated evidence going back to at least the 1980s. For instance, according to findings by the Government Accountability Office, the U.S. Congress’s main watchdog, after international tobacco companies moved into South Korea in 1989, teenage smoking increased fourfold within the first year.

“There’s no question about it,” Ellen R. Shaffer, co-director of the Centre for Policy Analysis, a group focused on trade and health issues, told IPS. “When you lower tariffs on cigarettes, prices become cheaper, greater numbers of kids and poor people become addicted, and overall health gets worse.”

Chilling effect

Advocates of tougher restrictions are warning that the U.S. scheme would be particularly dangerous to developing countries. Not only could the proposal open these economies to potentially cheap cigarettes coming from other countries, but it would also make them vulnerable to expensive litigation from powerful tobacco interests if these countries try to impose trade restrictions.

Smoking rates in the United States and many other developed countries have come down dramatically in recent years, in part on the back of a unique wave of international agreement about tobacco’s deleterious health effects. Indeed, the world’s only international health accord, the Framework Convention on Tobacco Control, which entered into effect in 2005, has been ratified by 176 countries – including each of the dozen in the TPP negotiations, except for the United States.

Yet smoking rates are rising in many developing countries. With tobacco use having led to roughly 100 million deaths during the last century, experts now estimate that it could cause upwards of a billion deaths this century – more than 80 percent of which will likely be in developing and middle-income countries, according to the World Health Organisation.

In the TPP negotiations, the new U.S. position rescinds an earlier draft proposal that included an exemption for tobacco-control measures. Instead, the new proposal simply recognises that countries are allowed to put in place health regulations, similar to other treaties.

It also offers a compromise of sorts. If any tobacco-related trade dispute were to arise due to the imposition of health-related regulations, health officials would be encouraged to engage in consultations before any settlement process goes forward.

The U.S. Department of Health and Human Services has signed off on the new proposal, with the agency’s deputy secretary, Bill Corr, stating that the “proposed language … will make a difference for tobacco control and public-health efforts”.

Yet such provisions still constitute a “retreat … and fail to prevent tobacco control measures from being challenged as violations of trade agreements,” according to Susan M. Liss, executive director of the Campaign for Tobacco-Free Kids, a U.S. advocacy group, reflecting similar sentiments recently expressed by several U.S. health associations.

On the other hand, Liss said in a statement, the Malaysia proposal “is appropriate and necessary to stop the tobacco industry from continuing to challenge tobacco control measures as trade violations, a tactic the industry increasingly has used around the world to fight efforts to reduce tobacco use.”

Indeed, not only are countries such as the United States and Australia currently fighting lawsuits brought by tobacco companies against various tobacco-control laws, but such suits are increasingly being aimed at developing countries. Uruguay, for instance, is currently battling former tobacco giant Phillip Morris over a law that requires particular packaging for cigarettes.

“Developing countries are particularly at risk from these trade rules and challenges simply because they do not have the financial and legal wherewithal to defend against trade suits brought against governments,” the Center for Policy Analysis’s Shaffer says.

“The international tobacco industry has changed dramatically in recent years, and this constitutes a two-pronged strategy: first, to shoot down existing tobacco-control regulations and, second, to have a chilling effect on countries that may be thinking about instituting regulations.”

Shaffer, too, lauds the Malaysian government’s proposal, which she says has reportedly met with “some favourable reception, including reportedly from Japan, which would be encouraging given that country’s economic strength.”

Slippery slope?

Although tobacco no longer makes up a large percentage of the U.S. economy, pressure on the Obama administration surrounding the TPP negotiations has come from business interests worried about a “slippery slope” effect – that an exemption for cigarettes would eventually lead to additional exemptions for a range of other products.

The U.S. Chamber of Commerce, the country’s largest business lobby group, has been increasingly vocal in recent days on the TPP tobacco proposals.

“[We risk] opening Pandora’s box by setting a precedent that others will try to follow for additional ‘unique’ products in ways that could be very damaging to American workers, farmers, and companies,” John Murphy, the Chamber’s vice president for international affairs, wrote last week.

“Following this example, other governments may seek similar treatment for alcoholic beverages, snack foods, genetically-modified organisms (GMOs), or a range of other products – the export of which supports many American jobs.”

Cigarettes are a popular buy from vendors selling imported goods here in Port Moresby in Papua New Guinea. Credit: Catherine Wilson/IPS

By Catherine Wilson
SYDNEY, Aug 19 2013 (IPS)

Governments in the Western Pacific Islands, believed to be home to a third of the world’s smokers, have begun a long battle with the growing crisis of non-communicable diseases. Such diseases currently account for 75 percent of the region’s fatalities.

Kiribati and the Marshall Islands have the highest rates of diabetes in the world at 25.7 percent and 22.2 percent respectively. Fiji carries the greatest burden of non-communicable diseases (NCD)-related deaths in the region at 501 per 100,000 in the population.

Major factors include heavy tobacco and alcohol consumption, physical inactivity, and poor nutrition. These are exacerbated by rapid urbanisation, and spreading consumerism.
In 2011 Pacific Island leaders declared NCDs to be at the centre of a health and development exigency with long-term impacts including lower economic productivity, loss of household income and unsustainable health costs.

The limited capacity of health services to cope with escalating financial and service delivery demands is of growing concern. Most national health expenditure, up to 90 percent in Vanuatu and 87 percent in Samoa, is already met by governments, and there is limited potential to increase budgets further.

“I don’t think any country can cope with the burden of NCDs, not even high-income countries,” Dr Wendy Snowdon of the Pacific Research Centre for the Prevention of Obesity and Non-communicable Diseases at the Fiji School of Medicine told IPS.

“NCDs are expensive to treat, and while countries in the region are increasing their investment in treating NCDs, the only viable solution is effective promotion [of prevention] which could reduce the burden.”

Challenging entrenched lifestyle habits and controlling access to tobacco are imperative to reducing the prevalence of hypertension, diabetes and cancer, and addressing cardiovascular disease, which is the greatest killer of all.

The World Health Organisation (WHO) cites tobacco as the second highest risk factor in NCD-related deaths, 80 percent of which occur in low- and middle-income countries.

The prevalence of smoking in men ranges from 74 percent in Kiribati and 60 percent in Papua New Guinea to 55 percent in Tuvalu and 47 percent in the Cook Islands. Female smoking rates, while on the increase, are lower at 43 percent in Kiribati, 41 percent in the Cook Islands and 27 percent in Papua New Guinea.

Stephanie Erick of Tala Pasifika, a New Zealand heart service aimed at empowering Pacific peoples in tobacco control, told IPS: “Smoking practices over the years have embedded themselves in [Pacific] cultural practices, for example, with kava drinking. Socially it has become a part of gift giving [of duty free cigarette packs] from overseas travellers coming into Pacific Island countries.”

A report last year by the United States-based health foundation Legacy and the Pacific Partnership for Tobacco Free Islands (PPFTI) highlighted the very young age at which dependence starts. Twenty-five percent of high school students in the Northern Mariana Islands are smokers. In the Marshall Islands, almost 90 percent of smokers start in adolescence, and two-thirds are daily consumers by18 years.

The socio-economic repercussions for this generation as it ages will be serious in a region striving, with mixed progress, to achieve the Millennium Development Goals.

The connection between NCDs and disability, such as stroke paralysis, amputations and blindness, is already taking its toll. In Fiji, diabetes is the main cause of amputations and the second main factor in adult blindness.

