HUMAN RIGHTS DAY 2024 JOINT OPEN LETTER FROM TOFAZA AND ZADEMA TO THE PRESIDENT OF THE REPUBLIC OF ZAMBIA – HIS EXCELLENCY PRESIDENT HAKAINDE SAMMY HICHILEMA

HUMAN RIGHTS DAY 2024
JOINT OPEN LETTER FROM TOFAZA AND ZADEMA TO THE PRESIDENT OF THE REPUBLIC OF ZAMBIA – HIS EXCELLENCY PRESIDENT HAKAINDE SAMMY HICHILEMA

Public Health Advocates Call on President Hakainde Hichilema to Put People Before Profits, Emphasizing Health as a Basic Human Right and Demanding Swift Action on Tobacco Control Legislation Amidst Tobacco Industry’s Role in Zambian Health Crisis.

Tuesday 10th December 2024
Dr. Hakainde Sammy Hichilema,
President of the Republic of Zambia,
State House

Your Excellency,
Health as a Basic Human Right
On this Human Rights Day, observed under the theme “Our Rights, Our Future: Right Now,” we are reminded of the critical role that human rights play in shaping our collective future. Access to health is a fundamental human right, vital for the well-being and progress of both individuals and communities. In this context, we urge you, as the President of the Republic of Zambia and the primary protector of the constitutional right to life and public health, to prioritize the swift passage of the long-awaited Tobacco Control Bill, following the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC). The scientific evidence is clear: tobacco use is a leading cause of death, morbidity, and disability in Zambia.

Tobacco Consumption: Zambia’s Leading Single Threat to Health
In line with the findings of experts at the World Health Organisation (WHO), the tobacco epidemic is one of the greatest public health threats the world has ever faced, killing over 8 million people globally each year. In Zambia, more than 7,000 people die annually due to tobacco use. All forms of tobacco are harmful, and there is no safe level of exposure. Cigarette smoking is the most common form of tobacco use in Zambia, but other products like water pipe tobacco, cigars, heated tobacco, roll-your-own tobacco, pipe tobacco, and smokeless tobacco are also prevalent.

Tobacco Harm in Zambia
According to a 2019 study by the Ministry of Health in conjunction with the World Health Organisation (WHO) and other partners, tobacco use results in over 7,000 deaths and costs Zambia an estimated ZMW 2.8 billion (US$ 165 million) annually. Tobacco consumption and production cause avoidable illness and premature death, resulting in economic losses, widening socioeconomic inequalities, and contributing to environmental degradation. As the Pan American Health Organisation aptly puts it, “Tobacco is the only legal consumer product that kills up to half of its users when used exactly as intended by the manufacturer.”
Health Impact of Tobacco Use
Over 7,000 Zambian lives are needlessly lost every year due to tobacco use, with over 60% of these deaths occurring among those below 70 years of age. The study reveals that four of the top ten leading causes of death in Zambia (lower respiratory infections, ischemic heart diseases, tuberculosis, and stroke) are caused by, exacerbated by, or associated with tobacco use. The top three leading causes of tobacco-related deaths in Zambia are lower respiratory infections, ischemic heart disease, and tuberculosis. It is deeply concerning that even non-smokers are innocently losing their lives due to tobacco consumed by smokers. In Zambia, more than 800 deaths each year are directly attributable to the effects of second-hand smoke. This highlights the urgent need for comprehensive tobacco control legislation to protect everyone’s right to health. The Tobacco Control Bill is crucial in addressing this public health crisis and preventing further unnecessary deaths. This high incidence of premature mortality and disability imposes a significant cost on the economy of Zambia.
The Economic Cost of Tobacco Use
Tobacco consumption imposes significant costs on Zambia’s economy. The study showed that in 2016, health expenditure on tobacco-attributable illness was estimated at ZMW 154.3 million (US$ 9 million). Government health expenditure as a result of tobacco-attributable illness is high at ZMW 74.2 million (US$ 4.4 million). Out-of-pocket healthcare expenditure at ZMW 42.5 million (US$ 2.5 million), and private insurance at ZMW 37.6 million (US$ 2.2 million), also represent significant health-related costs. The indirect costs include those associated with loss of productivity, for example, from missing work (absenteeism), reduced productivity while at work (presenteeism), and taking excessive breaks because of smoking. Absenteeism imposes a cost of ZMW 204 million (US$ 12 million), presenteeism a cost of ZMW 613 million (US$ 36 million), and excessive breaks a cost of ZMW 434.2 million (US$ 25.5 million) annually. Tobacco-related premature deaths impose an indirect cost of approximately ZMW 1.4 billion (US$ 82 million) on the Zambian economy annually, which brings the total economic cost of tobacco use to ZMW 2.8 billion (US$ 165 million).
Economic Cost of Tobacco Use as a Percentage of Annual GDP in Zambia
The study further revealed that tobacco use costs the Zambian economy about ZMW 2.8 billion (US$ 165 million) annually when all direct (ZMW 154 million) and indirect costs (ZMW 2.7 billion) are considered. This amounts to about 1.2% of Zambia’s annual GDP.
Comparison between Tobacco-Related Costs and the Amount of Taxes Collected from Tobacco Companies
Total tax revenue from tobacco in Zambia is estimated at ZMW 246.9 million (US$ 14.1 million) using 2016 data and falls significantly short of total tobacco-related costs at ZMW 2.8 billion (US$ 165 million).
Tobacco Use and Household Expenditure in Zambia
Smoking households consistently allocate less expenditure towards essential goods and services such as food, school, housing, and daily transport. This implies that smoking households have a lower standard of living than non-smoking households. This crowding-out effect of tobacco use is more severe for poorer households.
Tobacco farming and food security
While Zambia ranks among the top five producers of tobacco leaf in Africa, tobacco farming undermines food security because of the significant price risk associated with the activity, coupled with its high labour intensiveness.
In the case of Zambia, where the agricultural land devoted to growing tobacco increased twenty-fold between 1996 and 2016, and where the price risk for tobacco is significant, tobacco farmers often do not realise sufficient value from their tobacco harvest to meet their food needs. At the same time, farmers usually have insufficient stock of maize and other subsistence crops because the level of effort that tobacco farming requires limits their ability to tend to other crops adequately. The prevalence of price risk, combined with the labour intensiveness of tobacco farming, therefore presents significant potential for food insecurity for tobacco farmers and corroborates the experiences noted by many farmers. https://escholarship.org/content/qt76b25769/qt76b25769_noSplash_ba25f2daf2d92c0e6521ee2432d2873a.pdf?t=krn80d

