ASEAN health advocates push for sustainable funding mechanisms for health promotion and tobacco control

Tobacco control and other health advocates from 15 countries around the Southeast Asian and Western
 Pacific regions, North America and Europe recently held a regional workshop in Hanoi, Vietnam, to strengthen capacity for health promotion and tobacco control through sustainable funding mechanisms such as dedicated tobacco taxes. The Vietnam Steering Committee on Smoking and Health (VINACOSH) co-hosted the meeting with the World Health Organization’s Western Pacific Regional Office (WHO-WPRO) and the Bangkok-based Southeast Asia Tobacco Control Alliance (SEATCA). Read more

While there are global commitments and national laws in many countries to implement Article 6 of the WHO-Framework Convention on Tobacco Control (WHO FCTC), that is, a global

convention to use effective tobacco tax structures to reduce tobacco use, yet there is a need to support and strengthen best practices, and raise the capacity and cooperation between governments and civil society by initiating the establishment of more health promotion funds (HPF) for countries which are equipped and can already implement such programs. This becomes all the more important as ten percent of the world’s smokers–around 125 million people–are in Southeast Asia.

Delegates from Vietnam, the WHO, the Southeast Asia Tobacco Control Alliance (SEATCA), and participants from Cambodia, Indonesia, Lao PDR, Philippines, Malaysia, Mongolia, Samoa, and Tonga deliberated upon the existing HPFs from around the world to develop tools and mechanisms that can strengthen the legal, legislative, financial, and programmatic environments for tobacco control on the regional and national levels via the establishment of new HPFs.

Dr. Luong Ngoc Khue, Director of the Department of Medical Service Administration and VINACOSH, Ministry òf Health said that Vietnam, as co-host, is fully committed to forming its own Tobacco Control and Health Promotion Foundation, in line with its commitments to the WHO-FCTC.

SEATCA’s Southeast Asia Initiative on Tobacco Tax (SITT) Director, Dr. Ulysses Dorotheo said that experience from countries with HPFs demonstrate how “societies and governments can and should utilize revenues from tobacco and other ‘sin taxes’ to fight for the health of their citizens.”SITT uses globally proven evidence to encourage governments in Southeast Asia to adopt more progressive tobacco tax regimes that will lower smoking incidence while at the same time increasing government revenues that can further assist national health programs.

There already exist a number of successful HPFs throughout the region and the world. Thailand’s and Singapore’s HPF were established as early as 2001, and are fully funded by ‘sin taxes’ collected from producers and importers of tobacco and alcohol.

The Thai health Promotion Foundation, an autonomous agency, and the first to be established in the ASEAN region, supports health promotion programs in Thailand by strengthening smoking cessation programs and supporting government advocacy campaigns to educate the public about the dangers of tobacco use.

The Singapore Health Promotion Board similarly empowers its residents through health promotion and disease prevention programs which inform its citizens about smoking-related diseases and smoking cessation methods. It is worth mentioning here that Singapore government has recently banned alternative tobacco and nicotine products like snuff, electric cigarettes, nicotine water, fruit/candy flavoured cigarettes, which are generally not available in the local market. Nonetheless, their appeal to youngsters, including women is increasing. This ban on alternative products is important, given the recent increase in the number of young smokers in Singapore. Between 2004 and 2007, the smoking prevalence rose by 7% (from18% to 25%) in young men, and by 2% (from 7% to 9%) in young women.

The Phillipines Health Secretary Enrique Ona has been pushing for a 400 percent increase in cigarette tax with the intention of reducing the number of smokers in the country (especially young smokers) and mitigate the health cost that would arise from cigarette use. His suggestions have got the nod from President Aquino III who said that he will prioritize increase in the tax on cigarette as recently proposed by the Department of Health (DOH). This has raised hopes for a tougher policy in a country of 94 million people that has among the lowest taxes and retail prices for tobacco products in Southeast Asia.

Other Health Promotion Foundations and organizations which lend their experience and expertise to the workshop are the Swiss Health Promotion Foundation, Vichealth and Healthway in Australia, the Malaysian, Mongolian and Tongan Health Promotion Boards, Nossal Institute for Global Health, De La Salle University (Philippines), La Trobe University and the Johns Hopkins Bloomberg School of Public Health.

“Health promotion boards or foundations are vital to helping governments meet national commitments to the WHO-FCTC,” said Dr. Susan Mercado, regional adviser of the WHO’s Tobacco-Free Initiative. “Among other benefits, they bring governments and civil societies together in partnership to bridge gaps and hurdle challenges in the implementation ofgenuine tobacco tax reforms”.

The WHO Framework Convention on Tobacco Control recognizes that raising tobacco prices through tax increases and other means ‘is an effective and important means of reducing tobacco consumption by various segments of the population, in particular young persons.’ Generally, every 10-percent increase in the price of cigarettes will reduce youth smoking by about seven percent and overall cigarette consumption by about four percent. The World Bank recommends that governments increase tobacco tax to above 65-percent of retail price.

Higher taxes deter tobacco use among the young and the poor. Tax increases also directly benefit governments through increased revenues, which can be used for tobacco control and other important health and social programs.

Jittima Jantanamalaka, Thailand and Shobha Shukla, India (CNS) 


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