THE FRAMEWORK
CONVENTION ON TOBACCO
CONTROL (FCTC)
Zanele Mthembu
Director: Health Promotion
National Department of Health
February 2005
1
Introduction
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Tobacco is a leading preventable cause of death worldwide
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It kills 4,9 million people annually. This is predicted to rise to 10
million per year by 2030
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70% of future deaths will be in the developing world
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Tobacco use causes over 40 preventable diseases
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A smoker with TB is 30% to 50% more likely to die than a nonsmoker with TB
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Introduction cont.
• In South Africa, tobacco related diseases kill
about 25 000 people a year. This is more than
the deaths caused by motorcar accidents (about
10 000 annually).
• About 60% of all admissions to Groote Schuur
Hospital are from tobacco related illnesses
• The WHO has called this a “global public health
emergency” and initiated a global response to
the crises.
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Economics of Tobacco use
• Reducing smoking will reduce poverty and
produce huge economic savings.
• Tobacco is responsible for higher medical costs,
increased absenteeism from work, lower
industrial productivity, and loss of earnings for ill
workers
• These costs are not offset by the excise taxes
paid on tobacco products.
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The cost of smoking
• Smokers of more than 20 cigarettes a day have twice as much
time off work due to illness as do non-smokers.
• 40% of heavy smokers die before reaching retirement age
compared with 15% of non-smokers.
• Absenteeism is 35% to 45% higher among smokers than nonsmokers.
• In 1998, over 2.5 million work days were lost in South Africa due
to sickness absence from chronic bronchitis, emphysema, and
asthma
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The cost of smoking
Cont.
•
Loss of productive years of life through death from CVD – 90 000
deaths a year of which 40% are in the economically active work force.
R2,4 billion per year in loss productivity.
•
Loss of productivity through disability from CVD every year: At least
100 000 of whom 40% were economically active – about R2,4 billion
per year
•
The cost of maintaining the survivors (Health Care Cost and Disability
Grants). About R2 billion per year.
•
In 1994, the MRC estimated that for every R1 received by Government
from tobacco taxes, it cost the economy R2 to treat smoking related
illnesses and from lost productivity.
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The FCTC...
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The first international public health treaty negotiated by Member States of the
World Health Organization
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Objective: to protect present and future generations from the devastating
health, social, environmental and economic consequences of tobacco
consumption and exposure to tobacco smoke ...
•
Timeline: 1999 – 2003
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FCTC suggest various courses of action that would enable countries to develop
effective tobacco control measures. Recognises that legal and cultural
environments varies across nations.
•
The FCTC specifically recognizes that tobacco control in developing countries
and in countries with economies in transition will require sufficient financial and
technical resources, and it obliges the Conference of the Parties to seek ways to
assist developing countries to meet and exceed their obligations in terms of the
Convention.
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May 21, 2003: The Final Treaty
• 171 member states of WHO approved final text on March 1, 2003. The
text was adopted by the World Health Assembly on 21st May 2003.
• Treaty will go into force on the 28th February 2005 as more than 40
countries have ratified it. (57 countries of which 8 are from Africa)
• Provides a roadmap that could lead to comprehensive tobacco control
programs and strategies at the international, regional, national and
local levels.
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FCTC: Process of Enactment
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•
•
•
•
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Agreement
Adoption
Signature
Ratification
Entry into Force – 28 February 2005
Conference of Parties
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South Africa and the FCTC
• South Africa Hosted the first ground breaking inter-sessional
AFRO meeting in March 2001 which brought AFRO Unity
• Represented AFRO at the Bureau
• Elected as 1 of 6 Vice Chairpersons of Inter-governmental
Negotiating Body with Australia, India, Iran, Turkey and the USA
• Chaired the second session of the Inter-governmental Working
Group of the FCTC( 31 Jan to 04 February 2005)
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South Africa and the FCTC cont.
• We signed the treaty on Youth Day,
16 June 2003
undertook to strive in good faith to ratify
the Convention and show political
commitment not to undermine the
objectives set out in it.
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Current Status of the FCTC
• Signatories
-
168
• Ratification 57
– Including:- Kenya, Mauritius, Madagascar,
Seychelles, Lesotho, Botswana Fiji,
Ghana, Senegal,New Zealand, Bangladesh, India,
Japan, Norway, France, Mexico
Accessions - 2
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FCTC: Key Provisions:
Obligations & Exhortations
The Convention contains sufficient obligations and exhortations to
enable states to craft appropriate tobacco control policies to meet
their own needs.
