When Anne Jones began working on Australia’s campaign for tobacco control 20 years ago, only a handful of people were involved. Since then, Australia has become a model for what comprehensive tobacco control can accomplish, and Jones has become a leading advisor and advocate for tobacco control in low-and middle-income countries.
She first learned how governments work as a policy advisor for an MP from her home state of New South Wales. “I learned how both good and bad decisions are made, and the importance of advocacy,” she says. When she went on to serve as Chief Executive Officer of Action on Smoking and Health Australia (ASH) in 1994, she brought this experience to her new role.
A primary task for ASH was to strengthen the voice of tobacco control and public health in government. The tobacco industry has a strong voice, Jones points out, and, when it came to lobbying, she knew that “If we were not walking the halls of government, the industry would remain unopposed to block and delay every attempt to improve public health.”
In 1996, Australia’s smoking rate was close to 25 per cent. Today, with a comprehensive tobacco control strategy in place – including the world’s first “plain” or standardised packaging law – it has been reduced to 12 per cent. Despite the industry’s claims that these policies won’t work, the evidence has shown they do, and other countries have followed suit.
In 2007, Jones joined The Union to work on the Bloomberg Initiative to Reduce Tobacco Use (BI), which provided the platform for her to work on tobacco control globally. BI has focused on helping the 15 countries with the highest tobacco burden implement effective tobacco control, and she has worked as a technical advisor to China, Thailand, the Philippines and Viet Nam, as well as developing training programmes, technical guides and other resources.
Eight years ago, she recalls, low- and middle-income countries often had only one or two people working on tobacco control, so BI’s major goals were to build capacity, health data and commitment for effective tobacco control legislation.
“When you’re talking to political leaders, you need to show evidence and how the health benefits far outweigh the toll and costs of tobacco. In places like India and China, tobacco was normalised – and both evidence and strong local support were needed to reframe and overcome entrenched views.”
Today 180 countries have ratified the WHO Framework Convention on Tobacco Control (FCTC), more than 100 have passed some type of smokefree legislation, some 80 require graphic health warnings on tobacco packaging, many have banned tobacco advertising, promotion and sponsorship (TAPS) and some have raised taxes on tobacco.
“This is where The Union has achieved so much despite aggressive tobacco industry opposition at multiple levels, including legal and economic threats."
Now,” she says, “a two-pronged approach is needed – sustainable funding for tobacco control programmes, combined with measures to protect health policies from tobacco industry interference.”
The Union has developed a course on sustainable funding that will be piloted in Bangladesh in October and later made available to other countries.
“We’re in an ideal situation to help, as our organisation has been building relationships with governments for nearly 100 years driven by strong values and a vision for a world free of poverty, disease and death caused by tobacco.”
“The issue of sustainable funding is urgent,” says Jones, “because tobacco control in many countries is underfunded with only a small proportion of governments implementing sufficient tobacco taxes.”
“The good news is that we know how to solve the problem as countries have a right to take action to embed tobacco control into planning and infrastructure and to increase their tobacco taxes to cover the costs.”
“Tobacco tax is a win-win situation. With tobacco less affordable, fewer people smoke or chew, including the poor and the young – and the funds help pay to reduce the ravages of tobacco and non-communicable diseases.”
“These cost-effective strategies have been proven in many countries,” she concludes. “We can save up to six million lives a year, increase productivity, raise revenue to finance health – and take the pressure off healthcare systems.”
The United Nations agrees. The UN’s 3rd International Conference on Financing for Development this month called for tobacco tax not only to reduce tobacco and healthcare costs, but also to finance sustainable development.