Francisco Cabo

Rendez-vous 161 - January 29, 2007

Thank you Francisco for taking the time to answer our questions.
Please can you first introduce yourself  your background and tell us when, why and how you got involved in tobacco control?
Francisco Cabo: Since the mid-seventies I have been involved in public health issues at the international level (World Health Assemblies, Conferences) and I have held various positions with the Ministry of Health of Mozambique and the Maputo Province. Since 1998 I have been with the Mozambican Public Health Association and I was elected their Executive Director in 2000.

Thank you Francisco for taking the time to answer our questions.
Please can you first introduce yourself  your background and tell us when, why and how you got involved in tobacco control?
Francisco Cabo: Since the mid-seventies I have been involved in public health issues at the international level (World Health Assemblies, Conferences) and I have held various positions with the Ministry of Health of Mozambique and the Maputo Province. Since 1998 I have been with the Mozambican Public Health Association and I was elected their Executive Director in 2000.

 In 2000, I was invited by TFI to join the tobacco control network as Don't Be Duped Agent, that is, a focal point for all tobacco control issues in Mozambique.
Since then, I participated in many workshops, conferences organized by different organizations such as WHO, FCA, World Federation of Public Health Associations and other partners such as the Canadian Public Health Association (CPHA) and locally by the Mozambique Public Health Association. I participated, almost, in all INB sessions in Geneva, including the last one which ended with the conclusion of the final FTCT text.

As a public health professional, I am committed to fight against any factors that might prejudice the health of the communities, tobacco is one of these factors.

Q1. Can you tell us about the situation of tobacco in Mozambique and what you think the priorities are now for tobacco control?

Francisco Cabo: Currently, the situation of tobacco in Mozambique is characterized by the following factors:
1. Poverty that affects Mozambique and the region. This fact leads to the acceptance, by the governments, of any investments in tobacco production with the hope that it (tobacco) will help develop the country's economy. But the people, particularly political leaders of Mozambique and of the region as a whole, do not understand that tobacco business results in more tobacco consumptions by local communities, aggravating their status of absolute poverty and diseases, damaging the environment, etc.
2. High level of ignorance of political leaders, decisions makers, etc. and widespread illiteracy among the communities do not allow them to understand health risks of tobacco smoking.
3. Tobacco industry's influence on top government officials, using all means of pressure including corruption, makes it difficult for the government to decide in favor of public health interest.
4. Lack of sufficient material and financial resources to develop and sustain consistent tobacco control activities, namely: lobbying and advocacy for FCTC ratification and implementation, as well as IEC programs in the communities for awareness raising and leadership\ndevelopment in tobacco control limits our efforts, allowing the tobacco\nindustry to take the advantage; and finally, the absence of tobacoc control legislation.
5. The absence of tobacco control legislation in Mozambique allows the tobacco industry to take the advantage to increase its business without restrictions, including tobacco growing and advertising using all means at its disposal. 

At present, the priorities for tobacco control are as follow:

1. To convince the Mozambican government to ratify FCTC.

Since  tobacco control is not a priority for the government of Mozambique, it is important that an effort be made to make the Mozambican leaders understand that tobacco is also a serious public health problem that needs to be equally addressed alongside with malaria, tuberculosis,\nHIV/AIDS, etc.
The Mozambican leaders should be aware that failing to control tobacco today will have unbearable implications on the health of millions of Mozambicans in the next few years, maybe worse than those caused by malaria, tuberculosis, HIV/AIDS, etc.

2. Special training of the Mozambican leaders (at all levels) to help them understand the real nature of tobacco phenomenon in regard to health and to other issues

3. Medical personnel in the country should be given an opportunity to increase and widen the scope of their knowledge on tobacco related diseases so as to be able to determine tobacco related causes of death for the benefit of the public;
4. Specific training should be given to tobacco control agents to enable them to acquire technical and managerial capacities to ensure successful implementation of tobacco control programs in the country.
5. Technical assistance at this stage is necessary to help local tobacco control project coordinators draw up consistent programs that include not only social mobilization activities, but also and in particular, those activities with the aim of promoting: research, treatment of tobacco related diseases, smoking cessation, specific programs to counter tobacco industry propaganda, alternative cash crops, etc.

Q3. Although Africa is not considered -yet- as a priority for tobacco\ncontrol since the prevalence and the number of smokers is still low (except in Egypt) compared to countries like China or Russia, it is telling that Philip Morris (for instance) has decided to build a brand new plant in Senegal: obviously the industry considers Africa as a\ngrowth market and adversing and promotion are heavy. How do you assess the marketing activity of the tobacco industry in your country? Do you feel it is strong and growing?