The FCTC obliges Parties to adopt and implement effective
measures within 3 years after entry into force of the Convention
for that party, on a number of demand and supply- side measures;
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Key Provisions
• Measures related to reducing the demand for tobacco:
• Price and tax measures
• Protection from exposure to environmental tobacco smoke
• Regulation and disclosure of contents of tobacco products
• Packaging and labeling
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Key Provisions - cont.
 Education, communication, training and public awareness
 Comprehensive ban and restriction on tobacco advertising,
promotion and sponsorship
 Tobacco dependence and cessation measures
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Key Provisions - cont.
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Measures relating to reducing the supply of tobacco
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Elimination of the illicit trade of tobacco products
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Restriction of sales to and by minors
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Support for economically viable alternatives for growers
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The FCTC and International
Trade (Preamble)
• Parties to the Convention are “determined to give priority to their
right to protect public health”.
– To give interpretive guidance only if tobacco control measures
based on the FCTC are attacked under other international
agreements, including trade agreements.
– Encourages governments to prioritize the health of their citizens
over commercial interests.
• NB: This does not place any obligation on a Party to adapt or alter,
existing, or even future trade relations.
• FCTC does not affect the right of governments to enter into any
bilateral or multilateral agreements.
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Article 2
Relationship between this Convention and other
agreements and legal instruments
•
In order to protect human health, Parties are encouraged to implement
measures beyond those required by this Convention and its protocols.
•
The provisions of the Convention and its protocols shall in no way
affect the right of Parties to enter into bilateral or multilateral
agreements, including regional or sub-regional agreements, on issues
relevant or additional to the Convention and its protocols, provided that
such agreements are compatible with their obligations under the
Convention and its protocols.
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Article 5
General Obligations
Amongst other things and in accordance with
each country’s capabilities, this Article
advocates the need for the establishment of
national coordinating mechanisms / focal
points.
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Article 6
Price and Tax Measures to Reduce the
Demand for Tobacco
• Parties recognize that price and tax measures are an effective
and important means of reducing tobacco consumption [in] the
population, in particular young persons.
• Without prejudice to the sovereign right of the Parties, the
Convention encourages countries to determine and establish
their taxation policies.
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Article 8
Protection from exposure to tobacco
smoke
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Parties recognize that scientific evidence has
unequivocally established that exposure to tobacco
smoke causes death, disease and disability.
•
Each Party shall adopt and implement … effective
… measures, providing for protection from
exposure to tobacco smoke in indoor workplaces,
public transport, indoor public places and, as
appropriate, other public places.
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Article 9
Regulation of the Contents of Tobacco
Products
• The Conference of the Parties… shall propose
guidelines for testing and measuring the contents and
emissions of tobacco products, and for the regulation
of these contents and emissions.
• Each Party shall, where approved by competent
national authorities, adopt and implement..measures
for such testing and measuring.
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Article 10
Regulation of Tobacco Product Disclosures
• Each Party shall.. implement… measures requiring
manufacturers and importers of tobacco products to
disclose to governmental authorities information
about the contents and emissions of tobacco
products.
• Each Party shall.. implement.. measures for public
disclosure of information about the toxic constituents
of the tobacco products and the emissions that they
may produce.
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Article 11
Packaging and Labeling of Tobacco Products
• Countries are encouraged to adopt and implement effective
measures (in accordance with national laws) to ensure that
misleading words that created an impression that a particular
tobacco product is less harmful than the other, are not used.
These words may include terms like “low tar”, “ultra-light”, or
“mild”.
• Each unit packet and package of tobacco products and any
outside packaging and labelling of such products also carry
health warnings describing the harmful effects of tobacco use,
and may include other appropriate messages.
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Article 12
Education, communication, training
and public awareness
Each Party shall promote and strengthen
public awareness of tobacco control
issues, using all available
communication tools, as appropriate.
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Article 13
Tobacco Advertising, Promotion and Sponsorship
• The FCTC encourages countries to undertake a
comprehensive ban of all tobacco advertising,
promotion and sponsorship in accordance with each
countries national laws.
• Parties are encouraged to consider the elaboration of
a protocol setting out appropriate measures that
require international cooperation in dealing with
cross-border advertisement.
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Article 14
Demand reduction measures
concerning tobacco dependence and
cessation
Each Party shall take effective measures to
promote cessation of tobacco use and
adequate treatment for tobacco
dependence.
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Article 15
Illicit Trade in Tobacco Products
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. …the elimination of all forms of illicit trade in tobacco products,
including smuggling, illicit manufacturing and counterfeiting… are
essential components of tobacco control.