A report by the University of Sydney, Australia, blames smoking for the burden of lung cancer in 39-47 percent of men in the Pacific Islands and predicts this will increase to 70-84 percent within the next two decades.

Pacific Island leaders, fully cognizant of the implications for the region’s future, developed crisis response strategies during an NCD Forum last year focussed on tobacco control and building capacity in primary health care services. Their goal is 25 percent reduction in NCD-related fatalities in people aged 30-70 years by 2025.

However, there are significant challenges to implementation, with many health service providers constrained by low funding and resources.

Prevention through ‘whole of society’ and ‘whole of government’ approaches is being advocated by health ministers as the most likely to reverse the present scenario.

A critical step has been ratification of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) by all Pacific Island member states and territories. The framework is supported by the MPOWER strategy which promotes tobacco price and tax increases, tobacco advertising bans, regulation of tobacco use in public spaces and cessation services.

Jeanie McKenzie, NCD adviser on tobacco and alcohol at the Secretariat of the Pacific Community (SPC) in Noumea, New Caledonia, told IPS that the FCTC was an important catalyst to the emergence of tobacco policies in the region.

“SPC has been undertaking tobacco enforcement workshops in Vanuatu, Solomon Islands, Cook Islands and Palau, and these reflect the fact that there is legislation in place in these countries,” she said. “Countries in the Pacific are also increasing the tax on tobacco, with many increases at or above 20 percent.”

This year the sale of single cigarettes and smoking in public places became illegal in the Solomon Islands. Fiji also introduced new requirements that graphic health warnings cover 60 percent of cigarette packages.

“Increasing the price of tobacco affects price-sensitive [social groups], usually youth and women, and acts as a disincentive,” McKenzie explained. “Laws that prevent the sale of small cigarette packs and the illegal breaking open of a pack and selling of single cigarettes also assist in dealing with the problem of young people being able to access cigarettes for a smaller financial outlay.”

WHO claims that every 10 percent increase in the retail price of tobacco induces a drop in consumption in low- and medium-income countries by up to 8 percent.

The coral atoll nation of Niue, located northeast of New Zealand, with a population of 1,611, has emerged as an early success story. Last month it announced that sustained tobacco control and health support measures had led to a massive drop in the smoking rate in men from approximately 58 percent in recent decades to 15.8 percent, and in women from 17 percent to 7.6 percent. This places the island state well ahead of its 2021 objective of less than 25 percent for men and 13 percent for women.

A large portion of cigarette packages must be devoted to warnings on the health risks of smoking. Credit: Kara Santos/IPS

By Fabíola Ortiz
RIO DE JANEIRO, Apr 4 2013 (IPS)

Brazil has taken another step to combat the harmful habit of smoking with the creation of the Centre for Studies on Tobacco and Health (CETAB).

But the new centre, established by the state-run Oswaldo Cruz Foundation (FIOCRUZ) as part of the Sergio Arouca National School of Public Health, has set its sights even further. CETAB will also undertake research on three other risk factors for non-communicable chronic diseases, in addition to smoking: excessive alcohol consumption, lack of physical activity, and poor eating habits.

In 2011, Brazil adopted the Strategic Action Plan to Combat Non-Communicable Diseases, such as cancer, diabetes, heart disease and respiratory ailments.

“We are going to focus on these and conduct research on the risk factors. Cigarette smoking stands out as one of the worst villains. It offers no benefits whatsoever. There is no such thing as a reasonable level of cigarette smoking that could be considered harmless. It has only negative effects,” the coordinator of the new centre, Vera da Costa e Silva, told Tierramérica.*

The Ministry of Health will devote 6.2 million dollars to the plan adopted in 2011, which establishes actions to be undertaken up until 2022.

Among other targets, the plan is aimed at reducing premature death from these causes among people under 70 by two percent annually, to eventually reach 196 deaths per 100,000 inhabitants by 2022, as compared to 255 per 100,000 in 2011.

The World Health Organization (WHO) considers tobacco to be the leading preventable cause of death in the world, and estimates that about a third of the global population aged 15 and older, or one in three adults, are smokers.

The more than 4,700 toxic substances found in tobacco smoke make it a cause of roughly 50 different diseases.

In Brazil, lung cancer is the most lethal type of cancer and also one of the leading causes of death.

Reducing exposure to the risk factors associated with diseases will make it possible to reduce the incidence of the diseases as well, stressed Costa e Silva.

CETAB will focus on teaching, research and technical cooperation, both within Brazil and abroad.

“We want to work with information, education, regulation and public policies for prevention. We are going to provide health care professionals in the public health system with training and treatment options for the risk factors. The courses we offer can be taken long-distance,” said the CETAB coordinator.

In terms of international cooperation, the centre plans to work with other countries in Latin American as well as Portuguese-speaking African countries. This will mean sending Brazilian specialists to the offices that FIOCRUZ operates abroad, such as in Mozambique, and attracting specialists from these other countries to Brazil.

CETAB also plans to support the efforts of WHO and the Pan American Health Organization (PAHO).

“We have already had good returns with them as international partners, and we see a number of possibilities on the horizon,” said Costa e Silva.

The centre is starting out with a team of nine researchers from fields such as economics, engineering, pharmaceuticals, medicine and biology.

Tobacco use is an epidemic and the biggest known risk factor, according to the president of Brazil’s National Academy of Medicine, Marcos Moraes.

In the late 1980s, almost 40 percent of Brazilians were smokers. In 25 years, this percentage fell to around 15 percent. Brazil currently has a population of 192 million.

“We achieved these results thanks to the control measures we have adopted,” Moraes told Tierramérica. “The tobacco industry is always very active, even though they are fully aware that they are selling a disease, and our goal is for the country to safeguard its health and prohibit the sale of harmful products,” he added.

Moraes reported that a marked decline in smoking has been observed in middle-class youth, although there has been a “slow but steady increase” in young smokers from poorer segments of the population.

“One of the most important strategies for combating tobacco use is raising the price of cigarettes. In 2012, Brazil increased taxes on cigarettes substantially, but they are still among the lowest in the world. Where there is poverty, there is smoking,” said Moraes.

According to WHO, he added, for every dollar collected through these taxes, 4.5 dollars are spent on health care for tobacco-related diseases.

Around 10 billion dollars of public health care spending in Brazil goes towards the treatment of problems caused by smoking, while the revenues earned through taxes on the tobacco industry amount to only three billion dollars, he noted.

Statistics on the evolution of the number of smokers in Brazil serve as a measure of the efficacy of the country’s prevention policy, but “this policy is always under threat,” he warned.

Although it is recognised as an example for the rest of the world, Brazil cannot celebrate or “set off fireworks, because this is an ongoing battle,” Moraes commented.

The creation of this new study centre will serve as another tool to contribute to the work of the network of institutions already active in this area.

Brazil is frequently called upon to provide international cooperation and share its experiences in the fulfilment of the WHO Framework Convention on Tobacco Control, which sets out specific steps for governments to combat tobacco use.

* This story was originally published by Latin American newspapers that are part of the Tierramérica network.

Despite the great strides made in Latin America with tobacco control legislation, the industry deploys a range of strategies to circumvent the restrictions imposed on cigarette advertising, social organisations and experts complain.

With tobacco product advertisements banned in every country in the region, companies are now targeting points of sale in their efforts to increase product visibility, and implementing corporate social responsibility programmes to maintain brand popularity.