Francisco Cabo: Mozambique, until June 25, 1975, was a Portuguese colony. The Portuguese authorities, for many centuries, never promoted tobacco growing and consumption among the communities. One of the cash crops the Portuguese colonial regime had been promoting and even obliged people to grow, was cotton. That is why Mozambique had never been in the list of tobacco growing countries in Africa although its neighbors (Zimbabwe and Malawi) are the top tobacco growing countries in the region.

Taking advantage of ignorance and poverty, the tobacco industry, mainly monopolized by British American Tobacco (BAT), is increasing its business. Since there is no tobacco control legislation in Mozambique, advertising and promotion of tobacco products are heavily carried out through all mass media, including public television and radio networks.

Mozambique has not only become a tobacco market, but also a tobacco producing country. The Zimbabwan white settlers who, for many decades had been growing tobacco in that neighbouring country and because of land reform in Zimbabwe, have now moved to Mozambique and occupied fertile lands of Manica and Tete provinces as investors where they are destroying the vegetation to grow tobacco.

  Q4.In many countries the tobacco industry is very influent and is able to limit the impact of tobacco control legislation. How does the government deal with the industry in Mozambique?

Francisco Cabo: The tobacco industry is very strong in Mozambique, it even determines government's policy on tobacco, always in its favor. That is the reason why the Mozambican government is reluctant in deciding for the FCTC ratification and implementation.

The tobaco control movement is being seen by the government as an opposition and a foe for the national economy. Therefore, the government has closed all the doors for dialog with the Mozambique Public Health Association (AMOSAPU) on tobacco issues alleging that it is promoting subversive activities against the economy of the country.

Q5. NGOs have acted as watchdogs for public health. Can you tell us about their activities?

Francisco Cabo: The Right to Health of all Mozambican people is one of the fundamental principles embodied in the Constitution. Therefore, there is a political will to protect the health of the citizens against any risk-factors that can jeopardize it, tobacco being one of them.

The Mozambican Public Health Association (AMOSAPU), a non-governmental and non-profit organization, has become an outstanding entity that has assumed the leadership for tobacco control process agglutinating all civil society forces, working side by side with the Ministry of Health in the fight against tobacco epidemic. In this capacity, AMOSAPU, through its members has done a great deal in influencing the Government to adopt a positive attitude in support of FCTC and now, through its participation in the multi-sectoral tobacco control group, it is working very hard to have FCTC ratified and implemented in the country.
As a direct result of this effort, the follwing successes have been achieved:

The government has already signed the FCTC. Although this is not binding, it is an important step forward and it is encouraging to note that both the government and the Parliament have taken some initiatives by respectively, setting up a multi-sectoral tobacco control working group to prepare FCTC ratification and implementation process.

Tobacco is currently not only a public health problem, but has now become a social and economic problem that worries the entire Mozambican society.
The Mozambican people have become more aware of tobacco health hazards to the extent that they are beginning to look at the tobacco industry as an enemy for the damage its products are causing to their health and to the country's economy, as well as to the environment.
The Ministry of Health, recognizing that tobacco is indeed not only a public health problem, but an overall problem that needs to be globally addressed within the scope of economic and social development, has started drafting health regulations in an attempt to curb the epidemic.

As a result of this growing awareness, the Ministry of Health, through the National Health Director, announced that the Mozambican Government was going to begin, last October, the discussion on the possible ratification of the FCTC which it signed on June 18, 2003.

The Mozambican Parliament has always indicated that it would ratify the FCTC and adopt national tobacco control legislation as soon as the government brings up the issue to the Parliament. It has also indicated its intention and interest to work with civil society in drawing up and enacting national tobacco control legislation.

Q6. Is there anything else you would like to add?

Francisco Cabo: Since tobacco control is not a priority for the government of Mozambique, it is important that an effort be made to make the Mozambican leaders understand that tobacco is also a serious public health problem that needs to be equally addressed alongside with malaria, tuberculosis,\nHIV/AIDS, etc.

The Mozambican leaders should be aware that failing to control tobacco today, will have unbearable implications on the health of millions of Mozambicans in the next few years, maybe worse than those caused by malaria, tuberculosis, HIV/AIDS, etc.

Therefore, the following needs should be taken into consideration:

Special training of the Mozambican leaders (at all levels) to help them understand the real nature of tobacco phenomenon in regard to health issues;

Medical personnel in the country should be given an opportunity to increase and widen the scope of their knowledge on tobacco related diseases so as to be able to determine tobacco related causes of death for the benefit of the public;

Specific training should be given to tobacco control agents to enable them to acquire technical and managerial capacities to ensure successful implementation of tobacco control programs in the country.

