Pressure mounts on FCTC domestication of Tobacco and Nicotine Products Control Bill

… as Zambia Youth Alliance petitions Health Minister Dr. Jonas Kamima Chanda

By Derrick Sinjela

PRESSURE is mounting on the Zambian Government to domesticate the Framework Convention on Tobacco Control (FCTC) a global aspiration gathering dust at the Ministry of Health (MoH), 13 years after the country ratified the United Nations (UN) pledge.

 

After realising a tortoise pace at which the FCTC is walking, a Monday 19th April, 2021 Petition by Zambia Youth Alliance (ZYA) Director Mr. Samson Mwale, as a Principal Petitioner) and five others Mwape Mwenya, Rabecca Nayame, Akakulubelwa Mwangana, Moses Silungwe and Shekinah Mwale sought audience with Dr. Chanda, but could only interact with Permanent Secretary for Technical Services Dr. Kennedy Malama.

Prayed Mr. Mwale: “Zambia acceded to the WHO FCTC Treaty on 23rd May 2008 and all the provisions of the FCTC came into effect in 2003 (After the 5 years grace period). Ideally domestication should be effected within 5 years from date of ratifying. 13 years later, Zambia has not yet domesticated the WHO FCTC. It is our considered view, that we cannot wait any longer to have the ‘’ Tobacco and Nicotine Products Control Bill,’’ enacted into law”.

In a Wednesday 17th March 2021 petition tagged- Where Is Our Bill? Zambian CSOs call for Tabling of the TOBACCO CONTROL LEGISLATION before Parliament, three Civil Society Organisations (CSO’s) officials led by Evelyn Moloka, Christine Syatalimi and Sylvester Katontoka lobbied Ndeke House bureaucrats to restore confidence and as in the last paragraph, met Dr. Chanda’s technocrat Dr. Malama.

Zambian SCOs believe that tabling of The Tobacco Control Bill is in essence domestication of the World Health Organization Framework Convention on Tobacco Control (“WHO FCTC”) to which Zambia became a signatory on Friday 23rd May, 2008 is prudent.

“The Centre for Primary Care Research (CPCR), Cancer Association of Zambia (CAZ), Zambia Consumer Association (ZACA), Alcohol and Drug Abuse in Zambia (AADAZA), Zambia Media Network Against Tobacco (ZAMNAT) and Heart and Stroke Foundation as six (6) members of the Zambia Consortium on Tobacco Control with a vested interest in the health and  economic livelihoods of the people of Zambia, we are concerned that despite several deliberations and stakeholders’ consultations, our calls to enact appropriate tobacco control legislation have gone unheeded. Domestically, tobacco related illnesses and deaths cost the Zambian economy approximately ZMW 2.8 billion, which equates to 1.2 % of the Gross Domestic Product (GD),” prayed ZAMNAT Chairperson Paxina Phiri.

In 2020 alone, the Ministry of Health estimated approximately 7,312 tobacco related deaths , further exacerbated by the outbreak of the COVID-19 pandemic. Early indications are that smokers have a higher risk of contracting COVID-19 than their non-smoking counterparts thus the urgency to enact the tobacco control legislation,” noted Ms. Phiri.

On Wednesday1st June 2016, the Patriotic Front Manifesto 2016-2021: ‘Towards a Prosperous, Peaceful, Stable, and All-inclusive Zambia, Under One Zambia, One Nation’ had pledged to ensure a strengthened legal framework but as 2021 approached this vow captured in Article 18, is noticeably missing in the 2021-2026 manifesto, launched by President Edgar Chagwa Lungu on Wednesday 21st April 2021 at Lusaka’s Mulungushi International Conference Centre (MICC).

