The recent announcement by the World Health Organisation (WHO) that Minister of Health & Wellness Dr. Edwin Dikoloti had been elected as First Vice Chair for the WHO Regional Committee for Africa has lent credence to global media reports that billionaire businessman Michael Bloomberg’s tentacles of influence reach even as far as government enclave and the WHO.
The announcement came after Dikoloti successfully tabled the Tobacco Control Bill 2021, which advocates for non-engagement between government and the tobacco industry, as well as zero tolerance of any use of tobacco, in line with Bloomberg Philanthropies modus operandi.
Bloomberg Philanthropies has consistently been accused of channelling vast financing to the Campaign for Tobacco-Free Kids’ (CTFK) and the WHO to set up a network of influence in civil society, media and government in low- and middle-income nations (LMICs), through which it pursues a zero-tolerance approach to tobacco control.
“Where things get murkier is how the WHO and CFTK utilize that funding to influence key players,” wrote Competitive Enterprise Institute, a leading advocate for freedom on critical economic and regulatory policy issues.
In August 24, the WHO announced Dikoloti’s appointment to the top echelons of its operations in Africa, with the responsibilities of formulating policies as well as nominating and supervising the Africa Region Director. In pushing for the Tobacco Control Bill 2021, Dikoloti was hand-held by the Anti-Tobacco Network (ATN), led by Professor Bontle Mbongwe. Interestingly, she was also recently given an award by WHO in recognition of her advocacy for tobacco control.
During the campaign for the tobacco control bill, ATN and Dikoloti went on a media charm offensive, taking up hours of radio airplay and newspaper coverage to push for a unilateral promulgation, much to the chagrin of opposition and some ruling party Members of Parliament (MPs) who were agitating for a few amendments.
The WHO and Bloomberg Philanthropies’ tag team dates back to the Khama Presidency, when current Director in the office of the WHO Director-General Shenaaz El – Halaabi ruled the roost as Permanent Secretary in the Ministry of Health.
A staunch tobacco control protagonist, El- Halaabi naturally developed a close relationship with the ATN. As far back as 2013, the ATN held a meeting with El-Halaabi at which they hatched a plan to “fast-track the development of a comprehensive tobacco legislation and stop the interference of the tobacco industry on tobacco control.”
In November 2016, when speaking at a public debate under the theme “Smoke-Free Public Places – A Human Right,” El-Halaabi warned that the coming tobacco control law would be aggressive to offenders.
A few months later, El-Halaabi found herself facing the wrath of a livid opposition after she released a communique from the Ministry of Health, dated March 29th 2017, titled “Removal from medical cover for self-inflicted harm.”
According to the savingram, patients with among others lung cancer suspected to be caused by smoking were to be denied medical treatment. Other conditions and injuries that were cited related to drug or alcohol abuse, riding a motorbike without a helmet, failure to use a seat belt and participation in violent riots. Then Botswana Congress Party (BCP) Deputy President Kesitegile Gobotswang slammed the savingram as discriminatory, unconstitutional and “a ferocious attack on everything that health and medical practice stands for.”
He warned that there are no quick fixes in public health as results could only be attained through sustained education.
“The reality is that a sizeable proportion of the population will continue to smoke even if they are aware of the dangers. Determining the link between cause and effect is a serious matter in health and bio-medicine. What government is introducing is not in conformity with international best practice. Neither was it informed by scientific evidence. It was decided off the cuff… another revelation that previous knee-jerk policies aimed at curbing abuse of alcohol did not produce results,” said Gobotswang at the time.
ZERO TOLERANCE: A FUTILE EXERCISE
Meanwhile, government and the ATN have been castigated for refusing to engage with the tobacco industry; with many saying this was divisive and against the spirit of therisanyo and transparency. While there is general consensus that there is need to regulate the tobacco industry, many believe the bill in its current form would be ineffective and un-implementable. Legislators have also questioned a clause in the bill that precludes tobacco industry players from sitting in the tobacco control committee.
Part X of the bill, which speaks to the protection of tobacco control policies from commercial interests, also prohibits engagement between government and the industry. Those opposed to this clause have opined that good regulatory practice mandates transparency and the participation of all relevant stakeholders. They have also called for the dissolution of any legislation that attempts to exclude industry from legitimate interaction with government.
Globally, detractors of Bloomberg Philanthropies’ zero tolerance approach have warned that it may backfire as citizens of developing economies have different cultural and economic factors that determine how they react to regulatory changes.
“The reality is that policies that might reduce smoking in one country may not only fail to reduce smoking in another, but also cause people to engage in even more harmful behaviours,” they said.
Part VII (45) of the bill restricts the sale or distribution of any tobacco products to sealed unit packets of no less than 20 sticks. Legislators and the hawkers have warned that such a requirement would kill informal traders who mainly sell single cigarettes sticks and further fuel the illicit cigarette trade. As an example, opposition legislators cited the alcohol levy and Batswana’s response to the recent ban on alcohol; which led to the influx of illicit brews, job losses and massive tax losses to government.