Technical and financial assistance at this stage is necessary to help local tobacco control project coordinators draw up consistent programs that include not only social mobilization activities, but also and in particular, those activities with the aim of promoting research, treatment of tobacco related diseases, smoking cessation, specific programs to counter tobacco industry propaganda, promotion of alternative cash crops,etc .

 In 2000, I was invited by TFI to join the tobacco control network as Don't Be Duped Agent, that is, a focal point for all tobacco control issues in Mozambique.
Since then, I participated in many workshops, conferences organized by different organizations such as WHO, FCA, World Federation of Public Health Associations and other partners such as the Canadian Public Health Association (CPHA) and locally by the Mozambique Public Health Association. I participated, almost, in all INB sessions in Geneva, including the last one which ended with the conclusion of the final FTCT text.

As a public health professional, I am committed to fight against any factors that might prejudice the health of the communities, tobacco is one of these factors.

Q1. Can you tell us about the situation of tobacco in Mozambique and what you think the priorities are now for tobacco control?

Francisco Cabo: Currently, the situation of tobacco in Mozambique is characterized by the following factors:
1. Poverty that affects Mozambique and the region. This fact leads to the acceptance, by the governments, of any investments in tobacco production with the hope that it (tobacco) will help develop the country's economy. But the people, particularly political leaders of Mozambique and of the region as a whole, do not understand that tobacco business results in more tobacco consumptions by local communities, aggravating their status of absolute poverty and diseases, damaging the environment, etc.
2. High level of ignorance of political leaders, decisions makers, etc. and widespread illiteracy among the communities do not allow them to understand health risks of tobacco smoking.
3. Tobacco industry's influence on top government officials, using all means of pressure including corruption, makes it difficult for the government to decide in favor of public health interest.
4. Lack of sufficient material and financial resources to develop and sustain consistent tobacco control activities, namely: lobbying and advocacy for FCTC ratification and implementation, as well as IEC programs in the communities for awareness raising and leadership\ndevelopment in tobacco control limits our efforts, allowing the tobacco\nindustry to take the advantage; and finally, the absence of tobacoc control legislation.
5. The absence of tobacco control legislation in Mozambique allows the tobacco industry to take the advantage to increase its business without restrictions, including tobacco growing and advertising using all means at its disposal. 

At present, the priorities for tobacco control are as follow:

1. To convince the Mozambican government to ratify FCTC.

Since  tobacco control is not a priority for the government of Mozambique, it is important that an effort be made to make the Mozambican leaders understand that tobacco is also a serious public health problem that needs to be equally addressed alongside with malaria, tuberculosis,\nHIV/AIDS, etc.
The Mozambican leaders should be aware that failing to control tobacco today will have unbearable implications on the health of millions of Mozambicans in the next few years, maybe worse than those caused by malaria, tuberculosis, HIV/AIDS, etc.

2. Special training of the Mozambican leaders (at all levels) to help them understand the real nature of tobacco phenomenon in regard to health and to other issues

3. Medical personnel in the country should be given an opportunity to increase and widen the scope of their knowledge on tobacco related diseases so as to be able to determine tobacco related causes of death for the benefit of the public;
4. Specific training should be given to tobacco control agents to enable them to acquire technical and managerial capacities to ensure successful implementation of tobacco control programs in the country.
5. Technical assistance at this stage is necessary to help local tobacco control project coordinators draw up consistent programs that include not only social mobilization activities, but also and in particular, those activities with the aim of promoting: research, treatment of tobacco related diseases, smoking cessation, specific programs to counter tobacco industry propaganda, alternative cash crops, etc.

Q3. Although Africa is not considered -yet- as a priority for tobacco\ncontrol since the prevalence and the number of smokers is still low (except in Egypt) compared to countries like China or Russia, it is telling that Philip Morris (for instance) has decided to build a brand new plant in Senegal: obviously the industry considers Africa as a\ngrowth market and adversing and promotion are heavy. How do you assess the marketing activity of the tobacco industry in your country? Do you feel it is strong and growing?

Francisco Cabo: Mozambique, until June 25, 1975, was a Portuguese colony. The Portuguese authorities, for many centuries, never promoted tobacco growing and consumption among the communities. One of the cash crops the Portuguese colonial regime had been promoting and even obliged people to grow, was cotton. That is why Mozambique had never been in the list of tobacco growing countries in Africa although its neighbors (Zimbabwe and Malawi) are the top tobacco growing countries in the region.

