LACK OF POLICIES THAT SUPPORT HARM REDUCTION AFFECTING INTERVENTIONS
Despite some effort by Africa in achieving some of the Sustainable Development Goals (SDGs), reducing tobacco use has proved the hardest to deliver. Reducing tobacco use plays a major role in global efforts to achieve the SDG target to reduce premature deaths from non-communicable diseases (NCDs) by one third by 2030.
Significant disparities in health outcomes around the world are driven by unequal access to essential health products. Scientific advances have led to the creation of new nicotine delivery products that have saved millions of lives. Yet new products may not be readily accessible to those in need due to a variety of factors, including systemic challenges caused by weak regulatory oversight, particularly in Africa.
Most African countries have ratified the Framework Convention on Tobacco Control (FCTC),an evidence-based treaty that reaffirms the right of all people to the highest standard of health. While there has been some success in its execution, this international legislation focuses primarily on non-health related approaches to tobacco control — including price and tax measures to reduce demand, strategies to reduce smuggling, indoor air laws, and limits on tobacco advertising — but fails to directly address smoking cessation and harm reduction strategies.
Tobacco control efforts in Africa have mostly concentrated on increasing tobacco taxes, restricting or banning advertising, adding or expanding warning messages, and restricting smoking in public areas. Policy makers may not be aware that tobacco harm reduction has great benefits, both economically and for health; this lack of information, in turn, hinders a reduction in smoking prevalence in the region.As smoking rates drop in high income regions thanks to reduced risk alternatives, smoking rates in Africa have risen 50% in over 35 years.We now have over 77 Million smokers on the continent,with over 250,000 of them dying every year from smoking related disease.A contributing factor is the lack of adequate policy that supports tobacco harm reduction and an inappropriate belief of policy makers that tobacco harm reduction interventions are less urgent than action on other diseases.
Since tobacco control policy in most countries is informed by the F.C.T.C treaty ,law makers are reluctant to allow safer nicotine products into the market, placing smokers’ lives at greater risk.The Framework Convention on Tobacco Control (F.C.T.C), while successful in its execution, fails to acknowledge the harm reduction strategies necessary to help those incapable of breaking their dependence on tobacco. Based on the human right to health embodied in Article 12 of the International Covenant on Economic, Social and Cultural Rights, this article contends that international law supports a harm reduction approach to tobacco control.Harm reduction can be defined as a strategy that lowers total tobacco-related mortality and morbidity despite continued exposure to tobacco-related toxicants.
Tobacco harm reduction within a regulated framework, encouraging smokers to use safer nicotine containing products, should be supported by governments in Africa.New and innovative products, such as e-cigarettes,heat-not-burn and Snus can deliver nicotine at far lower risk than combustible cigarettes. Instead of moving to group e-cigarettes with tobacco products, legislation should recognize the health benefits of these products over smoking. A lag in regulatory approval of safer nicotine products in sub-Saharan Africa can mean the difference of life or death for smokers waiting for access to these proven alternatives.
