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UNDP and General Obligations of the Framework Convention on Tobacco Control

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UNDP and General Obligations of the Framework Convention on Tobacco Control Douglas Webb HIV, Health and Development Group Bureau for Development Policy – PowerPoint PPT presentation

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Title: UNDP and General Obligations of the Framework Convention on Tobacco Control


1
UNDP and General Obligations of the Framework
Convention on Tobacco Control
  • Douglas Webb
  • HIV, Health and Development Group
  • Bureau for Development Policy
  • UNDP, New York

2
UNDP works in seven core areas, many of which are
social determinants of health
Poverty and inclusive growth
Social determinants on which UNDPs HIV and
health work focuses
1
Democratic governance
2
Crisis prevention and recovery
3
Gender
4
HIV, Health and Development
5
Environment and energy
6
Capacity development
7
3
Starting points
  • Tobacco work is new to most of the UN system, so
    we are in the early stages of a coherent response
  • UNDPs work on social determinants of health is
    now addressing non-communicable diseases,
    building on a platform of HIV and AIDS work
  • UNDPs mandates are only very recently agreed

4
Many structural determinants impact multiple
health conditions at the same time
Structural determinant1
contributing to
Disease/ condition1
Urbanization, migration
Malaria, TB, leishmaniasis, plague, intestinal
helminthiasis
Anopheles mosquito, malaria vector
TB bacillus
Conflict, displacement
Malaria, measles, diarrhea
Climate change
Cholera, schistosomiasis, vector-borne diseases
(e.g., river blindness, sleeping sickness)
Woman with river blindness
Income inequality
Avg life expectancy, infant mortality, accidents,
smoking
1Not exhaustive list examples only Sources
Pronyk P. at Columbia University,WHO, McMichael
T.,Sharma VP Farmer P., Raviglione MC, Howarth
JP, Dick B., Wilkinson RG, and others
5
Structural interventions at a policy level were
critical in reducing smoking in the United States
Policy intervention(s)
  • Advertising restrictions
  • Public awareness campaigns
  • Cigarette taxes
  • Anti-smoking legislation
  • Smoking levels dropped from 52 to 25 over past
    30 years
  • 8 cent cigarette tax alone caused 2 million
    adults to stop smoking and prevented 60,000 teens
    from starting

Source McKeown T. et al. 1975, US Centers for
Disease Control 2000
6
UNDP Mandate
  • UNDP works in areas related to social
    determinants of health, including
    non-communicable diseases
  • (a) decision of the Conference of the Parties
    FCTC/COP/4(17) in relation to cooperation for
    implementation of the Convention.
  • (b) the Report of the Secretary-General on Ad Hoc
    Inter-Agency Task Force on Tobacco Control (July
    2012)
  • (c) ECOSOC resolution E/2012/L.18 on the United
    Nations system-wide coherence on tobacco control
    (July 2012)

7
ECOSOC Resolution United Nations system-wide
coherence on tobacco control
  • Encourages the Ad Hoc Inter-Agency Task Force to
    promote effective tobacco control policies and
    assistance mechanisms at the national level,
    including through the integration of the World
    Health Organization Framework Convention on
    Tobacco Control 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

8
Article 5.1 Discussion paper for the COP being
developed by UNDP and the FCS
  • Integrating tobacco control into national health
    and development planning strategies and
    frameworks and UNDAFs experience and best
    practice recommendations
  • Articulate the case for the integration of
    tobacco control plans into national development
    plans and UNDAFs
  • Provide an overview of current extent of
    integration of tobacco control plans into
    national development plans and UNDAFs
  • Provide collated information about best practice
    and recommendations for national action from
    current experience
  • Provide recommendations for action at national
    and global level
  • Provide list of information resources

9
Desired outcomes
  • Increased action at national level to integrate
    tobacco control plans in national development
    plans and UNDAFs through strengthened multi
    sectoral commitment.
  • Increased support provided by UN country teams
    for the same.

10
Article 5.1 in Africa
  • 34/41 Parties have some aspect of tobacco control
    incorporated into national plans/strategies
  • 15 (37) Parties have an operational
    comprehensive multisectoral national tobacco
    control strategy
  • 17 (41) Parties have included tobacco control
    into national health plans (out of which 2 also
    have multisectoral plans)
  • 13 (32) Parties have referred to any aspect of
    tobacco in other national strategies (out of
    which 9 parties also included tobacco in either
    multisectoral or national health plans)

11
Article 5.1 Globally
  • Of the 120 of the 174 FCTC parties for whom data
    is available from the 2012 reporting cycle
  • 74/120 (62) indicated a comprehensive
    multisectoral national tobacco control strategy.
  • 43 (36) of parties reported tobacco control
    being incorporated in national health plans and
  • 21 (18) parties reported including tobacco
    control in other national plans.

