Uganda's low tobacco tax rates make cigarettes affordable to young people

On 31st May, Uganda will join the world in commemorating the World No Tobacco Day. The World Health Organization (WHO) has chosen the increase on tobacco taxes as this year's theme. Uganda has the lowest taxes on Tobacco products in East Africa. Only Tanzania has lower excise duty on cigarettes. The effect of low taxes on tobacco products translates to low prices of cigarettes which makes smoking a very affordable pastime in Uganda. Sticks of cigarettes cost only a few hundred shillings that even primary school children can afford to buy at the nearest stall. You see in Uganda, it is not illegal to sell cigarettes to minors. A six-year old boy can buy a cigarette at the nearest stall. Which is why we all have to urge parliament to pass The Uganda tobacco control bill (2014)to make it illegal to sell tobacco to minors in Uganda. Under Kenyan law, it is illegal to do so and has been the case since 2007 when Kenya passed a tobacco control law. Because of stringent tobacco control policy in the developed world, governments have hiked tobacco taxes and made cigarettes less affordable,especially to younger people who are more price sensitive. Why should this worry the average Ugandan? Well, we now know that tobacco products kill half of all their users. Lets re-state that again. When used exactly as intended by the manufacturer, tobacco products kill half of all their users. The WHO reports that 71% of lung cancer deaths globally were due to using tobacco products. WHO's tax economist, Koffi Nti, has observed that cigarette prices in Uganda haven't changed in the last five years. This is mainly because Uganda's taxes on tobacco products have remained constant despite annual inflation. The implication is that cigarettes have actually been becoming cheaper for young people over the last five years because of constant tax rate that is not responsive to inflation. Koffi Nti also notes that that revenue contribution from tobacco products to total government revenue and total excise revenue has been falling. He cites an example of tobacco tax contribution to the total government tax revenue which has dropped from a peak of 5.3% in the fiscal year 1993/94 to only 0.9% in 2010/11, while the contribution to excise tax revenue has reduced from 49.5% to 14% during the same period. According to the Center for Tobacco Control in Africa(CTCA),Uganda’s tobacco tax rate currently stands at 37% of the average retail price, as compared to neighboring Kenya which is at 50%, and the WHO Framework Convention on Tobacco Control recommended rate of 70% of the retail price of cigarettes.

Why increasing tobacco taxes can reduce the increasing cancer and heart disease cases in Uganda

Last year four cabinet ministers were reported in the press to be on treatment for diseases of the heart and blood vessels. Sadly, two of these cabinet ministers eventually died from these ailments in the same year. This included a former health minister. In the same year,cancer claimed the life of the then Deputy Chief justice.Again last year,a former Vice President died from diseases of the same category. In parliament, the deaths were multiple. Rev. Diana Nkesiga of All Saints Church recently publically acknowledged that cancers are the most reported cause of death at funeral services conducted at the church. Uganda is in the throes of a new epidemic of non-communicable diseases (NCDs)-the 'big four'namely; cancers, diseases of the heart and blood vessels, diabetes and chronic respiratory infections. This of course, is in addition to the already existing AIDS, malaria and Tuberculosis epidemics. The only common risk factor associated with all the NCDs is tobacco use. Tobacco use has been known to cause all these diseases. To be clear, NCDs are also caused by physical inactivity, unhealthy diets and genetic factors among a multitude of risk factors. The World Health Organization(WHO)projects that NCDs will be the leading cause of death in low and middle income countries like Uganda by 2030. In a major 2013 report on NCDs in Sub Saharan Africa, the World Bank projects the cases of cancers alone to double by 2030. The most preventable risk factor for all these diseases in tobacco use. Tobacco use is the leading cause of death globally and claims more lives than AIDS, malaria and Tuberculosis combined. The commonest cancer in the world today is Lung cancer. Tobacco use has been determined to cause 71% of all lung cancer cases. If people didn't smoke, there would be 71% less deaths from lung cancer, 21% less cases of diseases of the heart and blood vessel globally. As the world commemorates the World No Tobacco Day on 31st May, it is an opportune moment to reflect on Uganda's burgeoning NCDs epidemic and to reflect on the role of tobacco use and in this largely preventable epidemic. Although tobacco use is often constructed as a public health issue, it is also actually about poverty and development. According the latest Uganda Demographic and Health Survey (UDHS),tobacco use is more common among the two lowest income groups in Uganda and those with the least education. Households where the breadwinner is a smoker spend less on education and health. In several studies conducted, expenditures on tobacco can mean less food on the table or less milk or kilos of maize purchased for a household.In fact children in households of smokers have poorer diet quality than those from non-smoking households. I have a smoker friend who confided in me that smoking does affect how much food he buys at home. In other words, because he spends money on cigarettes he buys less litres of milk for his children than he would have wanted. You see, tobacco use is an addiction and that it is how it is exactly intended by the tobacco industry . Many smokers want to quit but are unable to due to nicotine-dependence-thanks to one of the ingredients wired into cigarettes. A study in Bangladesh by Debra Efroymson and others found that ''average male cigarette smokers spend more than twice as much on cigarettes as per capita expenditure on clothing, housing, health and education combined. The typical poor smoker could easily add over 500 calories to the diet of one or two children with his or her daily tobacco expenditure'' But lots can be done to reduce tobacco use's contribution to the current NCDs epidemic in Uganda. Probably, the most effective tobacco control measure is increasing taxes on tobacco products such as cigarettes. Indeed, this year, WHO has selected the increase on tobacco taxes as theme of the World No Tobacco Day. In South Africa, a 10% increase in taxes on tobacco was followed by a 8% percent reduction in cigarette consumption. As we noted earlier, tobacco use is highest among the poorest and they are the most sensitive to cigarette price increases following a hike in tax. If a stick of cigarettes cost 150 shillings and you added 50 shillings in tax, at 200 it would be more costly to smoke. In fact studies show that among low income earners,an increases in taxes has resulted in reduction in demand for cigarettes. Young people are even 2 to 3 times more responsive and studies show that higher taxes and prices are most effective in preventing youth from moving beyond experimentation and into regular tobacco use. When I was in secondary school many youth were hard pressed to buy cigarettes because of prices and an increase would deter smokers or at least mean less sticks purchased. Uganda has one of lowest taxes on cigarettes in East Africa and is way below the recommended tax rate it commited itself to achieve when it signed the WHO's Frame work Convention on Tobacco Control in June 2007. Tobacco tax increases serve the twin goals of reducing consumption and increasing government revenue.