These are among the findings of a recent multi-organisation report that looks at case studies from Mexico, Colombia, Argentina and Brazil documenting civil society’s reactions to the tobacco industry’s ploys in 2010-2012.

The report, issued in Spanish under the title “Health is non-negotiable; Civil society addresses the tobacco industry’s strategies in Latin America”, was prepared by the Argentine and Mexican chapters of the Inter-American Heart Foundation (Fundación Interamericana del Corazón, FIC) and Brazil’s Alliance for the Control of Tobacco Use (Aliança de Controle do Tabagismo, ACT), among other organisations.

Mariela Alderete, assistant director of FIC Argentina, told IPS that tobacco companies in her country were taking advantage of the lack of regulations necessary to properly enforce the tobacco control law passed in 2011.

“The regulations would help enormously in covering legal gaps regarding, for example, advertising or no smoking areas,” she said.

Argentina is the only South American nation that has not yet ratified the World Health Organisation’s Framework Convention on Tobacco Control (WHO FCTC), although it was signed by the government in 2003. Pressure from the country’s tobacco-growing provinces has delayed ratification, as they argue that the treaty’s provisions harm their local economies, despite the fact that they export 80 percent of their tobacco.

The report observes that in the last few years “great strides” have been made in the efforts to curb smoking in the region.

“However, the (tobacco) industry is deploying innovative strategies to reach new publics, violating or circumventing health policies” aimed at preventing tobacco-related diseases and deaths.

In some cases, identical strategies are used, repeating the same arguments that have been effectively refuted again and again by health bodies that call for tobacco control.

These strategies are aimed at preventing the passage or enforcement of anti-tobacco laws, says the study, published in late 2012 but virtually ignored by the media.

According to the report, tobacco companies hide behind “front groups,” typically small tobacco-growers, café, restaurant or bar proprietors, convenience store owners and licensed gaming operators, using them to protest these laws by highlighting the negative impacts that smoking limitations allegedly have on their businesses.

They also lobby legislators and other politicians, helping to finance their election campaigns or other initiatives, and they manipulate figures to cast doubt on effective measures for combating the addiction to smoking, such as increasing taxes on tobacco products.

Argentina banned tobacco advertising in 2011, with the exception of points of sale, under the Advertising, Promotion and Consumption of Tobacco Products Act. Last year, the Health Ministry also ordered tobacco companies to display graphic health warnings on their product labels, accompanied by texts such as “Smoking causes cancer” or “Smoking during pregnancy causes irreparable harm to your unborn child”.

But according to Alderete, these warnings are being made light of with the sale of cigarette cases that cover packs almost entirely, leaving only the brand visible and displaying a message that says “Lay off” over the mandatory images.

The creation of regulations for implementing the law has been delayed, among other reasons, because of opposition from the National Lottery, the state agency that controls licensed betting offices. These businesses demand that they be allowed to install air purifiers and ventilation systems and that smoking areas be authorised in their establishments.

“This is what the tobacco industry proposes in its Living Together in Harmony programme, but such systems are known to be ineffective and to violate the right to health of workers and non-smokers. The industry is using the National Lottery as a front” to push its agenda, Alderete said.

In Mexico, tobacco companies fought attempts to raise taxes that affect the price paid by consumers, arguing that increasing taxes would only boost cigarette smuggling, based on figures that contradicted government data.

While tobacco companies claimed in the media and through street campaigns that illegal cigarette imports had increased fivefold, official figures cited in the “Health is non-negotiable” report indicate that smuggling has shrunk “significantly” in recent years.

However, the last few years have also seen a rise in the number of shops and other points of sale that sell loose cigarettes and in some cases to minors, despite the law’s explicit ban, Erick Ochoa, an expert with FIC Mexico, told IPS.

“It’s pointless to ratify the Framework Agreement and have solid legislation if neither instruments are enforced in practice,” Ochoa stressed. “Good intentions are not enough. You need commitment from political leaders willing to draft solid regulations and make sure they’re enforced.”

The industry has also found ways of getting around tobacco control laws in Brazil, which was among the first to ban cigarette ads (in 2000). As the ban does not apply to advertising within points of sale, cigarettes, which were formerly only sold in kiosks, are now sold in bakeries, supermarkets, newsstands and nightclubs.

According to the report, in 2012 the Brazilian branch of the multinational corporation British American Tobacco (BAT) filed a lawsuit against ACT to force it to pull an anti-smoking television spot from the air, but the suit was thrown out of court.
Litigation was also the strategy chosen by the tobacco industry in Uruguay, where smoking is banned by law in all indoor public spaces since 2008 and a 2009 decree requires that health warnings cover 80 percent of the front and back of cigarette packs.

U.S.-based tobacco giant Philip Morris took legal action against the government of Uruguay under the Switzerland-Uruguay Bilateral Investment Treaty (BIT) at the World Bank’s International Centre for Settlement of Investment Disputes, claiming that the South American country’s regulatory measures violated the investment protection agreement signed in 1991 between the two countries.

But the government of the left-wing Frente Amplio coalition is not abandoning its anti-tobacco policy, which began in 2006 under the administration of former president Tabaré Vázquez, an oncologist.

In Colombia, where a full ban on tobacco product advertising and promotion is in force, two claims of unconstitutionality were brought against the ban, arguing that it violates the freedoms of economy and enterprise. But both actions were dismissed.

The tobacco companies operating in the country then focused their strategy on retailers, offering to sponsor activities of the National Federation of Retailers, with events across the country.

This involves financing gatherings of kiosk owners and small shopkeepers and organising contests, discounts, prizes and incentives for the sector. “They even offered university scholarships for their children,” Alderete said.

Non-governmental organisations, however, are more concerned with tobacco company sponsorship of campaigns against child labour, artistic and cultural events, or social reinsertion programmes for demobilised combatants (former left-wing guerrillas or far-right paramilitaries) and their families, which are often carried out in partnership with the state.

This funding explains why it is not uncommon to see cigarette-makers praised in the news for their social contributions.

“It’s a mockery of the absolute ban (on tobacco advertising), and it’s not seen as an advertising strategy,” the report says.

A recent World Health Organisation (WHO) survey revealed that poor people in India were twice as likely to smoke as the rich. Credit: K. S. Harikrishnan/IPS

By Mauro Teodori
THIRUVANANTHAPURAM, India , Nov 30 2012 (IPS)

Mujeeb Rahuman (39), a mason in the Venjaramoodu village in Thiruvananthapuram, the southernmost district in India’s coastal Kerala state, has been a chain smoker for the past twenty years.

Rahuman told IPS he spends “about 1,500 rupees (27 dollars) per month on cigarettes”, representing a large chunk out of his modest monthly income of 8,000 rupees (144 dollars). “I use them as a way to pass the time.”

But this habit is not as leisurely as it sounds. In fact, Rahuman embodies a growing addiction to tobacco among the poor in India, who are now developing higher rates of cancer and experiencing increased mortality rates.

A recent World Health Organisation (WHO) survey revealed that poor people in India were twice as likely to smoke as the rich.

According to the Planning Commission of India, as many as 354 million people – or 29 percent of the population – currently live below the poverty line, which is defined by a monthly income of anything below 672 rupees (roughly 12 dollars) for rural India and 859 rupees (about 15 dollars) for urban labourers.