Taking advantage of ignorance and poverty, the tobacco industry, mainly monopolized by British American Tobacco (BAT), is increasing its business. Since there is no tobacco control legislation in Mozambique, advertising and promotion of tobacco products are heavily carried out through all mass media, including public television and radio networks.

Mozambique has not only become a tobacco market, but also a tobacco producing country. The Zimbabwan white settlers who, for many decades had been growing tobacco in that neighbouring country and because of land reform in Zimbabwe, have now moved to Mozambique and occupied fertile lands of Manica and Tete provinces as investors where they are destroying the vegetation to grow tobacco.

  Q4.In many countries the tobacco industry is very influent and is able to limit the impact of tobacco control legislation. How does the government deal with the industry in Mozambique?

Francisco Cabo: The tobacco industry is very strong in Mozambique, it even determines government's policy on tobacco, always in its favor. That is the reason why the Mozambican government is reluctant in deciding for the FCTC ratification and implementation.

The tobaco control movement is being seen by the government as an opposition and a foe for the national economy. Therefore, the government has closed all the doors for dialog with the Mozambique Public Health Association (AMOSAPU) on tobacco issues alleging that it is promoting subversive activities against the economy of the country.

Q5. NGOs have acted as watchdogs for public health. Can you tell us about their activities?

Francisco Cabo: The Right to Health of all Mozambican people is one of the fundamental principles embodied in the Constitution. Therefore, there is a political will to protect the health of the citizens against any risk-factors that can jeopardize it, tobacco being one of them.

The Mozambican Public Health Association (AMOSAPU), a non-governmental and non-profit organization, has become an outstanding entity that has assumed the leadership for tobacco control process agglutinating all civil society forces, working side by side with the Ministry of Health in the fight against tobacco epidemic. In this capacity, AMOSAPU, through its members has done a great deal in influencing the Government to adopt a positive attitude in support of FCTC and now, through its participation in the multi-sectoral tobacco control group, it is working very hard to have FCTC ratified and implemented in the country.
As a direct result of this effort, the follwing successes have been achieved:

The government has already signed the FCTC. Although this is not binding, it is an important step forward and it is encouraging to note that both the government and the Parliament have taken some initiatives by respectively, setting up a multi-sectoral tobacco control working group to prepare FCTC ratification and implementation process.

Tobacco is currently not only a public health problem, but has now become a social and economic problem that worries the entire Mozambican society.
The Mozambican people have become more aware of tobacco health hazards to the extent that they are beginning to look at the tobacco industry as an enemy for the damage its products are causing to their health and to the country's economy, as well as to the environment.
The Ministry of Health, recognizing that tobacco is indeed not only a public health problem, but an overall problem that needs to be globally addressed within the scope of economic and social development, has started drafting health regulations in an attempt to curb the epidemic.

As a result of this growing awareness, the Ministry of Health, through the National Health Director, announced that the Mozambican Government was going to begin, last October, the discussion on the possible ratification of the FCTC which it signed on June 18, 2003.

The Mozambican Parliament has always indicated that it would ratify the FCTC and adopt national tobacco control legislation as soon as the government brings up the issue to the Parliament. It has also indicated its intention and interest to work with civil society in drawing up and enacting national tobacco control legislation.

Q6. Is there anything else you would like to add?

Francisco Cabo: Since tobacco control is not a priority for the government of Mozambique, it is important that an effort be made to make the Mozambican leaders understand that tobacco is also a serious public health problem that needs to be equally addressed alongside with malaria, tuberculosis,\nHIV/AIDS, etc.

The Mozambican leaders should be aware that failing to control tobacco today, will have unbearable implications on the health of millions of Mozambicans in the next few years, maybe worse than those caused by malaria, tuberculosis, HIV/AIDS, etc.

Therefore, the following needs should be taken into consideration:

Special training of the Mozambican leaders (at all levels) to help them understand the real nature of tobacco phenomenon in regard to health issues;

Medical personnel in the country should be given an opportunity to increase and widen the scope of their knowledge on tobacco related diseases so as to be able to determine tobacco related causes of death for the benefit of the public;

Specific training should be given to tobacco control agents to enable them to acquire technical and managerial capacities to ensure successful implementation of tobacco control programs in the country.

Technical and financial assistance at this stage is necessary to help local tobacco control project coordinators draw up consistent programs that include not only social mobilization activities, but also and in particular, those activities with the aim of promoting research, treatment of tobacco related diseases, smoking cessation, specific programs to counter tobacco industry propaganda, promotion of alternative cash crops,etc .