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Heartline Magazine January - March 2006
Tackling Tobacco
 I
was invited by the Framework Convention Alliance (FCA) for
tobacco control to attend the first Conference of the Parties
(COP) to the Framework Convention on Tobacco Control (FCTC) as
the only NGO representative from the English speaking Caribbean.
The FCA is an international NGO with offices in Geneva and New
York and the Heart Foundation of Barbados has been a member for
about two years. The FCA sponsored and funded my trip covering
all expenses including return airfare to Geneva, hotel
accommodations and per diem.
I was expected to attend FCA meetings and
assist with various FCA duties, such as production of the FCA
Bulletin, lobbying and attending sessions.
The Plenary and Committee stages of the COP
Of the 122 countries that had ratified in time to attend COP 1,
some 116 sent delegates. Those who had not ratified were allowed
to send observers, and this latter list included the USA. Three
English speaking Caribbean countries - Barbados, Jamaica and St.
Lucia - sent delegates, whilst the two others that had also
ratified, Guyana and Trinidad & Tobago, did not.
The Plenary was divided into two committees.
Committee A was charged with discussing,
debating and bringing forward resolutions on:
1. Review of existing and potential sources
and mechanisms of assistance
2. Reporting and exchange of information
procedures.
3. Elaboration of guidelines for
implementation of non-price measures to reduce the demand for
tobacco control and regulation of the contents of tobacco
products.
4. Elaboration of protocols particularly in
relation to tobacco advertising, promotion and sponsorship.
Committee B looked at and resolved:
1. Adoption of rules of procedure for the
COP.
2. Designation of the permanent Secretariat
and arrangements for its functioning.
3. Adoption of financial rules for the COP
and financial provisions governing the functioning of the
Secretariat.
4. Adoption of the budget for the first
financial period of two years 2006 and 2007.
The Barbados delegate, Mr. Samuel Deane,
Chief Health Planner, Ministry of Health, and I decided that to
ensure Barbados covered all topics he would attend Committee A
whilst I would go to sessions of Committee B.
Financing agreed
A budget of US$8m for two years was agreed
to, also the method of financing by means of a levy on each of
those countries who have ratified. Barbados’s contribution will
be just US$1,241 with Japan the highest contributor at US$1.8m
and the lowest contributions at US$124 coming from a wide range
of countries including just one from the Caribbean, Guyana.
Recommendations on the review of existing
and potential sources and mechanisms of assistance were
proposed. This, however, effectively moved away from the idea of
a global fund which developing countries could seek grants from,
to a recommendation that urged developed countries,
international financial institutions, international
organizations and other development partners to channel
resources, based on specific requests, to developing country
Parties and Parties with economies in transition for the
implementation of the Convention, without which full
implementation of the convention will not be achieved.
This effectively means that countries like
Barbados and others in the Caribbean will be at a disadvantage,
as it will need a particular developed country to provide the
required funding rather than it coming out of a global fund to
which all have contributed.
It was also recommended that the COP adopt a
specific set of guidelines for implementation of the convention.
These include objectives, rationale and time frame for
implementing articles of the Convention:
• Protection from exposure to tobacco smoke
• Product regulation
• Packaging and labeling
• Cross-border advertising
• Education, communication, training and
public awareness
Fringe Meetings
A wide array of special lunch-time and
evening meetings were held covering a number of specific topics,
mostly related to the implementation of the FCTC articles. I was
not able to attend all of them because of clashes of
timetabling, however I did get to all those that held particular
significance for Barbados as well as others of passing interest.
Product regulation was not of vital
importance for us in Barbados since we are not manufacturers of
cigarettes, but the conclusions were interesting nonetheless:
1. Implementation of FCTC Articles 9-11 must
be guided by science-based tobacco product testing.
2. Measurements using current ISO methods
have been used to mislead consumers about exposure and risks
from different products.
3. Regulatory strategies using machine
measurements should focus on reducing the toxicity of smoking
generated, rather than on the amount of smoke generated per
cigarette.
Labeling, however, is important to us in
Barbados as Article 11 relates not just to manufacturers but
also to importers. Many countries have already introduced
legislation on this issue and several exceed the minimum
standard of size of warning being not less than 30% of the
principal display area. Article 11 also suggests that warnings
and messages may be in the form of or include pictures or
pictograms and shall contain information on relevant
constituents and emissions.
At the fringe meeting there were many
examples of the different types of labeling that have been
adopted. I particularly liked Canada’s:
“CIGARETTES ARE A HEARTBREAKER – Tobacco use
can result in the clogging of arteries in your heart. Clogged
arteries cause heart attacks and can cause death.”
And, given our forthcoming change of name to
embrace stroke, another of their exhibits was also appropriate:
“CIGARETTES CAUSE STROKES – Tobacco smoke
can cause the arteries in your brain to clog. This can block the
blood vessels and cause a stroke. A stroke can cause disability
and death.”