The WHO survey, entitled ‘Socioeconomic Inequality in Smoking in Low-Income and Middle-Income Countries’, reported that over a quarter of the country’s population of 1.2 billion people is addicted to tobacco, a habit influenced to a great extent by income.

For instance, the survey found that 46.7 percent of men in lower socioeconomic strata are smokers, compared to 21.8 percent of rich men.

Only 7.6 percent of Indian women smoke, but here, too, the discrepancy is stark: women in lower socioeconomic strata are four times more likely to smoke than their more affluent counterparts – 12.4 percent of women from a lower income bracket have taken up the habit, as opposed to just 3.1 percent of wealthy women.

This disparity does not merely represent a difference in lifestyle choices – it highlights the stress of poverty that leads to addiction and points to a growing health gap between the rich and poor in India.

The survey was initiated in response to reports that poorer people actually faced a greater risk of dying from smoking than more affluent people.

According to the WHO, the ‘smoking divide’ also deepens the gulf of income inequality, since the poor divert their limited wages away from housing, better food or healthcare towards the purchase of tobacco products.

The Mumbai-based Advocacy Forum for Tobacco Control listed various forms of tobacco products popular with the Indian masses including beedis, which account for 34 percent of tobacco products in the country; chuttas and cheroots, small rolls of tobacco leaves; Dhumtis, conical cigarettes created by rolling tobacco leaf in the leaf of another plant; and cigars.

Data from the National Sample Survey Office of India, under the ministry of statistics and programme implementation, shows that the price of beedis makes them a much more popular option – the cost of smoking cigarettes is 399 rupees (about seven dollars) per month, while beedi consumption costs as little as 93 rupees (close to two dollars), according to the Global Adult Tobacco Survey (GATS) for 2009-10.

In fact, 37 percent of rural households and 20 percent of urban households consume beedis, compared to just 3.7 and 9.6 percent respectively for cigarettes.

And meanwhile, the health impacts of tobacco consumption are growing increasingly more severe.

According to a book entitled ‘Kerala, Fifty Years and Beyond’, which documents Kerala’s impressive development record over the last five decades, tobacco has been identified as the leading cause of cancer in India, responsible for 40 to 50 percent of cancers in men and 20 percent of cancers in women.

“Tobacco chewing has resulted in a huge (medical) burden of oral cancer and oral precancerous conditions,” the book said.

Dr. R. Jayakrishnan, assistant professor at the community oncology division of the Regional Cancer Centre in Thiruvananthapuram, told IPS the leading cause of oral cancer was tobacco-related chewing, adding that most patients visiting the centre hail from low-income households.

“Today, 80 percent of lung cancer cases appear to be a result of smoking. The need of the hour is to develop prevention strategies that specifically focus on poor people,” he told IPS.

M. A. Oommen, a prominent Indian economist, told the media in Thiruvananthapuram recently, “While linking a high incidence of smoking with poverty is a simplistic correlation, the issue has to be tackled in a multi-pronged manner, such as giving incentives to the poor to get out of the habit, moral persuasion, a higher excise duty on tobacco products and structural reforms through better employment opportunities.”

A 2012 Asian Development Bank study predicted that increasing cigarette prices, by imposing higher taxes on manufacturers, would save more than 27 million lives in five Asian countries including India.

The Times of India recently reported that a 50 percent increase in cigarette prices in India will save 4.1 million people from the ravages of tobacco consumption, while a 100 percent increase in prices could prevent eight million deaths annually.

(END)

Women in Kasungu, a farming district in Central Malawi, select dried tobacco leaves to sell at the market. Its small farmers like these that grow tobacco in Malawi. Credit: Mabvuto Banda/IPS

By Mabvuto Banda
LILONGWE, Nov 9 2012 (IPS)

The latest proposals by the World Health Organization Framework Convention on Tobacco Control to stop farming of the crop could potentially affect about two million livelihoods in Malawi and decide the fate of an entire nation struggling with a sputtering economy.

This is according to the chief executive officer of Malawi’s Tobacco Control Commission, Bruce Munthali.

Tobacco is this southern African nation’s main foreign currency earner and accounts for more than 70 percent of exports and 15 percent of GDP. The industry employs an estimated two million of Malawi’s 13 million people.

The proposals, expected to be tabled during the Fifth Session of the Conference of Parties to the WHO FCTC (CoP5) in South Korea, Nov. 12 to 17, may change those statistics forever if bank loans to growers are stopped, contracts between growers and buyers are halted and official bodies working with tobacco producers are dismantled.

“If the proposals are adopted at the CoP5, this will mean the end of the source income for many in Malawi and the consequences would be far-reaching for our already fragile economy,” Munthali told IPS.

The FCTC recommendations include reducing the land allocated to cultivating the crop and denying farmers the right to grow tobacco. The Convention also suggests regulating the seasons of the year in which tobacco farming is allowed.

The suggestions have put Malawi at a crossroads. While the new administration of President Joyce Banda is trying to boost tobacco production to increase its foreign reserves this year, the proposals threaten to spoil the party.

Munthali accused the FCTC of imposing its recommendations on poor countries like Malawi.

“These proposals have not been fully discussed by most member countries and they have just been imposed on us. There should have been a process of consultation,” said Munthali.

The domino effect of these proposals would not only affect farmers in Malawi, but tobacco growers globally.

“If these measures go forward, the consequences will be devastating for millions of farmers and their families while the positive impact on public health will be negligible,” Antonio Abrunhosa, chief executive officer for the International Tobacco Growers Association (ITGA), told IPS.

The association held the first ever World Tobacco Growers Day in Nigeria in October and used the occasion to galvanise its base of 30 million tobacco growers and appeal to various governments not to assent to the proposals.

The FCTC was negotiated by the 192-member states of WHO to become the world’s first public health treaty after the final agreement was reached in May 2003. It also provides the basic tools for countries to enact comprehensive tobacco control legislation aimed at abolishing tobacco farming by 2025.

Though Malawi is not yet party to the treaty, the framework has already left the country bleeding.

One indication of how the global anti-tobacco lobby has affected Malawi is the slowdown in earnings. In the last three years, revenue from tobacco dropped from 416 million dollars in 2010 to 292 million dollars in 2011 and 177 million dollars this year.

Malawi is also currently recovering from a decision by donors to freeze aid which accounted for almost 40 percent of the budget.

“Growing tobacco has been our life for generations in my family. Though we have not become rich from this, we have managed to learn how to read and write and build homes that don’t leak,” Samson Phiri, a smallholder farmer, told IPS.

Yotamu Kalumbu, another farmer and father of five, told IPS: “If WHO enforces those rules against us, they will not only destroy Malawi but my family as well.”

The Banda administration said it was taking the proposals against tobacco as a major economic threat to the country.

“We won’t take this lying down because this is Malawi’s strategic crop and it will remain so for some time to come,” Minister of Trade and Industry John Bande told IPS.

Minister of Agriculture and Food Security Peter Mwanza told IPS: “Understandably, the FCTC will continue to take its toll…on production, marketing and consumption which is already affecting millions of our people and our economy.”

The Tobacco Association of Malawi (TAMA), a body that represents the interests of growers, said they would fight on.

“The battle continues. The good news is that burley tobacco may not be banned as an ingredient but that now presents the best opportunity for us as a country to start analysing the implications of the FCTC,” TAMA president Reuben Maigwa told IPS

He said there was a need for some policy changes within the tobacco industry, which the Ministry of Agriculture and Food Security needed to champion with a rational approach.

