Presentation by Dr Douglas Webb, UNDP, at the 44th Union World Conference on Lung Health. 3 November 2013, Paris, France.

1. Tobacco control in Africa:
Challenges, successes and
perspectives
44th Union World Conference on Lung Health
3 November 2013
Paris, France
Douglas Webb
HIV, Health and Development Practice
UNDP New York

3. Obstacles – Governance Challenges
6 Sub-Saharan African countries are not Parties to the FCTC

4. Obstacles – Governance Challenges
Nine of the 11 countries to have never submitted an FCTC report are
African. One third of African parties did not submit a report in 2012.
No countries in sub-Saharan Africa have identified FCTC
implementation as a priority in their UN Development Assistance
Frameworks
Fewer than a quarter of WHO-Afro States reported undertaking antitobacco mass media campaigns during 2009-2010 – lower than any
other region.
45% of parties Africa reported no attempts to counter industry
interference (article 5.3)
Sources: FCTC 2012 Global Progress Report and
2011 WHO Report on the Global Tobacco Epidemic

5. Regional Tobacco Control Priorities
• Raising awareness about the WHO FCTC ratification/accession
process and requirements ;
• Building capacity for the development of national action plan and
comprehensive tobacco control policy and legislation reflecting the
different provisions of the WHO FCTC such as protection from
tobacco smoke, support for cessation programmes, warning about
the dangers of tobacco, bans on tobacco advertising and promotion
and raising taxes on tobacco products;
• Establishing a full-time national coordinating mechanism with a
designed national focal point and a national multisectoral steering
committee;
• Establishing a system for surveillance, monitoring and evaluation
of tobacco use, tobacco control policies interventions as well as
tobacco industry activities;
• Mobilizing resources for national tobacco control programmes with
the participation of nongovernmental organizations and the private
sector.

6. Obstacles – Governance Challenges
Countries that report not responding to industry interference in health
policies

7. Obstacles – Governance Challenges
Why act now in Africa?
• Africa is a major target for tobacco industry sales and marketing.
• African governments are ill-equipped to cope with the added health
burden and costs from the wave of chronic diseases that inevitably
follows increased tobacco use.
• Tobacco-related illness and premature death impose high productivity
costs and loss of labor.
• Lost economic opportunities resulting from tobacco use can be
particularly severe since most tobacco-related deaths occur during the
prime productive years.
• Tobacco is a big contributor to the factors that continue to derail
governments’ efforts to attain the MDGs.
• Reducing and preventing tobacco use will improve individual health,
increase available household funds for food and education, and better
serve economic productivity.

8. UN system response; alignment with FCTC
• Context of goal of 30% reduction in prevalence of tobacco use
by 2025
• UN division of labour on FCTC within newly formed UN Inter
Agency Task Force on the Prevention and Control of NCDs
• ECOSOC resolution July 2012 requesting FCTC support
integration into UNDAFs
• COP Working Group on Sustainable Measure to Strengthen the
Implementation of the FCTC formed in October 2103; principal
requests– Better uptake and coordination of country needs
assessments
– Technical support to generate evidence of micro and
macro-economic impacts of tobacco
– Support to align tobacco control with development planning
instruments
– Coordinated support to parties regarding counter-litigation
from the industry

9. Drivers for UN go beyond tobacco alone
• UN Political Declaration on NCDs 2011
• WHO Global Action Plan on NCDs 2013-2020
• Post 2015 Development Agenda – imperative
to link tobacco control with maternal and
child health, NCDs and universal health
coverage
• Momentum towards integrated health
responses and financing – a grand
convergence – with investment approaches
• Does tobacco control need an investment
framework?

10. Overview of UNDP
• The UN’s global development network
• On the ground in 177 countries and territories
• Administrator of UN Resident Coordinator System
• Thematic areas: poverty reduction, governance,
environment & energy, capacity development,
gender equality and HIV
• HIV, Health and Development:
– Mainstreaming, social determinants
– Governance, human rights and the law
– Implementation and capacity development
(Global Fund to Fight AIDS, TB and Malaria)

11. UNDP and the FCTC – political mandate
• FCTC COP decision FCTC/COP4/17
• Report of the UN Secretary General to ECOSOC – July 2012
‘UNDP to take into account Article 5 in its country-level role as convener
and coordinator…and under its governance programmes’
• ECOSOC resolution RES/2012/4 – July 2012
‘… integration of the WHO FCTC implementation efforts within the
United Nations Development Assistance Frameworks, where
appropriate, in order to promote coordinated and complementary work
among funds, programmes and specialized agencies’
‘UN funds, programmes and specialized agencies to contribute, as
appropriate, to the goals of the Framework Convention, including
through multisectoral assistance, public outreach and communication, in
particular in the context of the prevention and control of NCDs.’

12. UNDP and the FCTC – substantive contributions
Current work
• FCTC Needs Assessments and follow-up
• FCTC regional implementation meetings
• Trade and NCDs/tobacco in the Pacific
• Analysis of FCTC integration in development
planning and assistance frameworks
• Article 5 analysis
Other
potential
contributions
• UN system coordination, UNDAF integration
• Post-2015 development agenda
• Support to NCD action plan development
• Integration into national development planning
• Support to national, local governance structures
• Anti-corruption and regulatory independence
• Strengthening law enforcement, justice
• CSO and parliamentarian engagement

13. Integration framework
United
Nations
Development
Assistance
Framework
National
Development Plan
NCD
Plan
FCTC
Plan
Bilateral
Bilateral
Bilateral

14. Emerging Lessons: FCTC inclusion in
UNDAF
UNDAFs should support
• achieving NDP priorities – so FCTC should be
included in NDP
• delivery of international treaty obligations –
so FCTC should be listed
• coordination of UN agencies actions – so
UNCTs must be sensitised to relevance and
responsibilities

16. Wrap up - key messages
• Article 5 matters and generally needs to be accelerated
• There are ways to do it – framing tobacco as development
issue, mainstreaming, evidence and political positioning
• UN has proactive and reactive (demand-driven) ways of
providing support
• Country needs assessments and coordination of technical
support through the COP will accelerate the UN response.

17. Thank you
Douglas Webb
HIV, Health and Development Practice
Bureau for Development Policy
UNDP New York
Email: douglas.webb@undp.org
Acknowledgements:
Brian Lutz, Alison Cox, Dudley Tarlton,
Michelle Sahal-Estime, Roy Small