12
Non Communicable Diseases and tobacco control
  • 11 countries have integrated NCDs into their
    latest UNDAFs
  • 3 countries have integrated any mention of
    tobacco into their latest UNDAFs (Burkina Faso,
    Djibouti, Mauritania)
  • Only 1 specifically mentions FCTC (Mauritania)

13
  • Case Study Ghana

14
Case Study Ghana
  • Planning Challenges
  • Lack of knowledge and representation of FCTC
    issues in the planning process
  • FCTC seeks to prevent a tobacco epidemic from
    occurring in Ghana not to deal with an existing
    epidemic therefore it is not seen as a priority
  • Development partners and their priorities still
    have a strong influence on the process. FCTC is
    not yet a development partner priority in
    comparison to HIV/AIDS, malaria and TB.
  • Adapting health plans to development planning
    formats and ME created unintended structural
    problems

15
Case Study Ghana
  • Implementation Challenges
  • Lack of funds to produce legislative instrument
    to progress the recently passed tobacco control
    bill
  • Lack of funds to promote tobacco control messages
    down to the district level
  • No further external nor internal funding
    allocated to tobacco control as an outcome of the
    process

16
Case Study Ghana Critical Enablers
  • Planning Key enablers
  • The thorough GHS health planning process that
    builds from district level up to a multisectoral
    national Health Summit to identify Health
    priorities and objectives
  • Including NCDs in the Health Plan, facilitated
    including NCDs in the National Development Plan.
  • Although FCTC and tobacco control not mentioned
    specifically in NDP, inclusion of NCDs
    facilitates including FCTC implementation in
    operationalizing the NDP

17
Case Study Ghana
  • Implementation Enablers
  • A National steering committee for tobacco control
    including, Ghana Health Service, Ghana Education
    Service, media and the NGO coalition
  • Media has been educated and sensitized to report
    on tobacco control.
  • Health care staff has been given public education
    through media outlets including preparing an
    educational video clip.
  • Capacity building in public health schools and
    medical schools has been initiated in order to
    make the future health workforce advocates of
    tobacco control (facilitated by FCS and WHO)

18
Case Study Ghana
  • Recommendations
  • The Government side needs to come to a consensus
    on national priorities and donors and other
    development partners should be more flexible and
    responsive to the country needs and priorities.
    (whether FCTC or other health issues)
  • NCDs should get their own section in the plans,
    not come under a sub-heading
  • Donors and partners should look beyond specific
    disease priorities to more broad health service
    issues its not enough to have the vaccines must
    also have the means to deliver them to people