As for the thousands of tobacco growers in the country like Phiri, their money is on the government and TAMA to win the battle for them.

“Our prayer is that they defeat the proposals when they go to CoP5 so that we can continue growing the crop without any worries of losing the source of our livelihoods,” said Phiri.

Local and state campaigns have become a moneyed battleground this year for corporations and special interest groups hoping to sway the results of elections for local and state offices on Nov. 6.

From California to Texas to Florida, global businesses as well as ideological organisations and extremely wealthy groups have helped channel more than 1.6 billion dollars through political action committees and into local campaigns and issues this year, according to the National Institute on Money in State Politics, a non-governmental organisation (NGO) that analyses state campaign-spending reports.

Some of the cash went into campaigns of local lawmakers. Other amounts supported campaigns for judges. More than 6,000 legislators are running for election Tuesday, according to the National Council of State Legislators, with most relying on private funding.

Campaign money can be difficult to track, since states set their own campaign finance laws, and money flows in and out of state and federal political parties, political action committees and non-profits and into campaigns and issue advocacy.

“Money is access, and it definitely influences the outcomes of elections,” Judy Nadler, a government ethics expert at Santa Clara University in California, told IPS. In some states, “huge amounts of money [go] unreported and unregulated.”

This “outside spending” increased 38 percent between 2006 and 2010, according to the National Institute on Money in State Politics. Spending by candidates increased 19 percent during that time, it found.

Large chunks of special interest money also were directed at state ballot measures, which are decided by voters in individual states. This year, 38 states have ballot measures, according to the National Council of State Legislatures.

From coast to coast

A national overview of money spent per state on election campaigns and committees. Credit: National Institute on Money in State Politics/Creative Commons

Nowhere is the impact of moneyed interests more obvious than in California, where 570 million dollars have been spent leading up to Tuesday’s elections. Of that amount, 421 million dollars have gone to groups arguing for or against ballot measures, including those related to tobacco and genetically modified foods.

A California proposal to raise taxes on a package of cigarettes by one dollar was voted on and narrowly defeated earlier this year during the state’s primary election. Pro-health groups spent 18.2 million dollars advocating for the measure, but tobacco companies, including global giants Philip Morris and Reynolds, spent 46 million dollars to bolster their pro-tobacco stance through advertisements.

A measure to label genetically modified foods has pitted consumers, organic farmers and businesses, who have ponied up 8.2 million dollars, against well-armed agricultural corporations and supermarkets, which have spent 48.7 million dollars.

The biotechnology giant Monsanto has contributed 7.1 million dollars to defeat the labelling proposal, followed by Dupont (4.9 million) and Pepsico, (2.1 million), among many others.

“We have been shut down by biotech on this issue,” Grant Lundberg, CEO of Lundberg Family Farms, an organic rice grower and processor, and co-chair of the Non-GMO Project, told IPS. “They have had a big impact. They have gotten their lies out and confused people. We have limited resources.”

In Texas, where donations to this year’s candidates exceeded 113 million dollars, some individuals and businesses stood out for their especially large contributions to the electoral process.

Bob Perry, the Houston real estate mogul who helped bankroll presidential candidate Mitt Romney, mainly by donating more than 10.7 million dollars to the Super PAC Restore Our Future, is one, according to the Centre for Responsive Politics, a Washington NGO that analyses campaign finance reports. This year, Perry has made a mark of 2.4 million dollars on Texas politics.

More than 72.5 million dollars were dumped into Florida campaigns for 2012, where pro-business special interests figured prominently. The utility company Progress Energy gave the most money – 709,000 dollars – to candidates, about 90 percent of them Republican.

Other major corporate donors include private health insurance company Blue Cross Blue Shield, which gave 648,000 dollars, and the Walt Disney Company, which donated 497,000 dollars. Multi-billionaire conservative Sheldon Adelson, a Las Vegas casino magnate, also got involved in Florida politics; he gave 250,000 dollars to the state Republican Party.

“What we shouldn’t have is corporate financing of elections. Corporations are not people. They don’t vote and should not be involved in selecting our government,” said Craig Holman, a government affairs lobbyist for Public Citizen, a consumer advocacy NGO in Washington, DC.

Influential PACs

Political action committees (PACs) and political non-profits also are influencing politics in Florida, as they do in many other states.

Three Florida Supreme Court justices are at risk of being unseated by conservative groups angry about the justices’ support for President Barack Obama’s 2010 healthcare law. According to an investigation by the Centre for Public Integrity, the attack against the judges is being waged largely by two well-funded ultra-conservative political organisations, Restore Justice 2012 and Americans for Prosperity, funded by the conservative billionaire Koch brothers. A third politics group, Defend Justice from Politics, is backing the judges.

How much money is involved in the judges’ re-election campaigns is unclear, however, due to Florida’s murky reporting requirements.

Grassroots efforts to expel money from politics are underway in a number of states, including New York. And a number of states including Arizona, Connecticut and Maine have already tightened up their campaign finance rules, mostly due to citizen efforts. A sweeping law to reform relaxed campaign finance rules in Massachusetts was passed by citizens in 1998, but was repealed by lawmakers.

Some candidates are taking matters into their own hands by refusing corporate money or in the case of one candidate running for the Massachusetts state house, refusing money altogether.

Mike Connolly, also known as No Cash Mike, told IPS that “money in the political system gets in the way of actual progress”. He added, “94 percent of the time the candidate who raises the most money wins. When a few individuals can have a profound impact on an election and on the direction of government, that really cuts against the essence of democracy.”

Tobacco use led to almost six million deaths in 2011, according to new research released here on Monday, of which nearly 80 percent were in low- and middle-income countries.

Philippine cigarettes are among the cheapest in the world, costing less than one U.S. dollar for a pack of 20. They are available right outside schools, in parks, in streets and other public places, and sold by vendors in single sticks for about two pesos. Credit: Kara Santos/IPS

Such trends, fuelled by tobacco industry tactics, are having a “devastating” impact on the global economy, health and development workers warned at the Washington launch of a new report tracking tobacco use worldwide. The findings are the results of nascent research into the links between development, economic growth and tobacco use.

“We have more and more data on these links,” Hana Ross, one of the lead authors of the new Tobacco Atlas, told IPS. “For instance, it appears that in Russia, gross domestic product would have grown by 1.0 to 1.5 percent faster over the past three decades if it weren’t for the tobacco-related costs. Once you start to accumulate over time, these numbers become huge.”

The tobacco industry’s products and “spurious legal challenges”, Peter Baldini, the CEO of the World Lung Foundation, said Monday, “hurt economies as much as they hurt people.”

According to the fourth edition of the Tobacco Atlas, put out by the American Cancer Society and the World Lung Foundation, tobacco use is the single most preventable cause of death in the world. It is also the only risk factor common to the four most significant non-communicable diseases, heart disease, cancer, respiratory disease and diabetes.

Several diseases exacerbated by smoking also inordinately affect developing countries. Between 2010 and 2050, for instance, 40 million smokers with tuberculosis are expected to die, with smoking estimated to directly cause 20 percent of all cases of TB worldwide.

“While smoking rates have been slowly declining in the United States and many other high-income nations during the past 25 years,” Baldini and John R. Seffrin, CEO of the American Cancer Society, write in the Atlas’s foreword, “they have been increasing in low-and middle-income nations, which are the least prepared to deal with the effects of tobacco-related disease.”

