Regional Consultation on Sixth Session of the Conference of the Parties

29-30 September 2014

Inaugural Address by Dr Poonam Khetrapal Singh

WHO Regional Director for South-East Asia

Distinguished participants from Member States, Dr Vera Luiza da Costa e Silva, Head of Convention Secretariat, Mr Amal Pusp, Vice President of the Bureau of the Conference of the Parties, dear colleagues, ladies and gentlemen;

It is with great pleasure that I welcome you all to this regional consultation. I am glad that the Member States have got this opportunity to meet before the sixth Conference of the Parties and discuss on various issues important for the Region.

The South-East Asia Region carries one of the highest tobacco burdens and continues to face a growing public health crisis. There are approximately 250 million smokers and nearly the same number of smokeless tobacco users, leading to more than 1.3 million deaths every year due to tobacco use. The widespread use of many forms of tobacco also complicates efforts to implement effective tobacco control initiatives in the Region. In addition to being a leading consumer of tobacco products, the Region is also a major tobacco producer. India and Indonesia belong to the top ten tobacco producers and consumers in the world. This not only allows for increased availability of the product, but also creates a political climate which often hinders tobacco control measures.

Although much progress has been made, particularly in recent years, the Region has a number of unique challenges and conditions that make controlling the tobacco epidemic in countries of the Region an extremely difficult task. The tobacco industry interferes with the adoption of policies and its implementation in Member States through litigation and various other tactics. Most recently we have seen that in Nepal, Sri Lanka and Thailand the industry sued the Ministry of Health for implementing large pictorial health warnings on tobacco products. The industry also threatens to challenge on every initiative including implementation of smoke-free public places. They have formed front groups of tobacco farmers and bidi workers in Bangladesh, India and Indonesia and used them to oppose stringent laws. Globally, we have seen that in recent times, implementation of tobacco control measures, including implementation of the WHO FCTC provisions, has been challenged under international trade and investment agreements. Tobacco has emerged as the most litigated product in the World Trade Organization during the past few years. It is important that Member States develop action plans to Implement the guidelines on Article 5.3 of the WHO FCTC. The WHO Regional Office for South-East Asia has organized a regional meeting and five national workshops on countering tobacco industry interference with tobacco control and will continue to do so in the future as well.

Distinguished participants, ladies and gentlemen, we have been continuously supporting Member States to effectively implement tobacco control measures in line with the WHO FCTC. Increasing progress has been made in areas related to Articles 6, 8, 11 and 13 of the Convention in most Member States of the Region. However, there are gaps, particularly with regard to implementation of the guidelines of the WHO FCTC. Additionally, even when strong tobacco control legislation is implemented, many countries face challenges in enforcing the law.

As Parties to the Convention, Member States are obliged to implement the provisions of the WHO FCTC. Article 15 of the WHO FCTC recognizes the need to eliminate all forms of illicit trade and calls on all the Parties to adopt and implement effective legislative, executive, administrative or other measures to eliminate illicit trade in tobacco products. Illicit trade in tobacco and tobacco products is an issue of serious concern in the Region. Studies show that Asia is one of the key targets of global illicit trade of international brands of tobacco products due to fiscal barriers such as high import and supplementary duties, domestic sales and value-added taxes, and a ban on imports. Illicit trade of tobacco products increases the affordability and accessibility of tobacco products which increases the burden of tobacco-related diseases and deaths.

The Protocol to Eliminate Illicit Trade in Tobacco Products, the first Protocol to the Convention, was adopted on 12 November 2012 at the fifth session of the Conference of the Parties in Seoul, Republic of Korea, and is currently open for ratification, acceptance, approval or accession by the Parties to the WHO FCTC. The Protocol was developed in response to the growing international illicit trade in tobacco products, which poses a serious threat to public health. Till date, Myanmar has signed the Protocol and I would like to urge Member States to accelerate their efforts to ratify or accede to the Protocol.

Colleagues, distinguished participants, ladies and gentlemen,

About 90% of global smokeless tobacco users reside in countries of the South-East Asia Region causing over 30,000 deaths annually. There is an increasing trend in the use of smokeless tobacco by young individuals in many countries. The increasing trend in smokeless tobacco consumption in South-East Asian countries points to inadequate tobacco control policies. Although many Parties in the Region have initiated steps to regulate smokeless tobacco, they need to strengthen policies and ensure they are fully enforced. Low taxes on smokeless tobacco and the myth that it is less harmful than smoking forms led tobacco users to switch from smoking to smokeless tobacco use. Production of smokeless tobacco is increasing globally and it has become a global epidemic. I am happy to note that smokeless tobacco is an agenda in the sixth session of the Conference of the Parties and I do hope that the Conference will suggest concrete measures to stop this epidemic.

Now, we have a new challenge. In recent years the electronic cigarette industry has been expanding rapidly. The electronic nicotine delivery systems known as ENDS, are frequently marketed by the industry as an aid to quit smoking or as being a healthier alternative to tobacco. But, the fact is that there is very little research on ENDS and no convincing evidence that they are effective as a “quit-smoking device”. ENDS contain varying levels of nicotine, many times similar to those in cigarettes, and without regulation there is no way to control this amount. Evidence shows that though likely to be less toxic than conventional cigarettes, e-cigarette use poses threats to adolescents and fetuses of pregnant mothers. According to some reports, e-cigarettes also increase the exposure of non-smokers and bystanders to nicotine and a number of toxicants. Half of the countries in developing world have no mechanism to regulate ENDs. I would like to urge the delegates to discuss this seriously and develop a regional position at the COP6.

Tobacco growing as well as bidi rolling accounts for a significant percentage of the workforce in countries such as Bangladesh, India and Indonesia. These people get paid minimum wages and suffer from hazards of handling tobacco leaves and inhaling of pesticides. There are also negative effects on the environment due to deforestation and curing of tobacco. This important issue of alternative livelihood needs to be addressed seriously, since we have mega countries in our Region where an alternative livelihood for the tobacco growers and workers needs to be provided by the government.

This meeting has been organized by the WHO Regional office for South-east Asia at the request of Member States. I would like to thank the Member States for their continued efforts towards curbing the tobacco epidemic in the Region. I hope the momentum will be enhanced within the context of prevention and control of NCDs to achieve our global voluntary target of 30% relative reduction of tobacco use by 2025.

I wish you all successful deliberations and a pleasant stay in New Delhi.

Thank you.