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 GroupUN Development Programme, New York

Presented to the Governance of Tobacco in the 21st Century Conference, University of Harvard/WHO February 2013

Mandate for UN system support• FCTC COP decision FCTC/COP4/17• ECOSOC resolution RES/2012/41. Encourages the Ad Hoc Inter-Agency Task Force to promote effectivetobacco 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;

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

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)

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.

NCDs mentioned in National Development Plans n=28

NCDsmentioned (22)

NCDs not mentioned (6)

Tobacco in National Development Plans n=28

no mention of tobacco (19)

tobacco mentioned(9)

NB – not one of thesample countries mentioned FCTC in NDP

Tobacco in UNDAFs n=46

FCTC

FCTCSpecified (3)

TobaccoSpecified(12)

Tobacconot men-tioned(29)

Desk Research Sample of 48 countries

• 28 NDPs reviewed– 0 mentions of “FCTC” – 8 include tobacco control measures– 22 include NCDs

• 46 UNDAFs reviewed– 3 include FCTC implementation– + 1 inclusion of FCTC in list of treaty obligations– 5 include tobacco control measures

Desk Research Sample of 48 countries

• 28 NDPs reviewed– 0 mentions of “FCTC” – 8 include tobacco control measures– 22 include NCDs

• 46 UNDAFs reviewed– 3 include FCTC implementation– + 1 inclusion of FCTC in list of treaty obligations– 5 include tobacco control measures

Case Studies

• 8 case study countries• Interviews with

– Ministry of Health Tobacco Control Focal Points– WHO Tobacco Control Focal Points – UNDP relevant contacts

Emerging Lessons: Inclusion in NDPs

• FCTC should be a health priority championed by Ministry of Health

• Policy advocacy should present:– Evidence for relationship to poverty reduction– Impact on other development priorities e.g.

reducing inequalities, improving access to education

– Inter-relationships with existing health MDGs (and emerging post 2015 development agenda)

Emerging Lessons: Inclusion in UNDAF

UNDAFs should support• achieving NDP priorities – so FCTC should be

included in NDP• delivery of international treaty obligations – so

FCTC should be listed• coordination of UN agencies actions – so

UNCTs must be sensitised to relevance and responsibilities

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

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

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

partners’ priorities• Lack of data on prevalence, morbidity, mortality

and costs• Fears of economic impacts of tobacco control• Tobacco industry influence

Recommendations

1. Support continued advocacy efforts at national and international level2. Provide capacity building to governments to support the integration of FCTC into NDPs and UNDAFs3. Learn from experience of mainstreaming HIV/AIDS4. Focus on tobacco taxation as key entry point

Recommendations

5. Invest in data and analysis (especially the political economy) of the epidemic and its impacts on other development priorities6. Support countries to develop cost estimates for FCTC implementation7. 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

National Development Plan

Integration framework

FCTCPlan

NCD Plan

United Nations Development

Assistance Framework

Bilateral

Bilateral Bilateral

Potential UNDP roles

Some specific opportunities for UNDP in tobacco are emergingo UN system coordination (RC) and UNDAF integrationo Post-2015 development agendao Support to national NCD action plan developmento Integration of tobacco/FCTC/NCDs into national development

planningo Support to national governance structures on tobacco/NCDso Anti-corruption and regulatory independenceo Intellectual property/TRIPS, tradeo Strengthening law enforcement, justiceo Strengthening local government-municipal programmingo CSO engagemento Gender and tobacco, human rights

Thank you

Douglas Webb, Ph.D.HIV, Health and Development PracticeBureau for Development PolicyUNDP New York Email: douglas.webb@undp.org

Acknowledgements to Alison Cox, Brian Lutz and Michelle Sahal-Estime