Reconceptualizing the rainbow nation: The post-ANC South Africa.

It is almost 20 years since that historic Nelson Mandela swearing in ceremony as South Africa's first majority President. Back then,the ANC could no wrong. It was the popular vanguard of the people's struggle against the evil that was apartheid. But 1994 seems like a really time ago. I have been resident in South Africa for a month now and have had a rare first hand insight into the changed South Africa. The black majority has become increasingly weary of the ANC. Unfulfilled dreams, dashed hopes, disillusionment and a hideous corruption streak among the ruling elite are partly to blame. President Jacob Zuma has been demonized in the press for having a swimming pool at his country home built on tax payer dimes. To be fair, the current South Africa is way better than the pre-1994 South Africa but it could have been even miles much better. It is surprising how much the ANC is struggling win an election that it should labour too much to win given its recent dark history. But getting a decent result come 7th May 2014 seems like an uphill task. To be sure, the ANC will carry the day. However it will be the smallest majority since 1994. When I pear into the future, say in 20 years, the ANC will hardly be unassailable. South Africans will have moved on. They already seem to be doing that. South Africa is really two countries in one-a country of stark contrast. The classic tale of haves and have-nots finds its most illustrious example here. And privilege is reproducing itself through generational cycles. The economic super structure from the days of apartheid is almost intact. There is clearly a growing black middle class and even a high-end entreprenuer class such as Cyril Ramaphosa of the MTN group connection but South Africa's inequality looks to be a problem for the ages. ''There is nothing new under the sun'' it says in Levitcus. I was reminded of our own post-independence euphoria in Sub Saharan Africa. Of a dream that was the new Africa. It seemed that the new African rulers simply replaced the colonial class- a changing of the guard if you will, and the life continued. How hard it is to change society for genuine social advancement. The captains of industry in South Africa still remain the same. It is not even fair to expect that the ANC can deliver a fairer South Africa after centuries of advantage of a minority. Because of an impatient population, wily politicians have taken advantage. Malema and Ramaphela and many others are promising a better deal for the black majority. But can they truly deliver on a fundamentally new South Africa? Clearly, the ANC could have done a lot better than it has managed but South Africa's inequality is inherently structural. What took centuries to build cannot be dismantled in years. It is in the interest of the privileged classes of South Africa to push for a fairer South Africa out of sheer self-interest. The current South Africa is not sustainable. We never learn from history. The survival of a capitalist society in Europe was not because of capitalism. It was inspite of Capitalism. It was a modification of capitalism that started in Bismarck's Germany. A capitalist society with a residual element of fraternity.

Finance ministry clears way for parliamentary debate of Uganda's Tobacco control bill

The Ugandan Ministry of Finance's Permanent Secretary, Keith Muhakanizi has formally granted a certificate of Financial implications for the Uganda Tobacco control Bill 2013,early in February 2014 which paves way for the vitally important bill to be tabled before parliament for consideration. Uganda's Tobacco control bill has been in the works since 2011 and many observers have been uneasy at the perceive slow pace of legislative process.Tobacco industry interference was initially suspected as a contributory factor beside the usual lengthy necessary legislative processes. The certificate of financial implications now clears way for consideration of the much delayed bill and 2014 seems a critical year in this regard. The certificate of financial implications is a requirement of all bills in parliament and implies that the financial obligations on the Ugandan state are manageable. Dr Chris Baryomunsi, the private member of parliament, pushing the bill is now expected to move the process forward in the August house. The Ugandan Tobacco bill is highly regarded with in the Ugandan and international tobacco control lobby and is seen is critical in stemming the public health,socio-economic,development and environmental effects of tobacco use in Uganda. Uganda has witnessed a spike in Noncommunicable disease such as cancers, cardiovascular diseases and diabetes for which tobacco use is the common risk factor. Uganda is already under strain from infectious diseases such as HIV/AIDS and Tuberculosis