The PF 2021-2026 manifesto circulated by Special Assistant to the President for Press and Public Relations, Mr. Isaac Chipampe is themed: ‘Making Every Zambian Count, Continuity for Prosperity, Peaceful, Stable  and an All-Inclusive Zambia,’was witnessed by Vice-President Ms. Inonge Mutukwa-Wina, PF Secretary General, Mr. Davies Mwila, Chairperson Samuel Ng’onga Mukupa, and Justice Minister Given Lubinda.

“We shall Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol; -By 2020, halve the number of deaths and injuries from road traffic accidents; -By 2021, achieve universal health coverage, including financial risk protection, access to quality essential health care services and access to safe, effective,

quality and affordable essential medicines and vaccines for all; and –Strengthen the implementation of the World Health Organisation Convention on Tobacco Control,” pledged Dr. Lungu in Article 18.

 

The President has explained that the platform upon which the PF is basing its message for the second term mandate will be a continuation of the pro-poor policies, it has been implementing in the last five years,” read a Media Statement circulated by then Special Assistant to the President for Press and Public Relations Amos Chanda.

 

According to Programmes/ Projects Advocated by a PF Think Tank ahead of 2011 General Elections approved by its founding leader, the late ‘King Cobra’ Mr. Michael Charles Chilufya Sata provided a framework of the campaign after analyzing the PF Manaifesto.

Whereas the PF Manifesto was a Letter of Intent, the Think Tank comprising Mr. Bob Sichinga, Dr. Mbita Chitala, the late Mr. Mike Isaiah Mulongoti, Lieutenant Colonel Panji Kaunda,  Mr. Pius Mambo,  Mr. Wylbur Chisiya Simusa  to name but six (6) actualized the desires contained in the manifesto with regard to Health and Nutrition thus: “Rehabilitating health institutions, controlling epidemics and chronic diseases, providing drugs and medical equipment/supplies”.

And CPCR Project Director Zambia Fastone Matthew Goma urged the local media to intensify the fight against tobacco which globally kills more than 8 million people annually and 1.2 million human beings being exposed to second hand smoking.

Professor Goma says his team based at the University of Zambia (UNZA) School of Medicine at the Ridgway Campus on Lusaka’s Nationalist Road, reiterated that CPCR decided to engage Zambian media as key partners helping to administer information in the right doses so that government and other stakeholders are educated, to facilitate prompt and speedy domestication of the Framework Convention on Tobacco Control (FCTC).

Professor Goma lamented that the monitor policy implementation was first introduced in 2012 and  by the year 2016, positive response was expected from government, though zero progress from the Patriotic government is now commonplace.

“It is long overdue, we now want the domestication of the Framework Convention on Tobacco Control being expedited, we are beginning to think the issue is dragging, it is too slow from the government side as a key stakeholder, though, my team has decided to engage the media, to help disseminate information to people in right doses,” Professor Goma stressed at a Sandy’s Creation Lunch with Editors on Saturday 20 March 2021.

Professor Goma said journalist as a Fourth Estate to the Government (Executive), Legislature and Judiciary are closer to the ordinary people suffering due to consequences of tobacco consumption. Scribes are influential in placing a good battle against a cancerous stick called cigarette.

That the Ministry of Health should as a matter of urgency, introduce in Parliament,

“The Tobacco and Nicotine Products Control Bill.’’

 

Background.

Tobacco kills more than 7,400 Zambians each year, most of them under 70 years of age. Indeed Tobacco use is a growing epidemic. Among 13-15 year old children 24.9% of Boys and 25.8% of Girls were said to be using tobacco in 2011 (Global Youth Tobacco Survey 2011), while Tobacco use among adult males was aid to be at 24% and adult females at 7.8%. These figures are all increased in comparison to ones recorded previously indicating that Zambia is still is still on an upward trajectory when all the developed countries are recording a decline. The World Health Organization (WHO) has advised the domestication of the FCTC in each member country to benefit from the evidence based clauses that are proposed for the domestic legislation.

