WHO's Public Health Strategy to Implement the WHO FCTC and Save Millions of Lives

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WHO's Public Health Strategy to Implement the WHO
FCTC and Save Millions of Lives

• Dr Douglas Bettcher
• Director, Tobacco Free Initiative
• World Health Organization

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The Tobacco Epidemic Worsening... Unless We Act
Now
Tobacco currently kills over 5 million/yr Will
increase to 8.3 million/yr (2030)

• If current smoking patterns continue,
• the death toll from tobacco use will be
  2000 2025 150 M
• 2025 2050 300M
• 2050 2100 500M
• TOTAL for 21st Century 1 billion
• (half the deaths in middle age)
• TOTAL for 20th Century 0.1 billion

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Tobacco Use a Key Preventable Risk Factor of
Noncommunicable Diseases

• Major noncommunicable diseases
• Cardiovascular disease
• Cancer
• Respiratory disease
• Diabetes
• Shared preventable risk factors
• Tobacco use
• Unhealthy diet
• Physical inactivity
• Harmful use of alcohol

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WHO Tobacco Control
CALL FOR ACTION World Health Assembly 2008 NCD
Action Plan 2008 - 2013
TOBACCO CONTROL WHO Framework Convention on
Tobacco Control 2003
TOBACCO FREE INITIATIVE Averting Deaths from
Tobacco Consumption
OPERATIONAL PLAN Medium Term Strategic Plan
2008 - 2013
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Tobacco Free Initiative (TFI)

• VISION To reduce the burden of disease and death
  caused by tobacco use, thereby protecting present
  and future generations from the devastating
  health, social, environmental and economic
  consequences of tobacco consumption and exposure
  to tobacco smoke

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TFI Strategies
Supporting health system development at country
level
Addressing economic policy issues with
evidence-based knowledge and information, and
filling knowledge gaps by strengthening policy
relevant research
Strengthening partnerships with strategic
international organizations, decision makers and
civil society
Providing technical support and relevant
documents on tobacco control legislation and
enforcement to all Member States
Scaling up capacity for implementation of tobacco
control interventions and the WHO-FCTC, in close
coordination with Regional Offices
Strengthening surveillance monitoring and
evaluation systems
Communications and advocacy
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WHO TFI Tobacco Control
TECHNICAL ASSISTANCE Country-level
implementation
CORE NORMATIVE FUNCTION In Conjunction with
Convention Secretariat
TOBACCO FREE INITIATIVE Averting Deaths from
Tobacco Consumption
CROSS-CUTTING ISSUES
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TFI Convention Secretariat

• TFI works synergistically and in complementarity
  with the Convention Secretariat to assist WHO
  Member States in building capacity related to
  tobacco control and to implement the WHO
  Framework Convention on Tobacco Control (WHO FCTC)

• Combined Operational Plan

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Global Level Implementation of WHO FCTC -
Normative

• TFI provides technical assistance for the
  implementation of the WHO FCTC
• Supporting the Normative Function of the
  Conference of Parties while working with the
  Convention Secretariat

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Global Level Implementation of WHO FCTC -
Normative

• Assisting Conference of Parties in development of
  Guidelines
• Article 5.3 Industry Interference
• Article 8 Smoke Free Environments
• Article 9 10 Product Regulation
• Article 11 Packaging and Labeling
• Article 12 Education
• Article 13 Advertising, Promotion, Sponsorship
• Article 14 Cessation
• Article 17 Alternative Livelihoods
• New Mandate of COP to TFI
• Article 6 Taxation Analyses
• Articles 910 Product Regulation
• Article 11 Pictorial Warnings Database
• Illicit Trade Protocol

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WHO TFI Tobacco Control
TECHNICAL ASSISTANCE Country-level
implementation
CORE NORMATIVE FUNCTION In Conjunction with
Convention Secretariat
TOBACCO FREE INITIATIVE Averting Deaths from
Tobacco Consumption
CROSS-CUTTING ISSUES
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Global Level Implementation of WHO FCTC
Country-level

• WHO Framework Convention on Tobacco Control (WHO
  FCTC)
• Foundation stone in the global fight against the
  tobacco epidemic
• mpower Six policies for tobacco control as part
  of WHO FCTC comprehensive implementation
• Key entry point for scaling up tobacco control
• Help countries build on WHO FCTC commitments
• Integral part of the WHO Action Plan for the
  Prevention and Control of Non-Communicable
  Diseases
• Matches WHO public health competency