A development issue

Overall, a billion people are expected to die due to tobacco use over the course of the 21st century. That figure includes a significant proportion of victims of second-hand smoke, 75 percent of whom are women and children.

The tobacco industry’s role in dragging down health indicators weighs heavily on national and international efforts at strengthening health systems, experts warn. In the United States alone, cigarette smoking has been directly blamed for around 193 billion dollars in annual health-related costs (in 2000-04), half in lost productivity.

With health-care costs already unsustainably high in many Western countries, the future impact of smoking on the developing world is now increasingly worrying those in the development sector.

China is a case in point, not only due to its massive population but also for the uniquely high percentage of the population that smokes. Although the Chinese government, under significant international pressure, has moved to cut down on smoking in recent years, Chinese men, more than 60 percent of whom use tobacco, continue to smoke roughly a third of the world’s cigarettes.

And if Chinese women were to begin smoking at anywhere near that rate, the Atlas’s writers warn, “the country’s economy and health systems will be overwhelmed”.

“The World Bank is greatly concerned about tobacco because … it is increasingly becoming largely a developing world problem at a time when the developing world can least afford to add another health problem,” World Bank official Keith Hansen told journalists Monday. “We need to all have a unified message: Tobacco control is a development issue, and we will not lose revenue by addressing it.”

The World Bank is reportedly looking to begin putting increased focus on tobacco-related research and programming.

“With tobacco now poised to explode in developing countries and addict a new generation,” Hansen says, “urgent action is needed to make sure that these countries are able to put tobacco behind them and not become the centre of tobacco for the 21st century.”

The remaining 90 percent

The Atlas was first published a decade ago, in 2002, and over that period significant forward steps have been taken in the fight against tobacco use.

In 2003, the World Health Organisation (WHO) adopted the Framework Convention on Tobacco Control, which now covers 174 countries and more than 87 percent of the global population. The WHO has set a goal of a 40-percent reduction in daily smoking among adults by 2025.

A year ago, in September 2011, the United Nations held its first-ever high-level meeting on non-communicable diseases, where world leaders unanimously agreed to a plan that calls for strengthened international anti-tobacco collaboration.

Despite such steps, today nearly 90 percent of the world’s population remain unprotected by smoking-related legislation. And according to WHO Director-General Margaret Chan, “Measures to tackle the epidemic remain seriously underfunded.”

In fact, funding for tobacco control should have a significant advantage in at least two regards, says Ross, the Atlas’s co-author.

First, it offers national governments a largely untapped opportunity for a massively increased tax base. The WHO itself has recommended that tobacco taxes be placed at around 70 percent of cigarette retail prices, although only five countries have yet reached that target.

“In many cases, this is a simple matter of political will, as control measures are not necessarily expensive – most countries already have some kind of tax system in place,” Ross says. “There is an opportunity for the international community to help in building that political will as well as to offer technical advice for setting up, for instance, efficient taxation systems.”

In this regard, Ross says, positive examples are coming in particular from Southeast Asia, where she highlights new government moves in Thailand, as well as in Laos and Vietnam.

Second, anti-tobacco funding offers something that many such public programmes do not: fast, measurable results.

“If you get people to quit smoking, the impact on health is visible within the first six months,” Ross says. “Results are typically available very quickly, reflected in specific and measurable data. For better or worse, that’s important to both the donor community as well as national policymakers.”

Credit:Fried Dough/CC BY 2.0

By Marcela Valente
BUENOS AIRES, Jun 12 2012 (IPS)

This month, Argentina will join the growing list of Latin American countries that compel tobacco companies to display health warnings about the dangers of smoking on cigarette packs, illustrated with graphic images.

The country is one of six in Latin America and the Caribbean that have not yet ratified the World Health Organisation’s (WHO) Framework Convention on Tobacco Control, but a national law enacted Jun. 13, 2011 provides a route to smoking prevention.

The law stipulates that from now on, cigarette packs must display a health warning message on the lower half of the front or back of the pack, and a picture of the same size illustrating smoking harm on the other side.

Along one of the edges of the pack, the Health Ministry also ordered the display of the free telephone number of one of its departments that will advise people on therapeutic approaches for quitting smoking.

This is a great improvement on the current timid warning, introduced in 1986, reading “Smoking is detrimental to health”. From now on the messages will be more specific, saying for example: “Smoking causes cancer”, or “Smoking causes heart disease and respiratory illnesses”.

Other warnings include: “Smoking causes addiction”, “Smoking causes death by suffocation”, “Pregnant women who smoke cause irreparable harm to their babies”, “Smoking causes pulmonary emphysema” and “Smoking causes sexual impotence”.

“Health warnings, together with smoke-free areas and a ban on tobacco advertising, are measures that, if properly implemented, have a large impact,” Dr. Marita Pizarro told IPS.

Pizarro is the national coordinator of the Smoke-Free Alliance of Argentina (ALIAR), a grouping of close to 100 associations working to promote anti-smoking regulations in order to protect human health and the environment.

According to ALIAR, one person dies every 12 minutes in Argentina from a preventable illness attributable to tobacco consumption, a phenomenon that particularly affects “men and women living in poverty, who leave their families completely unprotected.”

A 2010 survey by the Health Ministry found that in this country of 40.2 million people, 27.2 percent of people in the 18-65 age range smoke regularly. What is even more worrying is that in the 12-17 age range, the figure is 50 percent.

Pizarro said Argentina has made “significant advances” on the issue, but stressed that nevertheless, “we are still concerned that the detailed regulations for the law have not been issued, which means there are no bodies to monitor and enforce, for instance, the smoke-free environments.”

She recalled that the new law will also define “points of sale”, the only places where tobacco advertising will be allowed.

The legislation, whose official name is Law 26687 on Advertising, Promotion and Consumption of Tobacco Products, is currently in the process of being adapted locally in the country’s 23 provinces, and has only been fully adopted in half of them, while the rest are drawing up adaptive regulations.

But the Argentine capital and 10 provinces have declared themselves smoke-free zones, and have forbidden smoking in enclosed public spaces.

Moreover, the cigarette packs with the new text and pictorial warnings will become compulsory nationwide. “Someone who smokes 20 cigarettes a day will read the warnings 20 times a day, and illiterate people will see and learn from the photographs,” Pizarro said.

According to a research study titled “Políticas de Etiquetado en los Paquetes de Cigarrillos: Situación actual en América Latina y el Caribe” (Cigarette Labelling Policies: Current Situation in Latin America and the Caribbean), the first Latin American country to require pictorial warnings was Brazil, 10 years ago.

The study, by Argentine researcher Dr. Ernesto Sebrié at the Roswell Park Cancer Institute in the United States, was published in April in the journal Salud Pública de México and gives an overview of the regional situation.

Sebrié says that after Brazil, nine other countries added photos and warnings to cigarette packs: Bolivia, Chile, Colombia, Honduras, Mexico, Panama, Peru, Uruguay and Venezuela.

Uruguay requires the largest surface space on packs to be devoted to the warning and picture: 80 percent of each side, the highest proportion in the world, according to Sebrié.

The law in Uruguay was pushed through by the government of former president Tabaré Vázquez (2005-2010), a distinguished oncologist, and also adopted the legend “Toxic Product” and the image of a skull and crossbones on the packs.