Zambia has had a piece meal approach to tobacco control and up to date boasts of just pieces of legislation and/or regulations contained in several pieces of legislation. The following are examples:

1. The Public Health (Tobacco) regulations/SI 39 of 2008 banned smoking in public places
2. The Public Health (Tobacco) regulations banned the sale of tobacco to persons under the age of 16 (Compliance low and Law enforcement weak).

• Partial bans on advertising of tobacco products in the media such as billboards, posters, newspapers and magazines with very inadequate education and mass media campaigns

 

Action taken to date

The mandate to protect Zambians from the adverse health effects of tobacco use and exposure to tobacco smoke is given to the Ministry of Health which has been advised to enact the Tobacco and Nicotine Products Control Bill. The objects of this Bill are to –

1. declare tobacco product, tobacco device, nicotine product or nicotine device as a restricted product;
2. provide for the protection of present and future generations from the devastating, health, social, environmental and economic consequences of tobacco use, nicotine addiction, and exposure to the harmful emissions of tobacco products, tobacco devices, nicotine products or nicotine devices;

• prevent the initiation, continually and substantially reduce the use of tobacco product, tobacco device, nicotine product or nicotine device, and encourage quitting;

1. Domesticate the World Health Organization Framework Convention on Tobacco Control; and provide for matters incidental to, and in connection with, the foregoing.

Zambia acceded to the WHO FCTC Treaty on 23rd May 2008 and all the provisions of the FCTC came into effect in 2003 (After the 5 years grace period). Ideally domestication should be effected within 5years from date of ratifying. 13 years later, Zambia has not yet domesticated the WHO FCTC.

An attempt to enact the Tobacco Control Bill in 2014 failed because of what was termed “inadequate consultations”. The draft was referred back to MoH for consultations with other stakeholder Ministries. These “consultations” have been going on since then. Huge strides were made in 2019 when a number of consultations were made to reach the final mile in the enactment of the tobacco Control Bill. Among these were:

• Consultation with some line Ministries namely: Ministry of Agriculture, Ministry of Finance, Ministry of National Planning and Development, Ministry of Commerce Trade and Industry. This meeting on 10-13 September, 2019
• Consultation with the Tobacco Industry represented by British American Tobacco, Phillip Moris, and Tobacco Association of Zambia was held on 16 – 23^rd December, 2019. This was to hear their concerns about the Bill. At this meeting, MoH clarified most of their misunderstanding of the intentions of the bill.
• The tobacco Industry through the Zambia Chamber and Commerce and Industry (ZACCI) requested for conducting of the Regulatory Impact Assessment (RIA). This was supported by the Ministry of Commerce, Trade and Industry. While this is a requirement under Section 5 and 6 of the Business Regulatory Act No 3 of 2014, the Bill should have been exempted as health implications are supposed to be higher than the trade and commerce implications. However, the Regulatory Impact Assessment (RIA) was successfully conducted and report was submitted to Business Regulatory Review Agency (BRRA). Approval of the RIA Report by BRRA was communicated to MOH in a letter referenced BRRA/8/45/1 and dated 20th November 2020. The RIA demonstrated that enacting a new piece of legislation to domesticate the WHO FCTC had the lowest Cost Effectiveness Analysis (CEA) ratio compared to the other two options. The aforementioned option provided highest benefits compared to the others.  Considering the seriousness of tobacco and nicotine use and the commercial interest, the need for law enforcement is the best option.

 

• A Cabinet Memorandum requesting for “approval in principle” to introduce a Bill entitled The Tobacco and Nicotine Products Control Bill was considered and approved by the Ministerial Cabinet Liaison committee in meetings held on 21st July 2020 and 28th July 2020.

 

• In March 2021, the Ministry of Health instructed the technocrats in the ministry to do another inter-ministerial consultation which was conducted successfully in the first week of April, 2021.

 

• Despite overwhelming support for the Draft Bill from almost all the Ministries, the Ministry of Health is still not keen to bring the Bill to Cabinet.