Cross border advertising is likely to be
quite a problem for us here in Barbados given the array of TV
channels which we can access, particularly those from the USA
which has of course not ratified the FCTC. It was very useful to
learn what is being done in Australia and New Zealand to curb
the threat of cross border advertising. Internet advertising
using modern technology is a very real problem, but filtering
devices have been developed that can be used by operators such
as ISPs and mobile phone operators and/or offered to end-users.
There will be a need to regulate technology
providers, but carefully so as not to remove everything. This
will need input from CSME once all Caribbean countries ratify
the FCTC to ensure conformity.
Economics of Tobacco Control
A very interesting set of presentations were made, particularly
that on the “Cost of tobacco-related Illness in Bangladesh”, the
conclusions of which were very similar to those of a study
undertaken by Dr. Anthony Lwegaba of UWI carried out here in
Barbados. Both these studies clearly show that the cost of
treatment of patients suffering from tobacco related illnesses
is far greater than the tax income generated from the sale of
cigarettes.
Smoke-free success in the UK
During the second week of COP 1 the English parliament voted to
follow Article 8 and introduce a ban on smoking in all indoor
public places. Effectively all the UK will now be smoke free as
far as certain public places are concerned as the Scottish
parliament had already introduced similar legislation. In so
doing the UK joins a growing number of countries that have
introduced 100% smoking bans inside restaurants and bars. To
date six countries have legislated: Ireland, Norway, New
Zealand, Bhutan, Uruguay and the United Kingdom. The list also
includes 7 out of 8 Australian states, 9 out of 13 Canadian
provinces and 11 out of 50 U.S. states plus Bermuda.
So there is still a long way to go given
that over 125 countries have now ratified the FCTC.
We here in Barbados of course have the added
problem of what have been described as “quasi-outdoor public
spaces” by WHO/PAHO officials. On my raising questions about how
we should deal with this particular problem it was suggested
that Queensland, Australia with similar “quasi-outdoor spaces”
was the place to look at. Queensland apparently has introduced
legislation to deal with this possible problem including also
such areas as beaches.
In response to a question from the Barbados
delegate, Samuel Deane, re how UK had dealt with sports stadium,
the UK government official answered that they had included all
enclosed stadium even if once you entered the stadium you were
then out in the open. So let’s get moving on our legislation so
that Cricket World Cup 2007 can be smoke free.
The daily Bulletin
I managed to get involved in all of the activities of the FCA to
a greater or lesser degree. The FCA Bulletin was somewhat
surprisingly anxiously awaited by many of the delegates probably
because they wanted to find out if they had been awarded the
‘Orchid’ or the ‘Ashtray’. As the first bulletin explained:
“These awards are made each day by the civil
society organizations that make up the Framework Convention
Alliance. We make them to acknowledge the countries who show
real commitment to implementing the FCTC, and to expose those
whose action, or lack of action, slow it down.”
A few highlights from the publication during
the ten working days of COP:
• The death clock was launched showing that
25,726,183 have died from tobacco related diseases since work
began on the FCTC in October 1999.
• Orchid to South Africa and to other
Parties from the AFRO Region, for supporting a strong
secretariat that will be accountable to the Conference of the
Parties.
• Uruguay is to become the first country in
South America to protect all workers from the harmful effects of
second-hand smoke on March 1, 2006.
• Barbados warns on complacency. Groups like
the Heart Foundation of Barbados are lobbying for the government
to implement the FCTC with strong measures before something goes
wrong, as has happened in many other countries before and even
after the signing of this treaty.
• Ashtray to Japan which despite having
ratified the FCTC, is still promoting tobacco industry
positions.
• Clock watching. Is anyone counting? During
a typical day’s discussions another 3,600 people are killed by
tobacco.
• Orchid to Brazil for creating a National
Commission for FCTC implementation.
• Brazil, Barbados, the Cook Islands and
Uruguay are among the Parties calling for guidance on the
implementation of Article 14. This deals with tobacco
dependence, cessation and promotion of adequate treatment.
• We’ll say it again, and again and
again…stump up the cash! Donor countries need to identify
financial resources and mechanisms and developing countries must
make a realistic assessment of their needs.
• Calling all cricket fans – action alert.
The Heart Foundation of Barbados is urging all member countries
of the International Cricket Council (ICC) to petition ICC for a
tobacco-free Cricket World Cup to be held in the West Indies in
2007.
Looking back at what I hoped to get out of
the COP on behalf of the Heart Foundation, I have to conclude
that I now do have a better understanding of the FCTC as a
result of primarily attending the fringe meetings and conversing
with FCA colleagues.
I was also able to gain know how from those
countries who are ahead of Barbados in implementation, and
importantly to make many useful contacts from around the globe.
Probably the most successful objective achieved was that faces
were put to names and new NGO contacts added. The wealth and
depth of experience within FCA is enormous. My one disappoint
was the lack of other Caribbean or heart NGOs present.
Although there was not as much opportunity
as I would have liked, I believe that the Heart Foundation of
Barbados and the Ministry of Health now understand one another
much better, and the HFOB CEO and the MOH Chief Health Planner
could now be said to have a much closer working relationship.
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