19
  • Emerging UN wide support

20
Health or Tobacco?
21
Areas of collaboration within the Convention
Article of the WHO FCTC Agency Specific action
Article 5 (General obligations) UNDP Take into account requirements of Article 5 in UNDP's country level role as convener and coordinator, where appropriate and under its governance programmes.
Article 6 (Price and tax measures)   World Bank Support countries with the design, implementation and evaluation of tobacco tax issues, upon countries demand. This effort would complement ongoing efforts by WHO/TFI in this area. Collaborate with the WHO FCTC secretariat to assess the possibility of having joint Needs Assessment missions with regards to Article 6 issues. Research to assess the potential regressivity of tobacco taxes as well as the impact of tobacco use in poverty. Research on the effects of tax incases on tobacco economic agents, particularly farmers as well as illicit tobacco trade.
22
Areas of collaboration within the Convention
Article 8 (Protection from exposure to tobacco smoke) ILO Implement the ILO SOLVE programme (an interactive educational program designed to assist in the development of policy and action to address health promotion issues at the workplace) to promote smoke-free workplaces.
Article 12 (Education, communication, training, and public awareness) UNESCO (International Bureau of Education) Include tobacco awareness in school curriculums and teacher trainings. Promote smoke-free schools.
Article 12 (Education, communication, training, and public awareness) World Bank Integrate tobacco in education programmes within Trust Funds.
Article 15 (Illicit trade in tobacco products) WCO Provide support to the negotiations of the Protocol on Illicit trade.
23
Areas of collaboration within the Convention
Article 17 (Support for economically viable alternative activities)   FAO (Agriculture Department)             FAO (Economic and Social Development Department) Provide technical support in tobacco growing areas for sustainable crop production intensification with the goal to diversify production, reduce environmental and health impact and reduce the risks of tobacco growers in depending on one single product (subject to funding). Update of the world tobacco production and market situation (subject to funding minimum budget required 50,000).
Article 17 (Support for economically viable alternative activities)   UNCTAD (Special Unit on Commodities (SUC), Division on Trade in Goods and Services, and Commodities (DITC)) Collaborate with key partners including international agencies to conduct research and analysis of the tobacco supply chain analysis from the farm to the cigarette. Policy review of tobacco producing developing countries (include diversification options).
24
Areas of collaboration within the Convention
ILO   Expert input to the WHO FCTC Working Group on Articles 1718. Updating a 2003 study on the state of employment in the tobacco sector globally (forthcoming November 2012 report). Develop economic labour market analysis toolkit on agricultural cooperatives training material for establishing small enterprises local development value chain development tools (rural) rural skills development tools, etc. Develop research on diagnostic and scope studies on decent work, food security and alternatives for tobacco growers. Promote social dialogue to support economically viable livelihoods for tobacco growers and workers
UNEP Promote green economy framework for economically viable alternatives for tobacco growers and workers
WIPO (Development Agenda, under the thematic project Project on intellectual property (IP) and Product Branding for Business Development in developing countries and least developed countries (LDCs)) Provide through Technical Assistance and Capacity Building support to actions by governments to help farmers move to tobacco alternative livelihoods.        
25
Areas of collaboration within the Convention
Article 18 (Protection of the environment and the health of persons) UNEP       Technical assistance related to Sound management of chemicals in tobacco growing Environment audit, impact assessment of tobacco growing Integrating tobacco related issues within national environmental protection programmes
Articles 20, 21 22 (Research, Surveillance and exchange of information) and (Reporting and exchange of information) UNCTAD (International Investment Agreements (IIA) Section, Division on Investment and Enterprise (DIAE)) Share database and information on Trade data (all bilateral official trade data at HS-6 digit). Border measures import tariffs at 6-digit, tariff rate quota (TRQ) and other (e.g. domestic support). Non-tariff measures.
26
Areas of collaboration within the Convention
UNDP Integrate WHO FCTC/NCDs reporting into the Human Development Reports (HDR).
UN Women Ensure gender sensitive data collection, in particular for surveillance, survey including data on women's role in tobacco products. Gender specific strategies to ensure women are equally informed about their rights.
World Bank             Cooperate with WHO for harmonization of tobacco questions into surveys such as Living Standards Measurement Study (LSMS) and LSMS-like surveys and provide input to existing tobacco questions in the WHO surveys. Cooperate also with the Convention Secretariat for analyzing the data collected from the reporting instrument.
27
  • Potential UNDP roles
  • Some specific opportunities for UNDP in tobacco
    are emerging
  • UN system coordination (RC) and UNDAF integration
  • Post-2015 development agenda
  • Support to National action plan development
  • Integration of tobacco/FCTC/NCDs into national
    development planning
  • Support to national governance structures on
    tobacco/NCDs
  • Anti-corruption and regulatory independence
  • Intellectual property/TRIPS, trade, and plain
    packaging
  • Strengthening law enforcement, justice
  • Strengthening local government-municipal
    programming
  • CSO engagement
  • Gender and tobacco, human rights

28
Principles of strategies
  • Principles for tobacco strategy development 
  • strategies need to become more fit for purpose
    and integrated integrate the tobacco strategies
    into wider health and development strategies
  • A national strategy that is shorter, higher level
    with emphasis on planning processes that are
    smarter and lighter on peoples time and money
  • Strategies and implementation plans should aim
    for results, prioritizing interventions and
    represent value for money, determined by the
    effectiveness, efficiency and equity of the
    programme that is planned. In particular,
    strategies and implementation plans must
    prioritise halting tobacco use initiation and not
    only invest the bulk of resources in treatment.
  • Strategies should give more effort and attention
    to implementation and review, linking
    interventions to expected results, and then
    monitoring progress
  • Developing indicative, medium term budgets with
    realistic costing of major programme areas,
    together with ensuring the level of investment is
    closely aligned with evidence of what works and
    development of scenarios for what interventions
    are to be prioritised in low, medium and high
    level funding scenarios

29
Organisational options
Tobacco
HIV (TB and Malaria)
NCDs
30
Conclusions
  • A multisectoral response is essential
  • Experiences of Article 5 implementation are now
    being gathered
  • Only One third of parties in Africa have a
    comprehensive multisectoral strategy on tobacco
  • Around one third of parties mention tobacco in
    other development or sector plans
  • Experience suggests that integration of FCTC into
    other development instruments leads to greater
    implementation
  • UN Mandates are recent so work can now accelerate
  • UN partners can assist if the demand is there at
    country level
  • Coordination structures are to be assessed to
    determine efficiency of different models
  • There is political capital in tobacco control,
    isnt there?
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