An article by Dr Kofi Ahmed, Ag. Chief Medical Officer at the Ministry of Health , from the Accra Daily Mail.
TOBACCO! - Accra Daily Mail
The only legal product that causes the death of half of its regular users!
Wednesday, February 28, 2007
By Dr Kofi Ahmed, Ag. Chief Medical Officer at the Ministry of Health
Introduction
Tobacco is the second leading cause of death globally, causing nearly five million deaths per year. Estimates show that it will prematurely kill ten million people a year by 2010 if current trends are not reversed. Tobacco is the only legal product that causes the death of half of its regular users.
This means that about 1.3 billion smokers, 650 million people will die prematurely.
Evidence shows that smoking harms nearly every organ of the body. Tobacco use is the cause of the majority of lung cancer cases and it has been linked to many other types of cancer, such as cervical and kidney cancer.
Other health risks associated with tobacco include heart attacks strokes, and other cardio vascular diseases, bronchitis, asthma and other respiratory diseases as well as infertility.
Tobacco Control Activities in the country:
In 1978 the then Director of Medical Service, the late Dr. E.G. Beausoleil who was himself a smoker went on air to launch the country’s programme to stop smoking as part of the WHO global activity. The following few days saw him being lampooned by way of cartoons in a local newspaper, showing a pot bellied man speaking through a microphone advising the nation not to smoke whilst at the same time holding on to a packet of cigarette in one hand behind him hiding from public view.
Through the instrumentality of the Director of Medical Services, Dr Moses Adibo in 1991, cigarette manufacturing companies in the country were administratively directed to have health warning on packets of cigarette to be sold locally. Since then all such cigarette packets bear the inscription ‘’The Ministry of Health warning: Cigarette smoking can harmful to your health’.
Commodore (Rtd.) Steve Obimpeh, as the NDC Secretary for Health in 1992, also administratively banned smoking in any Ministry of Health facility. He was recognized at the subsequent World Health Assembly (WHA) meeting. Up to the present time smoking is not allowed in hospitals, clinics, ambulances and on any property belonging to the MOH.
The Fifty Second World Health Assembly (WHA.52) in May 1999 adopted the Resolution on the Intergovernmental Negotiating Body (IGNB) for the WHO Framework Convention on Tobacco Control (FCTC).
In January 2002, the Minister of Health Dr Kwaku Afriyie inaugurated the National Steering Committee for Tobacco Control in response to the WHA.52 Resolution on the FCTC. The Programme Manager for the Non Communicable Diseases, Dr. J. K. Teprey was appointed the focal person at the secretariat of the Non Communicable Diseases Control office. The committee was provided with funds from WHO and the Ministry of Health to draft a Bill on Tobacco and to celebrate the ‘World No Tobacco Day’ that year. The Health Research Unit of the GHS was also given funds to undertake studies to support policy development of Tobacco Control.
This committee met three times during the year and tasked a sub-committee, which produced the first draft Bill entitled Tobacco Products Bill under the coordination of the Programme Manager. It was submitted to the Minister in 2003 and later to Cabinet in September of the same year.
Cabinet’s Social Services committee was of the view that the draft Tobacco Products Bill could pose implementation difficulties and that an existing agency under the Ministry of Health should undertake the functions proposed for the National Tobacco Regulatory Board in that Bill. It continued that it was not clear whether there was consultation with other agencies such as the Food and Drugs Board when the proposals for the Bill were formulated.
In 2004, the Ministry sought permission to review the existing health legislation. Cabinet gave approval for the review, and advised that where possible, the laws should be consolidated to reduce the number of Bills to be presented.
When the Ministry started the process of reviewing all its existing health legislation, a draft Public Health Bill was proposed to consolidate the existing obsolete Ordinances such as the Mosquito, Infectious Diseases Ordinances and the new Bills related to Public Health that were to be drafted. The legislation related to Tobacco Control, Food and Drugs control and others were thus considered part of this new Bill.
The components of the draft Public Health Bill are as follows:
1. Food and Drugs
2. Tobacco Control
3. Mosquito Control
4. Quarantine
5. Vaccination
6. Infectious Disease
7. Public Nuisance
8. International Health Regulation
9. HIV/AIDS and
10. Patients Charter
Tobacco Control Bill has been placed in the ambit of the Food and Drugs Board as the Government’s Agency that will be responsible for Tobacco Control when the Bill is passed. The Bill is currently being drafted in the Attorney General’s office with the co -operation of the Food and Drugs Board and the Ministry of Health.
The Framework for Tobacco Control (FCTC) is a global policy that was developed by WHO member nations through the Intergovernmental Negotiating Body (IGNB), unanimously approved by the 56th WHA on 21 May 2003, and opened for signatures from member countries. It is the world’s first public health treaty to be passed by a UN Agency. It gives guidance and legal backing to all member countries’ local laws against tobacco. It has provisions that set international standards on tobacco price and tax increase, tobacco advertising and sponsorship, labeling, illicit trade and second-hand smoke among others.
Ghana was among the first WHO member countries to sign the FCTC on 20 June 2003 by His Excellency Mr. Fritz Kwabena Poku, Ghana’s Ambassador and Permanent Representative to the UN office in Geneva.
At the opening of the 57th World Health Assembly in June 2004, Ghana was among the 138 WHO member countries that had signed the convention. To demonstrate its commitment to the treaty, Ghana made a public statement at the Assembly that it would deposit its Instrument of Ratification in New York the same month. The Ratification of Ghana, the 39th country was however on 29 November 2004 and the accession of Armenia on the same date, brought the total number of Contracting Parties to 40 and that triggered the countdown for entry into force of the Convention.
The Convention came into force on 27 February 2005 that is the 90th day following the date of deposit of the instrument. Ghana feels proud to be among the 40 signatories required to ratify the Convention into law.
As part of the preparation towards the development of the FCTC, the then Programme Manager for Non Communicable Diseases and Hon. K. A. Kyeremateng, the former M.P. for Afigya Sekyere, who was the Chairman of the Parliamentary Select Committee on Health represented Ghana on the IGNB for over 3 years. They attended all the working sessions held in the Africa Region and at the WHO Headquarters, sometimes in the company of other delegates from Ghana including the Minister of Health. Ghana’s representative at the UN office in Geneva and the Ambassador to Switzerland, His Excellency Mr. Fritz Poku was a regular member of the Ghana’s delegation to the meetings of the IGNB.
Ghana was made the spokesperson for the Africa region at the initial stages of the meetings. The Honorable M.P. was made Chairman of one of the working committees. Unfortunately, he could not stay long in the august house to be at the final meeting of the IGNB, though he was recognized. Locally the two served on the Committee that drafted the policy document, which led to the drafting of the present Tobacco Control Bill.
In October 2006, the Ghana Health Service in collaboration with the Canadian Tobacco Control Research Initiatives and Research for International Tobacco Control (RITC) also initiated a study by collecting data on issues related to tobacco control in Ghana. The object of the study was to assess Ghana’s readiness for Tobacco Control. The study was to help it make policy decisions for the implementation of Tobacco Control in Ghana.
Policy decisions on health including that of Tobacco Control in Ghana, are however a function of the Ministry of Health with contributions from all stakeholders and agencies in the country.
Conclusion:
Ghana recognized the need to control tobacco use, long before the WHO FCTC idea, which culminated in the treaty and the country’s draft legislation on Tobacco Control. Tobacco Control has been one of the regular activities undertaken by the Health Education unit of the Ministry of Health and the Ministry of Information. It is hoped with the current impetus, all stakeholders will help make tobacco use outdated, so as to improve the health of the people in the country, despite the economic gains from the tobacco industry.
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