Southeast Asia Tobacco Control Alliance

www.seatca.orgwww.seatca.org

Priorities and policy making for tobacco control in ASEANPriorities and policy making

for tobacco control in ASEAN

Ulysses Dorotheo, MD, FPAO29 August 2014

Ulysses Dorotheo, MD, FPAO29 August 2014

www.seatca.orgwww.seatca.org

Southeast Asia Tobacco Control Alliance (SEATCA)

Southeast Asia Tobacco Control Alliance (SEATCA)

• Vision: Towards a healthy, tobacco-free ASEAN

• Mission: Working together to save lives by accelerating effective implementation of the FCTC in ASEAN

• Approach to mission: collaborative and strategic partnerships, capacity building, and evidence-based policy advocacy

• Partner countries: Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, Vietnam, (Brunei and Singapore)

• Vision: Towards a healthy, tobacco-free ASEAN

• Mission: Working together to save lives by accelerating effective implementation of the FCTC in ASEAN

• Approach to mission: collaborative and strategic partnerships, capacity building, and evidence-based policy advocacy

• Partner countries: Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, Vietnam, (Brunei and Singapore)

Costs: TC makes senseCosts: TC makes sense• Cost of inaction• Lives lost• Healthcare costs• Disability costs and productivity losses• Environmental costs

• Cost of FCTC implementation• USD 0.14 per person per year in China,

USD 0.16 in India, and USD 0.49 in Russia

• Cost of inaction• Lives lost• Healthcare costs• Disability costs and productivity losses• Environmental costs

• Cost of FCTC implementation• USD 0.14 per person per year in China,

USD 0.16 in India, and USD 0.49 in Russia

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Tobacco control policyTobacco control policy

Win – Win

Win – Lose

Lose – Lose

Win – Win

Win – Lose

Lose – Lose

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How priorities are decidedHow priorities are decided

• National health agenda• Role of civil society• Role of tobacco industry

• National health agenda• Role of civil society• Role of tobacco industry

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“Economically, there may be many alternatives available, but where health and life are concerned, do we have any alternative? The answer is clearly no. There are no alternatives as far as health and life are concerned, because health and life are all that we have.

“Therefore, the issue before us is really quite obvious, whether we want to survive with smoking from the economic viewpoint, which has many alternatives, or do we choose one that totally has no alternative, that is to safeguard health and save lives?”

“Economically, there may be many alternatives available, but where health and life are concerned, do we have any alternative? The answer is clearly no. There are no alternatives as far as health and life are concerned, because health and life are all that we have.

“Therefore, the issue before us is really quite obvious, whether we want to survive with smoking from the economic viewpoint, which has many alternatives, or do we choose one that totally has no alternative, that is to safeguard health and save lives?”

His Majesty Sultan Haji Hassanal Bolkiah Mu'izzaddin Waddaulah, Brunei Darussalam, 11 July 2002

Policymaking considerationsPolicymaking considerations

• Lack of capacity: human, technical, financial

• Government conflict of interest: state-owned TI

• Politicians’ personal COI• TI interference• Misinformation, corruption, front groups• Litigation• Legal and illicit trade

• Lack of capacity: human, technical, financial

• Government conflict of interest: state-owned TI

• Politicians’ personal COI• TI interference• Misinformation, corruption, front groups• Litigation• Legal and illicit trade

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Evidence is not enoughEvidence is not enough

• Capacity building• Monitoring and countering TI

interference• Media advocacy

• Capacity building• Monitoring and countering TI

interference• Media advocacy

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179 Parties as of August 2014

• Art. 2(1) - Introduction• In order to better protect human health,

Parties are encouraged to implement measures beyond those required by this Convention and its protocols, and nothing in these instruments shall prevent a Party from imposing stricter requirements that are consistent with their provisions and are in accordance with international law.

• Art. 2(1) - Introduction• In order to better protect human health,

Parties are encouraged to implement measures beyond those required by this Convention and its protocols, and nothing in these instruments shall prevent a Party from imposing stricter requirements that are consistent with their provisions and are in accordance with international law.

Tobacco harmsTobacco harmsThe objective of this Convention and its protocols is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke.

(FCTC Article 3)

The objective of this Convention and its protocols is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke.

(FCTC Article 3)

”What gets measured gets done.””What gets measured gets done.”