Adopted: an intriguing German documentary

The German cultural centre in Kampala features twice-monthly German and African movies. Yesterday,a thoughtful documentary was screened at their lush gardens at Nakasero in Kampala. Four Germans who are enstranged in Germany from their social lives and western life in general leave for Ghana to be 'adopted' by four 'foster' families. They leave behind careers and families to start over in Africa living in semi-rural lives of pit latrines, wells and an agrararian life. The triple heritage of Africa popularised by Mazuri comes into sharp focus. What follows is an intriguing journey one that inspires very deep reflections on the meaning and purpose of life, culture and humanity. Expectations and illusions become instantly endangered.

Jerichow: A German movie review

A German soldier back from a tour in Afghanistan after a dishonourable discharge finds himself penniless in a non-descript,poor Northern German town of Jerichow. The movie begins at his newly inherited family home following the death of the main character's mother. Thomas loses the mothers' inheritance(some leafy euros in 50 notes) to a bunch of low-lifes he owes money from a gambling debt. He has to make ends meet as a cucumber harvester at a large commercial farm- a colourless,dead-end job. Then comes a chance meeting with a wealthy Turkish business man (Ali) who has his car, a Range Rover, stuck near a river after a drunken stupor. Because the cops have a trail on him and want to take Ali's driving license,the Turk asks for a favour: can he claim it was the ex-army man who was driving so he can save his driving permit? And so begins a life of temptation and a sure recipe for disaster. The rich Turk has a much younger attractive wife called Laura. It almost love at first sight between Laura and Thomas. Thomas is soon offered a job as the rich Turk's consigliere, quickly winning his trust or does he? Ali has a chain of supermarkets with a very canny business sense. But he has issues with trusting people. He believes all who work for him in his multiple retail businesses are untrustworthy and cheating him. He doesn't even trust Laura and spies on her constantly. You see, Ali and Laura are not an ordinary couple. Ali literally purchased her by buying off her hefty debt. Its a transactional relationship peppered with wife battery and emotional abuse. Ali treats Laura like one of his possessions. Laura longs for something deeper. Thomas and Laura soon fall desperately in love. They seem to fill the void in each others' lives. Laura in an unrequited marriage and Thomas in an empty life. But there is a problem. They are all broke and they are all economically dependent on Ali. Ali soon announces that he has to go away to Turkey to check on his relations and asks Thomas to take charge of his multiple business concerns. Is this an incredible opportunity for Thomas and Laura to sink into their wildest lustful desires or is this a test for both? Rottentomatoes.com usually awards a percentage mark for movies it reviews and I would give this movie a 68% rating. It is certainly worthy of your 90 minutes. The plot and concept of the movie is a brilliant one although it is not as brilliantly executed and more could have been demanded of the leads. There is alot more dramatic potential and opportunity that the director squanders. This is a good movie but it could have been a great movie. It is a little understated for those used to Hollywood-fare. Overall, one of the best German movies I have seen in a long-while.

Tobacco control in Africa and the challenge of a colonial political economy

Public health advocates scarcely appreciate how entrenched the tobacco industry is in Africa given its colonial political economy. An analysis of the leading tobacco companies in Africa will reveal a colonial hang over. The leading tobacco company in most of Anglophone Africa is actually British American Tobacco (BAT) and the leading Tobacco companies in Franco phone Africa are actually French. In Kenya,Uganda, South Africa,Zambia and Zimbabwe, for instance, BAT has dominant market leadership. In Burkina Faso, Mali and Senegal, the leading tobacco companies have French-ties. Using economic history lenses we would need to appreciate that the tobacco crop is actually not native to Africa. In Uganda, for instance, it was introduced in the 1920s by the British. The British were majorly interested in a colonial empire in Africa partly because they wanted a base for raw materials for their budgeoning industries and here cash crops like coffee, cotton, etc come to mind. Public health advocates need to appreciate how deeply entrenched the colonial political economy in Africa in many respects is still intact. BAT of course is no longer wholly British-owned, indigenous Ugandans for example can freely buy shares on the stock exchange in Kampala reflecting the hybridization of the colonial economy by marrying it with narrow elite African interests. The Board Chairmen of BAT Uganda have in the past ten years been very carefully selected representing the most foremost indigenous Ugandans even when all they do is really serve as fronts for complex multinational interests. By offering Ugandans shares in BAT Uganda, multinational commercial interests are diversified by co-opting a narrow African middle class thereby spreading the risk of regulatory oversight in African markets. In Uganda, UMEME, the local power company was bought by a British consortium. After getting market intelligence that the Ugandan state was growing weary of its efficiency standards and protracted grambling over a badly negotiated sale, UMEME about two years hastily sold some shares to native Ugandans. Recently, the Ugandan government threatened to reverse its power deal with UMEME which has wisely pre-empted this by hastily selling its shares to Ugandans. Today the Energy Minister announced Government will not go ahead with its threat.