Another six countries have approved laws to incorporate text and pictorial warnings on packs. Of these, Argentina is the first to put the measures into effect, while the rest are still at an earlier stage of the process. The study says the WHO Framework Convention on Tobacco Control, adopted in 2005, has been ratified by the majority of countries in the region, except for Argentina, Cuba, the Dominican Republic, El Salvador, Haiti and St. Vincent and the Grenadines.

In accordance with the obligations imposed under the convention, 33 countries in the region adopted warnings on cigarette packs, although most were only text warnings, and not all the countries required them to appear on the front and back of the pack.

However, they did all ban misleading information about smoking, as well as “brand descriptors” on the pack, such as “light”, “mild” or “low tar”, that seek to play down the harm cigarettes do.

According to Pizarro, a recent study carried out in Brazil showed that 76 percent of respondents agreed with the use of graphic images, and 67 percent of smokers said they planned to give up, after picture warnings came into use.

The survey also indicated that 50 percent of interviewees said they had changed their mind about the harm smoking could do to their health.

Brazil spends some 10 billion dollars a year on health care for smokers – more than three times the tax revenue from the tobacco industry in this country, which is the world’s top exporter and second producer of tobacco.

The effects of tobacco consumption in Brazil can be measured by the economic impact, according to a study by the state Oswaldo Cruz Foundation (Fiocruz), dedicated to public health, and the Alliance for the Control of Tobacco Use (ACT), a civil society organisation.

The report “Carga das doenças tabaco-relacionadas para o Brasil”(Burden of tobacco-related diseases in Brazil), launched by ACT in Brasilia May 31, says the costs of treating smoking-related illnesses like cancer, heart disease, lung diseases and strokes is equivalent to 0.5 percent of GDP.

Graphic picture-based health warnings on cigarette packs can help prevent youngsters from starting to smoke. Credit:Kara Santos/IPS

ACT executive director Paula Johns told IPS that the study calculated the costs of treatment of the 15 main tobacco-related illnesses. But she pointed out that overall, smoking plays a role in 50 diseases.

“The tobacco industry takes no responsibility for the cost, and argues that it pays a lot in taxes. The burden of treating the diseases falls on the public health sector,” she said.

In 2011, the total tax revenue from Brazil’s tobacco industry amounted to three billion dollars, less than one-third of state expenditure on treating patients with tobacco-related ailments.

According to Johns, taxes on the sector should be at least tripled, to cover the costs that active and passive smokers will generate after two or three decades of smoking. “In addition, indirect costs like early retirement should be taken into account,” she said.

Brazil has a population of nearly 200 million, of whom 25 million people are smokers, 15 million of them men. But Johns said the bad news is that women and children are beginning to smoke more, and from an earlier age.

The aim of the study is to demonstrate the need for more regulation of the tobacco industry and for more investment in prevention measures to curb addiction to smoking.

“Prevention is not just about running educational campaigns; access to cigarettes must be made harder, with higher prices and fewer sales outlets,” Johns said.

A pack of cigarettes in Brazil now sells for three dollars.

The country is the world’s second largest tobacco producer, after China and ahead of India and the United States. Last year 85 percent of Brazil’s tobacco was sold abroad, making it the leading tobacco exporter, a position it has held since 1993. Foreign sales brought in 2.89 billion dollars.

The ACT study, the first to measure the economic impact of smoking in Brazil, describes the profile of the country’s smokers as predominantly black, poor, rural dwellers with limited education.

The study reported that 20 percent of smokers began before the age of 15, and most of the rest started before they were 19.

Another indicator that alarms the authorities struggling to reduce consumption is that 60 percent of teenagers who start smoking do so with cigarettes containing additives with flavours such as cherry, chocolate or mint.

Study coordinator Márcia Pinto said the economic cost to the state could be reduced to a minimum because all the diseases caused by smoking can be prevented.

“All that money could be invested in vaccination programmes, wider access to cancer diagnosis and treatment, and sanitation programmes,” Pinto, of the Fernandes Figueira Institute which is part of Fiocruz, told IPS.

Pinto, who coordinates a team of six researchers, has been studying different aspects of the tobacco industry for 12 years. She emphasises that measuring the cost of smoking for the country is essential in order to promote public policies to prevent children, teenagers and women from being drawn into consumption.

The expert pointed out that smoking is the cause of 90 percent of cases of lung diseases.

The study found that heart disease, followed by lung diseases including lung cancer, and strokes, accounted for 83 percent of smoking-related costs in the public health system.

In 2011, about 30 percent of the total budget of the National Health Fund (FNS) which manages the resources of the state unified health system (SUS) was devoted to treating smoking-related illnesses.

In spite of this, the study says, the average life expectancy of smokers is at least five years less than that of the general population.

“Smokers lose five years of their lives. Tobacco addiction is an illness, and it is also related to alcoholism and a sedentary lifestyle,” said Pinto.

The 10 billion dollars a year devoted to health care for smokers could be used instead to provide basic sanitation throughout Brazil, which will require an investment of six billion dollars a year over the next two decades, according to the environmental health department of the University of São Paulo.

The same figure represents half the annual budget of the Growth Acceleration Programme (PAC), the second phase of which was launched by President Dilma Rousseff to provide the infrastructure the country needs.

The emblematic social housing programme “Minha casa, minha vida” (My House, My Life), aimed at reducing the housing deficit, cost the government 6.2 billion dollars in 2011, considerably less than what smokers cost the public health system.

Smoking is responsible for the deaths of 5.4 million people worldwide every year, according to the World Health Organisation (WHO).

WHO predicts more fatalities in future: in 2030, deaths from smoking will total eight million, 80 percent of them in developing countries.

The global cost of smoking-related illnesses is 500 billion dollars a year, according to the American Cancer Society. (END)

Tobacco corporations threaten public health with lawsuits against anti-tobacco legislation. Credit: Fried Dough/ CC by 2.0

By Isabelle de Grave
UNITED NATIONS, Jun 2 2012 (IPS)

Lawsuits from major tobacco corporations challenging anti-tobacco policies all over the world underscore the ever greater need for a global crackdown on tobacco use, for the sake of both public health and global development goals.

The World Health Organisation (WHO) highlighted this situation when it chose “industry interference” as the centrepiece of its anti-tobacco campaign this year for World No Tobacco Day, observed annually on May 31.

The WHO has taken a “bold stance” in a bid to stop the tobacco industry’s attempts to undercut steps to improve public health, John Stewart, senior international organiser of Corporate Accountability International (CAI), told IPS.

“Tobacco and poverty create a vicious circle, since it is the poor who smoke most and bear the brunt of the economic and disease burden of tobacco use,” said United Nations secretary-general Ban Ki-moon in his address on World Tobacco Day.

Tobacco kills nearly 6 million people each year. It will kill up to 8 million people per year by 2030, of which more than 80 percent will live in low- and middle-income countries, according to the WHO.

Many countries have taken steps towards kicking a lethal global habit, and the Global Tobacco Treaty (formally known as the WHO Framework Convention on Tobacco Control, or FCTC) is a crucial tool in the struggle. If fully implemented, it could save more than 200 million lives, Stewart told IPS.

Ahead of global tobacco treaty meetings to be held in Seoul in November, groundbreaking policies in Australia and Uruguay have been lauded as positive steps towards reducing tobacco consumption.

Health warnings must now cover 80 percent of cigarette packages in Uruguay and each brand is permitted only one design per package. Australia has gone further still, implementing a policy of plain packaging in an attempt to de-glamorise the appeal of smoking.