Zambia needs to grow more food. Not more tobacco.
Environmental Degradation Caused By Cigarettes
Smoking and cigarette disposal are also significant contributors to environmental damage. Smoke from cigarettes and other smoked tobacco products releases toxic chemicals into the air. Greenhouse gases such as carbon dioxide, methane, formaldehyde, and nitrous oxides are also found in tobacco smoke; these chemicals have been found on surfaces although people have not smoked there for months.
Up to two-thirds of cigarettes are disposed of on the ground, and often end up in water systems. Not only are these polluting the environment with plastic, but cigarette filters contain cancer-causing chemicals and other dangerous toxins. Bialous et al., (2017).
Following the establishment of cigarette-manufacturing facilities in the Lusaka Multi-Facility Economic Zone, the capacity to manufacture cigarettes has increased significantly and the facilities can produce up to 20 million cigarettes daily for both the export and domestic markets.
As you would imagine, the long-term effects of the residue of millions of cancer-causing cigarette filters disposed onto the Zambian soil and waterways are nothing short of catastrophic.
Proposed Tobacco Control Bill
The proposed Tobacco Control Bill aims to regulate the tobacco industry, protect individuals from the harmful effects of tobacco smoking, and enforce a ban on smoking in public areas. However, the industry’s attempts to remove crucial clauses will undermine the bill’s effectiveness and compromise the health and well-being of Zambians.
Industry’s Attempts to Thwart Legislation
As Zambia moves closer to enacting the Tobacco Control Bill, the industry is pulling all strings to dilute the bill’s contents. Their target? Key clauses covering partnerships and incentives for the tobacco industry. These clauses are essential to the spirit of the WHO FCTC, a treaty Zambia ratified in 2008. Article 5.3 of the FCTC explicitly warns against industry interference, stating that governments should protect their public health policies from the commercial and vested interests of the tobacco industry. Yet, the industry continues to exert its influence, prioritisng profits over people’s lives.
Prolonged Delay in Tobacco Control Legislation Adversely Affecting Zambia’s Present and Future Generations
“Iya kokola ilalokwa”. Procrastination is the thief of time- and in this case, a thief of thousands of precious Zambian lives. It would be unfortunate for a government that is on the verge of history as the first Zambian administration to endorse the Tobacco Control Bill to approach the 2026 elections without putting their decision into action.

The prolonged legislative process has allowed the tobacco industry to continue marketing and selling products with minimal restrictions, making them more accessible and appealing to young people. Alarmingly, thousands of children in Zambia are reported to be addicted to smoking, with a growing number using products like e-cigarettes, vaping shisha, and Nsunko. A “Big Tobacco / Tiny Targets” survey conducted by TOFAZA and ATCA and TOFAZA in recent years exposed how cigarettes and other Tobacco products are being advertised and sold with impunity near primary and secondary schools. It exposed how the tobacco industry in Zambia is targeting schools in Zambia to attract young learners and make them their “life-long customers” of their addictive and harmful products. The TOFAZA/ATCA “Big Tobacco Tiny Targets” study of 2019 established that there is unequivocal evidence that the tobacco industry deliberately and systematically targets children to encourage smoking and the use of other tobacco products. Tobacco sales outlets are often very close to schools and cigarettes are widely sold in single sticks and packs of 20 around schools.
It is disturbing to note that cigarettes are so affordable and accessible to young children and they are in many instances cheaper than a sweet or a lollipop.

Our Appeal To His Excellency President Dr. Hakainde Hichilema

Your Excellency, in your recent widely quoted statement, you proudly mentioned that you have never smoked a cigarette in your life. This commendable choice has undoubtedly shielded you from the harmful effects of tobacco. On this Human Rights Day, celebrated under the theme “Our Rights, Our Future: Right Now,” we urge you to extend this protection to all Zambians with urgency.
As someone who has wisely guarded your health, we appeal to you to protect the current and future generations of Zambians from the harms of tobacco and second-hand smoke. By ensuring that your administration promptly enacts the Tobacco Control Bill, you will be taking a decisive step toward safeguarding the health and well-being of our nation.

The Tobacco Free Association of Zambia (TOFAZA) and the Zambian Developmental Media Alliance (ZADEMA) believe that the enactment of the Tobacco Control Bill is crucial in combating Non-Communicable Diseases, preventable deaths and disabilities and overall misery linked to tobacco use.
Your Excellency, this is not just a legislative matter; it is a matter of life and death for Zambia’s children.

Yours Sincerely,

Brenda Chitindi
TOFAZA – Executive Director

Derrick Sinjela
ZADEMA -Executive President