GROUP 1. Marching towards a tobacco free world.

Transcription

1 GROUP 1 Marching towards a tobacco free world. Chair : Dr Douglas Bettcher(WHO/HQ) Facilitator : Dr Nyo Nyo( WHO/SEARO) Rappoteur: Pubudu Sumanasekara ( ADIC/Sri Lanka) Sherub Gyeltshen(Bhutan)

2 What is working well in the region? 1. Dedicated funds for tobacco control e.g. India and Thailand, 2. Comprehensive Tobacco control Laws 3. Pictorial Health Warnings in five countries I. Thailand-85% II. Nepal-75% ( all tobacco products) III. Sri Lanka 60% IV. Indonesia 40% V. India 40% -front (All tobacco packs)

3 What is working well in the region? continued Smoke free at public and work places Bhutan 100% Nepal 100% Thailand 100% TAPS bans Maldives (comprehensive) including cross border and internet Thailand TV rule India and Sri Lanka TV and movie Advocacy on tobacco control Bangladesh Bhutan India

4 What are not working well 1. Weak law enforcement and monitoring, and lack of public awareness of law. 2. Tobacco tax too low and laws are too complicated, and taxes don t apply to all tobacco products. Tobacco tax enforcement is weak. 3. Lack of funding for tobacco control 4. Cessation of tobacco use 5. Laws and regulations are not covering indirect TAPS 6. Inadequate human resources 7. Control of illicit tobacco trade 8. Lack of tobacco testing facilities 9. Lack of multisectoral collaboration 10.Lack of alternative crops and livelihood-farmers and bidi/cherrot/tendu workers

5 What are major gaps and obstacles 1. Tobacco Industry interference 2. Lack of code of conduct for tobacco industry interference 3. Lack of multisectoralcollaboration-conflicting policies such as with agriculture, finance & trade department 4. Corruption from law enforcement, tax collection and custom duties 5. Agriculture and manufacturing is used by the tobacco industries in many countries to counteract tobacco control laws 6. Porous borders facilitates illicit trades

6 Building on the ongoing best practices 1. Integration of TB and tobacco control programmes. Few pilots have been done in Nepal, Indonesia, and India. This needs to be institutionalized at national and subnational levels in all SEAR countries given that high comorbidity and mortality. 2. These recommendations/guidelines have existed for many years but they need to be presented to the SEAR Regional Committee.

7 Building on the ongoingbest practices contd 3. Tobacco cessation to be included into NCD/Diabetes/hypertension/CVD clinics 4. Integrating tobacco control with maternal and child health: WHO has finalized a global guideline and recommendations for integrating tobacco cessation and reproductive health. SEAR countries should advocate for integrating these into the MCH guidelines for the countries.

8 Challenges and opportunities for inter-country co-operations 1. Good example of inter country cooperation such as training of health professionals in tobacco cessations and tobacco control and sharing of pictorial warnings, guidelines (India and Thailand). 2. Sharing of evidence for litigations 3. Training programme for promoting sources of sustainable funding for tobacco control in the region 4. Sharing best practices on tobacco control in the region in a uniform way

9 Challenges and opportunities for inter-country co-operations contd 5. Establish NCD knowledge hub in countries such as India to build capacity in SEAR countries. 6. Tobacco testing laboratories being set up in India could be a referral centre for other SEAR countries. 7. Horizontal South-South collaboration and cooperation. 8. Joint training and capacity building in the area of trade laws as they intersect with tobacco control laws and regulations in the region 9. Improvement of system for collecting and analysing data at country level

10 Gaps in country level monitoring and surveillance mechanisms 1. Not all countries are using standard questions for tobacco surveys. Therefore, the key data for monitoring key indicators and targets for tobacco control are not comparable. 2. Several countries do not have the capacity to establish sustainable surveillance system for tobacco control. 3. Only a few SEAR countries have translated and incorporated the global NCD targets, including the 30 % relative reduction of tobacco use in the age group of 15 plus into national action plans. This need urgent attention.

11 Gaps in country level monitoring and surveillance mechanisms contd.. 4. Lack of country tobacco specific morbidity and mortality data. 5. Lack of dissemination and utilization of data for translating into action. 6. Lack of Industry data on tobacco production and distribution. 7. Lack of regulation for requirement from industries to provide data on tobacco production and distribution, and how much they spent on marketing and advertising. 8. Lack of information and evidence to inform rational regulation of new products in particular ENDS (electronic, nicotine delivery system) such as e-cigarette.

12 Accountability measures to be instituted at the country level 1. Development of law enforcement manuals 2. Training of law enforcement officials on tobacco control legislations 3. Awareness campaigns to increase public on tobacco control legislations 4. Publishing annually on violations and actions taken on tobacco control 5. Setting up of mobile courts/raiding squads for violation of tobacco laws 6. Setting up national and sub-national level multisectoraltask force committee for review and implementation of tobacco control 7. Including tobacco control violations in the regular police crime reports. 8. Public hearing for violation of tobacco control laws

13 Training and capacity building for Tobacco control programmes 1. Compendium of tobacco control guidelines, tools, public awareness campaigns and materials as well as pictorial warnings at SEARO website in English version 2. Training of Trainers for Tobacco control focal points in the SEAR countries 3. Explore possibility for pool of funds to support inter country tobacco control initiatives-regional public good or countries can offer to host trainings for other SEARO countries.

14 Recommendations for SEAR countries 1. Comprehensive tax policies in line with the WHO FCTC Article 6 guidelines and WHO technical documents. 2. All SEAR countries should aim to implement and enforce large pictorial warnings (at least 75%) on all tobacco products, complete TAPS bans including ban of point-of-sale display (POS) of tobacco products, and complete bans on smoking in all public places with no provisions for designated smoking areas. 3. All countries to collate data and publish reports on tobacco industry interference and work towards development of code of conduct/administrative/ executive orders/laws in line with guidelines for implementation of Article 5.3 of WHO FCTC.

15 Recommendations for SEAR countries continued.. 3. All Parties to the WHO FCTC should form committees with representation from key stakeholders/ departments/ministries like health, finance, commerce and industry, etc to move forward the process of ratification /accession of the illicit trade protocol. 4. All countries should provide adequate and sustainable funding to support tobacco control programme and full implementation of WHO FCTC at the earliest. 5. Take urgent steps to incorporate the tobacco prevalence reduction global NCD target into national action plan (30 % reduction). 6. Integration of tobacco control measures into TB and MCH programmes in all SEAR countries. 7. Integrate TQS (standard Tobacco Questions for Surveys) in all ongoing SEAR health surveys to ensure regular tracking of the NCD target for reducing tobacco use.

16 Recommendations for WHO SEARO: 1. Organize regional multisectoralawareness workshops to advance the process of Parties to the WHO FCTC to become Parties to the FCTC Illicit Trade Protocol. 2. Compendium of tobacco control guidelines, tools, public awareness campaigns and materials as well as pictorial warnings at SEARO website in English version 3. Facilitation and coordination between SEAR countries for hosting training programmes on tobacco control.

17 Recommendations for WHO SEARO contd 4. Facilitate and coordinate with Member countries on multisectoraltechnical cooperation for tobacco taxes, legislation development and enforcement including litigation support to defend the laws. 5. Provide support and technical assistance to farmers in Member countries to develop feasibility options for alternative crops and livelihoods.

18 THANK YOU