Wednesday, May 30, 2012

Tobacco industry killing efforts to cut smoking deaths

Every year on May 31, the world stops and reflects on the millions who have lost their lives to tobacco use and the one billion others who are set to lose their lives to tobacco this century, if current trends are not reversed. Tobacco remains the largest preventable cause of death in the world. 

Every year it kills more people than AIDS, malaria and Tuberculosis (TB) combined. On average, smokers die 15 years earlier than non-smokers.

Tobacco use is set to become the leading cause of death in low and middle income countries by 2030. This vice causes 15 cancers, particularly lung cancer, and is the only common denominator in the non communicable diseases (NCD) epidemic which involves diabetes, heart and respiratory diseases.

This year, the World Health Organization (WHO) has selected tobacco industry interference in tobacco control efforts as the theme of the World No Tobacco Day.

The tobacco industry has been defined as ‘those persons and companies engaged in the growth, preparation for sale, shipment, advertisement, and distribution of tobacco and tobacco-related products’.
The leading tobacco companies in the world include Phillip Morris, British American Tobacco (BAT) and Japan Tobacco International. In Uganda, British American Tobacco Uganda (BATU) and Mastermind are the leading ones.

The tobacco industry is one of the most lucrative in the world. The Tobacco Atlas last year estimated that revenues from the global tobacco industry were likely to reach half a trillion US dollars, a year. Many tobacco companies are actually wealthier than many developing countries.

“The tobacco industry has historically employed a multitude of tactics to shape and influence tobacco control policy. It has used its economic power, lobbying and marketing machinery, and manipulation of the media to discredit scientific research and influence governments in order to propagate the sale and distribution of its deadly product. Furthermore, the tobacco industry continues to inject large philanthropic contributions into social programmes worldwide to create a positive public image under the guise of corporate social responsibility,” reads a WHO statement.

Because of the economic muscle tobacco companies wield, they hold sway over poor African governments and frustrate national efforts to cut tobacco deaths.

“The entry point for the tobacco industry in Uganda is the overly hyped economic importance of the industry in government tax revenue and tobacco farmers’ livelihoods,” says Dr Sheila Ndyanabangi, the Tobacco Control focal person in the ministry of Health.

But the disease burden and the costs of treating tobacco-related diseases far outweigh the reported economic importance and are not worth any life. The Centre for Tobacco Control in Africa (CTCA), a regional project funded by the Bill and Melinda Gates Foundation, is pioneering alternatives to tobacco farming through pilot projects in the tobacco-growing districts of Arua and Kanungu.

According to information from Uganda Tobacco or Health Forum, the tobacco industry reportedly put Uganda government under pressure not to increase excise duty on cigarettes in the 2008/2009 national budget, yet globally, taxes on tobacco products are said to be one of the most effective deterrents to tobacco use.

Tobacco companies all over the world are known to frustrate national anti-tobacco legislation through instituting stalling lawsuits and sustained media campaigns against proposed legislation.
John Amanya, Deputy Executive Secretary of the Uganda National Tobacco Control Association, observes that in Uganda we have already seen the tobacco industry sponsor press articles to try and punch holes in the proposed tobacco control bill which had its first reading before Parliament recently.
Despite the ban on tobacco advertising in Uganda, tobacco companies still stealthily advertise under the guise of corporate social responsibility sponsorships or indirect advertising, such as glossy job adverts in the print media.

Jackie Tumwine, a tobacco control advocate, recalls that despite the law banning tobacco advertising and promotion, BATU sponsored and chaired the Commonwealth Business Forum in 2007.

“The global tobacco industry kills six million people every year. It does this in a deliberate, systematic manner, complete with business plans, lobbying, political contributions and favours, and cash bonuses to its executives who kill the most people by successfully selling them their deadly cigarettes and other tobacco products,’’ says Dr Thomas Glynn of the American Cancer Society.

Tuesday, May 1, 2012

Kenya generic AIDS drugs court ruling sets East African precedent

Thousands of people living with HIV and AIDS in East Africa were given new hope last week (25 April 2012), when a High Court judge in Nairobi ruled that Kenya’s anti counterfeit law is unconstitutional in its interpretation of generic HIV drugs as illegal counterfeits.

A generic drug is an identical copy of a brand name, the latter of which are usually manufactured by pharmaceutical giants. Brand drugs such as those manufactured by Pfizer and Norvatis go for prices tailored to Western markets and thus are unaffordable for the majority of patients in sub Saharan Africa. However, many can afford Indian generics, which cost as little as a tenth of the brand price.

Generic drug manufacturers such as CIPLA of India imitate the exact formulas used in brand antiretrovirals (ARVs) drugs through a process called ‘reverse engineering’. The drugs are understood to be as effective as the brand names.

Justice Mumbi Ngugi ruled that intellectual property rights do not override the right to life and health. She found the definition of a ‘counterfeit’ in the Kenya Anti-Counterfeit Act of 2008 to be too broad leading to generic HIV drugs being bundled together with other counterfeits. Justice Mumbi said this vagueness is posing a grave threat to the right to life and health for thousands of Kenyans who depend on life-saving generic ARVs.

The High Court judge has now instructed the Kenyan parliament to review the Anti Counterfeit Act of 2008 and amend the offending articles, which can lead to arbitrary seizures of generic HIV drugs under the pretext that they are ‘counterfeits’, as happened at a Dutch port last year.

Under common law, a high court ruling in Kenya sets a precedent for countries such as Uganda and it is now thought that human rights activists in Uganda and the rest of East Africa will invoke the ruling in any potential suits.

The news will also comes as a welcome development for Ugandan pharmaceutical companies such as the Quality Chemicals Plant in Luzira, most of whose products are generic drugs

While testifying before a Ugandan parliamentary committee last month, Moses Mulumba, a human rights lawyer and intellectual property rights expert, revealed that the Uganda Counterfeit Bill 2010 regards generic AIDS drugs as ‘counterfeits’ and would render 90 % of HIV drugs in Uganda illegal should the bill be passed by parliament and assented to by President Museveni.

With efforts to deepen East African regional integration taking centre stage, the Kenya High Court ruling becomes even more instructive for Uganda and the rest of members of the East African community (EAC).

“A vast majority of people in Kenya rely on quality generic drugs for their daily survival. Through this important ruling, the High Court of Kenya has upheld a fundamental element of the right to health,” said UNAIDS Executive Director Michel SidibĂ©.
“This decision will set an important precedent for ensuring access to life-saving drugs around the world.”

“The court has correctly interpreted the Constitution and guaranteed the right to health. This ruling speaks against any ambiguity that serves to undermine access to generic medicines and puts the lives of people before profit”, Patricia Asero, one of the three petitioners, was quoted as saying.

Last week also marked the successful passage of the East Africa HIV/AIDS Prevention and Management Bill 2012 by the East African Legislative Assembly (EALA), a timely milestone as the assembly’s term of office expires in June this year.