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About a third (1/3) of all cigarettes that are exported, disappear enroute and end up in the contraband market.
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Worldwide, this amounts to about 355 billion cigarettes.
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Therefore the FCTC encourages regional and international cooperation
in addressing this problem.
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The FCTC encourages countries to adopt measures that will ensure
that all unit packets and packages of tobacco products, and any outside
packaging of such products, are clearly marked in order to assist
countries in determining the origin of tobacco products. The cost to be 28
born by the tobacco industry.
Article 16
Sales to and by minors
• Each Party shall … prohibit the sales of tobacco
products to persons under the age set by domestic
law, national law or eighteen.
• Each Party shall prohibit or promote the prohibition of
the distribution of free tobacco products to the public
and especially minors.
• Each Party shall endeavour to prohibit the sale of
cigarettes individually or in small packets which
increase the affordability of such products to minors
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Article 17
Provision of support for economically
viable alternative activities
Parties shall, in cooperation with each other and
with competent international and regional
intergovernmental organisations, promote, as
appropriate, economically viable alternatives for
tobacco workers, growers and, as the case may
be, individual sellers.
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Article 18
Protection of the environment and
the health of persons
Parties agree to have due regard to the protection of the
environment and the health of persons in relation to
the environment in respect of tobacco cultivation and
manufacture within their respective territories
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Article 19
Liability
Countries are encouraged to consider taking
legislative action to deal with criminal and civil liability
related to the harm caused by the tobacco
companies. This issue is raised in the Convention to
enable Parties (to the Convention) to take
appropriate steps to deal with liability. However, the
Convention does not compel any Member State to
embark on any action against tobacco companies.
This is in line with the currently held policy of the
South African government not to participate in
litigation in other countries.
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Article 20
Research, surveillance and
exchange of information
The Parties undertake to develop and
promote national research and to
coordinate research programmes at the
regional and international levels in the field
of tobacco control
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Article 21
Reporting and exchange of
information
Each Party shall submit to the Conference
of the Parties, through the Secretariat,
periodic reports on its implementation of
this Convention
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Article 22
Cooperation in the scientific, technical
and legal fields and provision of
related expertise
The Parties shall cooperate directly or through
competent international bodies to strengthen their
capacity to fulfill the obligations arising from this
Convention, taking into account the needs of
developing country Parties and Parties with
economies in transition. Such cooperation shall
promote the transfer of technical, scientific and legal
expertise and technology, as mutually agreed, to
establish and strengthen national tobacco control
strategies, plans and programmes
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Part VIII:
Institutional arrangements and
financial resources
• Article 23: Conference of the Parties
• Article 24: Secretariat
• Article 25: Relations between the
Conference of the Parties and
intergovernmental organisations
• Article 26: Financial resources
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Part IX:
Settlement of Disputes
• Article 27: Settlement of disputes
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Part X
Development of the Convention
• Article 28: Amendments of this
Convention
• Article 29: Adoption and amendments of
annexes to this Convention
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Part XI
Final Provisions
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Article 30: Reservations
Article 31: Withdrawal
Article 33: Protocols
Article 34: Signature
Article 35: Ratification, acceptance, approval,
formal confirmation or accession
• Article 36: Entry into force
• Article 37: Depositary
• Article 38: Authentic texts
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Financial Implications
of the FCTC for SA
• The FCTC will be integrated within the existing tobacco
control initiatives of the Department of Health
• The main expense will be the financing of the
Conference of the Parties (COP), its subsidiary bodies
and the secretariat, estimated at US $ 30 000 per year
• At its first meeting, the COP will determine how it is to
be funded.
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Constitutional Implications
• The preamble of the FCTC makes reference to three human
rights Conventions: the International Covenant on Economic,
Social and Cultural Rights, the Convention on the Elimination of
All Forms of Discrimination Against Women and the Convention
on the Rights of the Child, as other means of protecting and
restoring human rights and dignity.
• The FCTC will enhance important values enshrined in our
Constitution. In particular, it will promote and protect the Rights
to a Safe Environment, the Rights of Children, as well as Health,
Gender and Human Rights.
• None of the provision of the FCTC is in conflict with any aspects
of the South African Constitution. (Confirmed by the State Law
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Advisors)
Implications of Ratifying for SA
• Thousands of lives of South Africans will be saved from
premature deaths
• Thousands of South Africans will be spared ill-health and
disability
• Millions of South Africans will be spared the unnecessary loss of
family members, including those who are economically active.
• Savings of billions of Rands related to loss of production,as well
as health care costs related to premature death and disability
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THANK YOU
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