Dr. Margaret ChanWHO Director-General

• Art. 5(3) – General Obligations• to “protect these [public health]

policies from commercial and other vested interests of the tobacco industry”

• Art. 5(3) – General Obligations• to “protect these [public health]

policies from commercial and other vested interests of the tobacco industry”

Article 5.3

Demand reduction measuresArt. 6 – Price and tax measures Art. 7 – (Non-price measures)

Art. 8 – Protection from exposure to tobacco smoke Art. 9 – Regulation of the contents of tobacco products Art. 10 – Regulation of tobacco product disclosures Art. 11 – Packaging and labeling of tobacco products Art. 12 – Education, communication, training and public awareness Art. 13 – Tobacco advertising, promotion and

sponsorship (TAPS) Art. 14 – Demand reduction measures concerning tobacco dependence and cessation

Demand reduction measuresArt. 6 – Price and tax measures Art. 7 – (Non-price measures)

Art. 8 – Protection from exposure to tobacco smoke Art. 9 – Regulation of the contents of tobacco products Art. 10 – Regulation of tobacco product disclosures Art. 11 – Packaging and labeling of tobacco products Art. 12 – Education, communication, training and public awareness Art. 13 – Tobacco advertising, promotion and

sponsorship (TAPS) Art. 14 – Demand reduction measures concerning tobacco dependence and cessation

Supply reduction measures Art. 15 – Illicit trade in tobacco products Art. 16 – Sales to and by minors Art. 17 – Provision of support for economically viable alternative

activities • Protection of the environment Art. 18 – Protection of the environment and the health of

persons • Questions pertaining to liability Art. 19 – Liability• Scientific and technical cooperation and communication of

information Art. 20 – Research, surveillance and exchange of information Art. 21 – Reporting and exchange of information Art. 22 – Cooperation in the scientific, technical, and legal fields

and provision of related expertise

Supply reduction measures Art. 15 – Illicit trade in tobacco products Art. 16 – Sales to and by minors Art. 17 – Provision of support for economically viable alternative

activities • Protection of the environment Art. 18 – Protection of the environment and the health of

persons • Questions pertaining to liability Art. 19 – Liability• Scientific and technical cooperation and communication of

information Art. 20 – Research, surveillance and exchange of information Art. 21 – Reporting and exchange of information Art. 22 – Cooperation in the scientific, technical, and legal fields

and provision of related expertise

16 |

Monitor tobacco use & prevention policies

Protect people from tobacco smoke

Offer help to quit tobacco use

Warn about the dangers of tobacco

Enforce bans on tobacco advertising, promotion, & sponsorship

Raise taxes on tobacco

• Conference of Parties, 1 to 5• Guidelines for implementation• Art 5.3: TI interference• Art 6: tax and price (draft)• Art 8: smoke-free• Art 9&10: product regulation and disclosure

(partial)• Art 11: packaging and labeling• Art 12: Education and awareness• Art 13: TAPS ban• Art 14: cessation

• Protocol• Art 15: illicit trade

• Conference of Parties, 1 to 5• Guidelines for implementation• Art 5.3: TI interference• Art 6: tax and price (draft)• Art 8: smoke-free• Art 9&10: product regulation and disclosure

(partial)• Art 11: packaging and labeling• Art 12: Education and awareness• Art 13: TAPS ban• Art 14: cessation

• Protocol• Art 15: illicit trade

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Are we really winning?

Are we really winning?

WHO, 2013 Global Tobacco Control Report

195

Cambodia Cambodia

• Passage of the TC Law• Enforcement and monitoring of sub-

decrees• Increasing tobacco tax• Partial SFE• Partial TAPS ban•

• Passage of the TC Law• Enforcement and monitoring of sub-

decrees• Increasing tobacco tax• Partial SFE• Partial TAPS ban•

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IndonesiaIndonesia

• FCTC accession• Rejecting the proposed Tobacco Bill

(that will weaken PHW articles to text warnings only)

• Enforcement of PHWs• Effective tax increases• Implementation of earmarked local

tax

• FCTC accession• Rejecting the proposed Tobacco Bill

(that will weaken PHW articles to text warnings only)

• Enforcement of PHWs• Effective tax increases• Implementation of earmarked local

tax

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Lao PDRLao PDR

• Collection of LAK 200/per pack for TC Fund

• International campaign to end the Investment License Agreement with TI

• Revision of TC Law

• Collection of LAK 200/per pack for TC Fund

• International campaign to end the Investment License Agreement with TI

• Revision of TC Law

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MalaysiaMalaysia

• Good governance seminar (Art 5.3)• Inclusion of trade agenda in COP 6• Amendment of TC regulations: SFE,

POS

• Good governance seminar (Art 5.3)• Inclusion of trade agenda in COP 6• Amendment of TC regulations: SFE,

POS

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PhilippinesPhilippines

• Utilisation of tobacco tax revenues• Further tax increase in 2017

• Implementation of the GHW law• Expanding SFE• Tobacco industry interference •

• Utilisation of tobacco tax revenues• Further tax increase in 2017

• Implementation of the GHW law• Expanding SFE• Tobacco industry interference •

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ThailandThailand

• 85% PHW• Tax increase for RYO• Countering fake TI CSR (amend the

law to push for total ban)

• 85% PHW• Tax increase for RYO• Countering fake TI CSR (amend the

law to push for total ban)

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VietnamVietnam

• Tobacco tax increase• TC Fund and TC Law implementation

• Tobacco tax increase• TC Fund and TC Law implementation

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Thank youThank you

Email: ulysses@seatca.orgEmail: ulysses@seatca.org