 

• The draft bill is said to be awaiting the Second Approval of the Cabinet memorandum by the Hon. Minister of Health.

This is where the Bill has stalled to date and there is no more time to bring it to pass it through all the rigorous processes remaining for it to be brought to the House.

Conclusion.

It is our considered view, that we cannot wait any longer to have the ‘’ Tobacco and Nicotine Products Control Bill,’’ enacted into law.

CPCR Project Director Zambia Fastone Matthew Goma has urged the local media to intensify the fight against tobacco which globally kills more than 8 million people annually and 1.2 million human beings being exposed to second hand smoking.

Professor Goma says his team based at the University of Zambia (UNZA) School of Medicine at the Ridgway Campus on Lusaka’s Nationalist Road, reiterated that CPCR decided to engage Zambian media as key partners helping to administer information in the right doses so that government and other stakeholders are educated, to facilitate prompt and speedy domestication of the Framework Convention on Tobacco Control (FCTC).

Professor Goma lamented that the monitor policy implementation was first introduced in 2012 and  by the year 2016, positive response was expected from government, though zero progress from the Patriotic government is now commonplace.

“It is long overdue, we now want the domestication of the Framework Convention on Tobacco Control being expedited, we are beginning to think the issue is dragging, it is too slow from the government side as a key stakeholder, though, my team has decided to engage the media, to help disseminate information to people in right doses,” Professor Goma stressed.

Professor Goma said journalist as a Fourth Estate to the Government (Executive), Legislature and Judiciary are closer to the ordinary people suffering due to consequences of tobacco consumption. Scribes are influential in placing a good battle against a cancerous stick called cigarette.

Meanwhile, Prof Goma  says  a special drug that can help people addicted to Nicotine found in cigarettes is available in form of ones desire to be healthy, a deliberate act that  will help Zambia  achieve sustainable development goals  through  reducing number of smokers to 11 per cent by the 2030.

Speaking during a Saturday 20^th March 2021 one-day Editors workshop at Lusaka’s Sandy’s Creation, Professor Goma said the World Health Organisation (WHO) is on a vigorous campaign to birth a generation born in 2010 that is cigarette smoking-free.

Professor Goma  said Zambia is one of the countries  globally lagging and less represented on  the world  platform due to lack of knowledge translation thus a renewed  media campaign compelling stakeholders and politicians to domesticate the Tobacco Control bill, which Zambia ratified 13 years ago.

During the question and answer session, moderated by Ms.  Paxina Phiri, Professor Goma said his team has managed to incorporate 20 Members of Parliament and traditional leaders to help overcome challenges delaying domestication of the Framework Convention on Tobacco Control (FCTC).

Facts about Tobacco

`26th July 2019

 

Key facts

• Tobacco kills more than 8 million people each year. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke
• Tobacco kills up to half of its users, when they use it following manufacturers recommendation
• Contains more than 7000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and at least 69 are known to cause cancer.
• Around 80% of the world’s 1.1 billion smokers live in low- and middle-income countries.
• Leading cause of death, illness and impoverishment.
• Nearly 16.0% of Zambians currently consume some form of tobacco products.
• More men (24.0%) than women (7.8%).
• 3% of Zambians are currently using smoked tobacco products that include manufactured cigarettes, hand rolled cigarettes, pipes and shisha.
• 0% of Zambians are daily tobacco smokers (the vast majority being males at 17.1 against females at 1.3%).
• Mean age for starting to smoke being 15.7 years.
• Up to 4.5% use smokeless tobacco, and of these 6.8% were women and 2.2% were men.

World Health Organisation (WHO) response

The 6 MPOWER measures are:

• Monitor tobacco use and prevention policies
• Protect people from tobacco use
• Offer help to quit tobacco use
• Warn about the dangers of tobacco
• Enforce bans on tobacco advertising, promotion and sponsorship
• Raise taxes on tobacco.

 

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