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TFI Bringing in Change

• monitor tobacco use and 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
  and sponsorship
• raise taxes on tobacco

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WHO FCTC and MPOWER

• An evidence-based tool for tobacco control
  (demand and supply side measures)

r
p
w
Article 6, 15
Article 11, 12
Article 8
e
o
m
Article 14
Article 20, 21
Article 13
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TFI's Technical Assistance Plan Building
managerial, technical and policy infrastructure
Core Competencies
Economics
Surveillance
Legal
Global Networks
National tobacco control plans
Country-level partnerships
Global partnerships
Infrastructure
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Building Capacity for Tobacco Control
IMPLEMENTATION OF TOBACCO CONTROL
25 of countries do not have a
national/federal agency or a technical unit
with responsibility for tobacco control
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TFI's Technical Assistance Plan Building
managerial, technical and policy infrastructure

• New Tools
• - Capacity Assessments for Tobacco control
• Training packages
• New monitoring evaluation tools e.g. GATS/GTCR

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TFI Bringing in Change

• monitor tobacco use and 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
  and sponsorship
• raise taxes on tobacco

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WHO TFI Tobacco Control
TECHNICAL ASSISTANCE Country-level
implementation
CORE NORMATIVE FUNCTION In Conjunction with
Convention Secretariat
TOBACCO FREE INITIATIVE Averting Deaths from
Tobacco Consumption
CROSS-CUTTING ISSUES
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Global Level Implementation of WHO FCTC
Cross-cutting

• Cross Cutting Issues
• Tobacco Product Regulation
• Tobacco Industry Monitoring
• Gender
• Litigation support
• Economics
• International Development
• Social Determinants
• Expert Groups
• WHO Study Group on Tobacco Product Regulation
• WHO Tobacco Laboratory Network
• SG's United Nations Task Force on Tobacco Control

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• How can Public Health Associations support WHO's
  efforts to counter the tobacco epidemic ?

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Health Professionals Have a Key Role in Tobacco
Control
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Key role of public health organizations

• Advocate for ratification of Treaty by
  non-parties
• Routinely providing tobacco cessation support to
  tobacco users
• Contribute to other WHO FCTC interventions
  through their role to
• Advocate tobacco control policies
• Act as a model for general population
• Organize and support community anti-tobacco
  campaigns and interventions
• Countering the interference of tobacco industry
• Helping countries to reject partnerships and
  non-binding or non-enforceable agreements with
  the tobacco industry.
• To avoid conflicts of interest
• And not to engage in activities described as
  socially responsible by the tobacco industry

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Tobacco Free Initiative

• .for a tobacco free world

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Policy impact after 18 months Monitor tobacco
use

• mpower (supporting Article 20)
• The WHO Report on the Global Tobacco Epidemic
  The Report, which presents the first
  comprehensive global analysis of tobacco control
  efforts, is based on a data-collection process
  that provides a unique and comparable set of
  country-specific tobacco policy data from all WHO
  Member States.

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Policy impact after 18 months Monitor tobacco
use

• Brazil Incorporated the Global Adult Tobacco
  Survey (GATS) into its national tobacco
  surveillance system.
• Turkey Launch of Turkish-language translation of
  the WHO Report on the Global Tobacco Epidemic,
  2008 sparked considerable media attention. This
  week Turkey will be the first country to release
  preliminary results for GATS.

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Policy Impact of country work after 18 months

• mpower (supporting Article 8)
• Turkey Revised national law provides 100
  smoke-free public and workplaces

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Policy Impact of country work after 18 months

• mpOwer (supporting Article 14)
• Nigeria Provision of Incentives (blood
  pressure monitors) to encourage PHC providers to
  include cessation support as a component of NCDs
  treatment

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Policy Impact of country work after 18 months

• mpoWer (supporting Articles 11 12)
• Egypt new health warnings now available

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Policy Impact of country work after 18 months

• mpowEr (supporting Article 13)
• Philippines Banned all forms of mass media
  advertising, including printed materials

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Policy Impact of country work after 18 months

• mpoweR (supporting Article 6)
• Indonesia Excise taxes revised in early 2009
  and simplified (Eliminated Ad valorem and levied
  specific excise taxes)