The document discusses integrating tobacco control plans into national development plans and UN development assistance frameworks. It finds that while most countries have tobacco control strategies, few mention tobacco or the WHO FCTC in their national development plans or UNDAFs. Case studies found enabling factors include government leadership, civil society advocacy, and WHO/UNDP support. Challenges include lack of priority, resources, and data. It recommends continued advocacy, capacity building, learning from other health issues, focusing on taxation, protecting policy discussions, and monitoring integration efforts.
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Tobacco Control for Development (2013)
1. Tobacco Control for Development
Integrating the WHO Framework
Convention on Tobacco Control into
national development plans and United
Nations Development Assistance
Frameworks (UNDAFs)
Douglas Webb, PhD, HIV, Health and Development Group
UN Development Programme, New York
Presented to the Governance of Tobacco in the 21st Century Conference,
University of Harvard/WHO February 2013
2. Mandate for UN system support
⢠FCTC COP decision FCTC/COP4/17
⢠ECOSOC resolution RES/2012/4
1. 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 WHO FCTC 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;
2. Invites all members of the Task Force and other United Nations funds,
programmes and specialized agencies to contribute, as appropriate, to the
goals of the Framework Convention, including through multisectoral
assistance, public outreach and communication, in particular in the context
of the prevention and control of non-communicable diseases;
3.
4.
5. Discussion paper; aims
⢠Articulate the case for the integration of tobacco
control plans into national development plans
and UN Development Assistance Frameworks
(UNDAFs)
⢠Assess current extent of integration of tobacco
control plans into national development plans
and UNDAFs
⢠Provide collated information about good practice
and recommendations for global and national
action from current experience
6. Sample countries
⢠120 reported on 2012 reporting cycle
⢠Of these, 48 sample countries:
⢠15 completed needs assessment
⢠CSO funding to integrate FCTC into
instruments (10)
⢠High tobacco use and burden (15)
⢠Countries that had made deliberate
integration efforts (8)
7. 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.
8. NCDs mentioned in National Development
Plans n=28
NCDs
mentioned
(22)
NCDs not
mentioned (6)
9. Tobacco in National Development Plans n=28
no mention
tobacco
mentioned
(9)
NB â not one of the
sample countries
mentioned FCTC in NDP
10. Tobacco in UNDAFs n=46
F
FCTC
Specified (3)
Tobacco
Specified
(12)
Tobacco
not
mentioned
(29)
11. Desk Research Sample of 48 countries
⢠28 NDPs reviewed
â 0 mentions of âFCTCâ
â 8 include tobacco control measures
â 22 include NCDs
⢠46 UNDAFs reviewed
â 3 include FCTC implementation
â + 1 inclusion of FCTC in list of treaty obligations
â 5 include tobacco control measures
12. Desk Research Sample of 48 countries
⢠28 NDPs reviewed
â 0 mentions of âFCTCâ
â 8 include tobacco control measures
â 22 include NCDs
⢠46 UNDAFs reviewed
â 3 include FCTC implementation
â + 1 inclusion of FCTC in list of treaty obligations
â 5 include tobacco control measures
13. Case Studies
⢠8 case study countries
⢠Interviews with
â Ministry of Health Tobacco Control Focal Points
â WHO Tobacco Control Focal Points
â UNDP relevant contacts
14. Emerging Lessons: Inclusion in NDPs
⢠FCTC should be a health priority championed
by Ministry of Health
⢠Policy advocacy should present:
â Evidence for relationship to poverty reduction
â Impact on other development priorities e.g.
reducing inequalities, improving access to
education
â Inter-relationships with existing health MDGs (and
emerging post 2015 development agenda)
15. Emerging Lessons: Inclusion in UNDAF
UNDAFs should support
⢠achieving NDP priorities â so FCTC should be
included in NDP
⢠delivery of international treaty obligations â
so FCTC should be listed
⢠coordination of UN agencies actions â so
UNCTs must be sensitised to relevance and
responsibilities
16. Emerging Lessons:
Multisectoral Approach
⢠Multisectoral tobacco control coordinating
committees facilitate integration into planning
processes
⢠Should include representation of other
ministries
(finance, justice, trade, agriculture, tourism
etc.)
⢠High level government leadership desirable
⢠Civil society representation desirable
17. Enabling Factors
⢠High level government leadership
⢠FCTC needs assessments and Secretariat support
⢠WHO technical support
⢠Civil society advocacy
⢠Accountability to the international
treaty, including reporting
⢠Top level UN recognition of need for support of
FCTC implementation
18. Challenges
⢠Lack of resources in Ministry of Health
⢠Lack of awareness of tobacco use as a health and
development issue
⢠Absence of tobacco control from development
partnersâ priorities
⢠Lack of data on prevalence, morbidity, mortality
and costs
⢠Fears of economic impacts of tobacco control
⢠Tobacco industry influence
19. Recommendations
1. Support continued advocacy efforts at
national and international level
2. Provide capacity building to governments to
support the integration of FCTC into NDPs and
UNDAFs
3. Learn from experience of mainstreaming
HIV/AIDS
4. Focus on tobacco taxation as key entry point
20. Recommendations
5. Invest in data and analysis (especially the political
economy) of the epidemic and its impacts on other
development priorities
6. Support countries to develop cost estimates for
FCTC implementation
7. Protect multisectoral discussions of FCTC
implementation from tobacco control interference
(article 5.3).
8. Monitor situation as function of the Mechanisms
of Assistance WG of the COP
22. Potential UNDP roles
Some specific opportunities for UNDP in tobacco are
emerging
o UN system coordination (RC) and UNDAF integration
o Post-2015 development agenda
o Support to national NCD action plan development
o Integration of tobacco/FCTC/NCDs into national development
planning
o Support to national governance structures on tobacco/NCDs
o Anti-corruption and regulatory independence
o Intellectual property/TRIPS, trade
o Strengthening law enforcement, justice
o Strengthening local government-municipal programming
o CSO engagement
o Gender and tobacco, human rights
23. Thank you
Douglas Webb, Ph.D.
HIV, Health and Development Practice
Bureau for Development Policy
UNDP New York
Email: douglas.webb@undp.org
Acknowledgements to Alison Cox, Brian Lutz and
Michelle Sahal-Estime
Hinweis der Redaktion
FACT:Expected to cause 6.4million deaths by 2015 â i.e. 10% of all deathsBy 2030 the number of smoking related deaths in LMICs alone is expected to rise to 6.8 million
In 2011 55% of the worldâs population was covered by just one of the FCTC key interventions, and less than 17% by more than two. (NB figures from MPOWER report not FCTC implementation reports)
FACTL Just 4 countries were found to include tobacco control in their NDP and support for FCTC implementation or tobacco control measures in their UNDAF (including the one that just lists FCTC amongst its treaty obligations)
FACTL Just 4 countries were found to include tobacco control in their NDP and support for FCTC implementation or tobacco control measures in their UNDAF (including the one that just lists FCTC amongst its treaty obligations)
Bolivia, The Gambia, Ghana, Jordan, Mauritania, Moldova, Niger, Palau, The Solomon Islands