In response, the tobacco firm Philip Morris International has declared the policies “excessive” and filed a lawsuit at a World Bank affiliate, seeking unspecified damages for lost profits.

“While governments and the international health community try to implement effective measures to contain tobacco use and protect the health of people, their efforts are being aggressively opposed by an industry whose products kill people,” said Ban, noting big tobacco’s aggressive attempts to derail public health initiatives.

The prospect of lengthy and expensive lawsuits threatens to become an effective deterrent to anti-tobacco policies of the type pioneered by Australia and Uruguay.

“Big Tobacco’s bullying is the single greatest threat to implementation of the Global Trade Treaty,” Stewart said.

“Marlboro Man” Awards

The Marlboro Man awards, part of CAI’s Challenging Big Tobacco campaign, are a mock celebration of governments’ failures to stand up to the tobacco industry

By buoying big tobacco’s litigation campaign, some countries, including the Netherlands, Indonesia, Honduras and Ukraine, qualify for nomination in this year’s awards.

Ukraine complained at the World Trade Organisation about Australia’s ban on branding cigarette packets, saying it violated international intellectual property laws.

Yet Ukraine doesn’t have any trade with Australia, Stewart pointed out. “It seems a pretty obvious case of the industry somehow influencing the government of the Ukraine to do their dirty work for them.”

Given the increasingly aggressive and manipulative tactics taken by big tobacco, public health policymakers and anti-tobacco campaigners have little trust in the industry.

“Public health initiatives should be focused on challenging this deadly industry,” Stewart told IPS.

“The tobacco industry presents itself as a stakeholder in public health policy. We are calling on governments to keep big tobacco out of the room when public health policy decisions are being made” he said.

But others believe in the possibilities of reining in corporate giants and challenging them face to face.

“The industry can’t be painted with one brush stroke,” said Scott Ballin, a health policy consultant and former vice president for public policy and legislative counsel at the American Heart Association.

“There is a need to think from the standpoint of what the companies could do if they wanted to – for instance, stopping the production of tobacco tainted with other products, cracking down on smuggling and raising standards,” Ballin told IPS.

From this perspective, dialogue can’t be ruled out. Ballin suggested “challeng(ing) these companies and forc(ing) them to develop the products that technology says can be developed. This will move people away from cigarettes to using low-risk products,” he said.

Targeting youth

According to CAI’s 2012 report “Cutting through the Smoke”, tobacco giants have and continue to operate a shamelessly exploitative marketing strategy in the developing world.

Faced with dropping sales in the U.S., UK and European markets, big tobacco has turned to consumers in the developing world to bolster cigarette sales.

For the past seven years British American Tobacco Nigeria (BATN) has been utilising underground parties held at secret locations in Lagos to attract hip Nigerian party goers with the allure of free fun.

At a conference organised for World No Tobacco Day, Gigi Kellett, CAI’s Challenging Big Tobacco campaign director, described the scene.

“Picture a dance floor throbbing to the beat of music, young women in sequined mini-skirts adding sparkle to the crowded throng, young men in fedoras making their way to an all-you-can-smoke-and-drink buffet, courtesy of the nation’s largest tobacco corporation: British American Tobacco Nigeria,” Kellett told reporters and policy makers.

Environmental Rights Action Nigeria, a Nigerian advocacy group dedicated to the defence of the human ecosystem in terms of human rights, has worked tirelessly to bring the Global Tobacco Treaty into force in Nigeria.

But big tobacco skirts regulation with these smoking parties, advertised online or by word of mouth, Kellett added.

These corporations’ exploitation of alternative regulatory contexts in emerging countries like Nigeria worsens the already tarnished image of the industry. It exemplifies one of several points of conflict between big tobacco and the Global Tobacco Trade Treaty.

Ballin suggested that “the best way to find a path forward is to sit down with the stakeholders”. But as tobacco companies’ underhanded marketing strategies transgress the boundaries of international law, anger and suspicion overtake the landscape, transforming it into a battlefield.

The immense majority of women diagnosed with HIV in Argentina in the last two years were infected through unprotected sex with their stable partners, a new report says.

“In some cases, they are couple who have been together for years,” Maria Eugenia Gilligan, an activist with the Argentine Network of Women Living with HIV, told IPS. “The age range has even expanded, and we are finding more and more women over 60.”

This national organisation and the Buenos Aires Network of People Living with HIV jointly surveyed 465 women in that situation around the country for the “Study of Recently Diagnosed Women”.

The women interviewed were all diagnosed since Jan. 1, 2009. The aim was to find out in what circumstances they were infected. Gilligan said many of the women were “uninformed.”

The sample included women between the ages of 17 and 70, although 51 percent were 25 to 39. Around 70 percent had reached but not necessarily completed secondary school, and a few had university or other tertiary level education.

The report to which IPS had access has not yet been officially released, but the preliminary results were presented on the International Day of Action for Women’s Health, celebrated Monday May 28.

The survey described the living conditions of the respondents. For example, it reported that more than half of them live in crowded homes, 70 percent have no social security coverage, and only 46 percent work outside the home.

The study was carried out by the Gino Germani Research Institute of the University of Buenos Aires, and the Centre of Population Studies, with the backing of the Health Ministry and multilateral organisations like U.N. Women and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The chief conclusions are that 92 percent of women living with HIV were infected by means of unprotected sexual relations, while 73 percent said they were infected within a stable relationship.

The results partly coincide with Health Ministry statistics which indicate that there are 130,000 people living with HIV in this country of 40 million people, where the main channel of transmission is unprotected sex.

“We noted that since 2008 there is less public information available and there are more uninformed women. Specific campaigns are needed, and counselling and advice are failing. Although a lot is being done, there is much more to do,” Gilligan said.

For 60 percent of those surveyed, the diagnosis was “totally unexpected.” One 51-year-old woman said that after being faithful to the man she lived with for 11 years, she couldn’t believe she had been infected.

Official statistics suggest that up to half of all people living with HIV in this country do not know they are infected.

“We almost always see the same thing. The women didn’t know (their male partners) had the virus,” said Gilligan, who added that violence “is one factor that increases the vulnerability of women by making them reluctant to demand the use of condoms, as a precautionary measure.”

She said a majority of the women living with HIV had suffered physical and/or sexual abuse from a young age.

“It’s not that they don’t insist on condom use because they are crazy,” Gilligan said. “The problem is that many of them cannot negotiate the issue with their partners, out of fear of violence, so they use other methods of birth control.”

The study also found that over 44 percent of the women had experienced conflict or tension with their partners at some point over the use of condoms.

Most of the women interviewed said they discovered they were HIV-positive by chance: when they were pregnant, during a routine check-up, or in pre-surgery tests. Only 10 percent had gone in for testing after finding out that their partners were living with HIV.

The report also discusses what happens once a woman has found out that she tests positive for the AIDS virus. It points to shortcomings in terms of confidentiality, and in counselling to help women deal with the situation.

Some women, for example, face “hostile situations” when they are told they test positive for HIV, the report says. It also mentions cases in which a family member is informed even before the woman herself, or in which she is told of her HIV-positive status in front of others, such as doctors, nurses or relatives.

The personal accounts also show that there are women who leave the medical clinic or hospital without fully understanding the results of the test. “They told me it was ‘reactive’, but I didn’t know if that meant positive or not,” one of the respondents said.