Introduction
In the complex policymaking landscape, nations often confront a profound dilemma when economically crucial industries collide with public health imperatives.[1] This challenge is exemplified in Malawi’s agro-based economy, where the financial backbone, tobacco production, clashes with global health concerns. As the World Health Organization’s Framework Convention on Tobacco Control gains prominence, policymakers are tasked with navigating the intricate balance between sustaining economic vitality and addressing the pressing health risks associated with a lucrative yet contentious industry. This scenario encapsulates the broader struggle faced by nations compelled to reassess economically indispensable sectors in the pursuit of public health objectives.
Tobacco Production as a Pillar for Malawi’s Economy
Malawi’s economy is agro-based. This reflects the reality that the country’s revenue is mainly driven by the proceeds realised from agricultural produce. The main crops that form a more significant percentage of this economy are tobacco,[2] tea, and other cash crops. In the 2022-2023 tobacco season, Malawi realised over USSD 206.4 million.[3] Against a primarily donor-dependent budget, this suggests that Malawi was in a position to address its economic and social needs from this revenue in one way or another. It also suggests that the families and communities that rely on tobacco as their source of income could pay for school fees for their children, invest in other assets within their households and afford quality health services from private hospitals rather than from the poorly resources government health centres. Therefore, any threat to this industry threatens these families’ right to health, education and economy. Inversely, growth in this industry will probably translate into an improved economic and social status of the families and the country as a whole.
Snippets of the Convention
In 2005, under the auspices of the World Health Organisation, a WHO Framework Convention on Tobacco Control (WHO FCTC) entered into force. Among other things, the Convention was developed in response to the globalization of the tobacco epidemic, which is one of the biggest public health threats killing millions of people globally.[4] The Convention’s aspirations are driven by supply and demand provisions complemented by provisions that address liability, including scientific and technical cooperation and exchange of information.[5] For instance, Article 6 of the Convention recognises that the price and taxation of tobacco and tobacco products can influence a reduction in consumption. Therefore, the Convention implores Parties to implement tax policies and pricing mechanisms to reduce tobacco consumption and importation.[6] Furthermore, the Convention restricts the sales of tobacco products to minors as well as the selling of cigarettes individually or in small packets, which increases the affordability of such products to minors.[7] For the transfer of scientific and technical cooperation and communication of information, Parties to the Convention undertake to develop research and scientific assessments that address determinants and consequences of tobacco consumption and research initiatives to identify alternative crops.[8]
Implications of the Commitments in Case of Effective Implementation
The signing of this Convention by the government of Malawi on 16 November 2023 is praised as a historical step and reaffirmation of Malawi’s commitment to a collective effort in the protection of public health and work towards a tobacco-free future.[9] There is no doubt that this is also a piece of good news for people who advocate for the eradication of tobacco production because of its health hazards for consumers and its effects on the environment. For what its wealth, it would also please child rights advocates who claim that a lot of tobacco production involves labour solicited illegally from children.[10]
By signing this Convention, with high possibilities of ratification, Malawi commits itself to set policy and legal framework as one way of ensuring the aspirations of this Convention are met. This denotes that the country has to develop a policy and legal framework to reduce tobacco consumption, tobacco advertising, promotion, and sponsorship. It also implies that regulations must be set up or strengthened on smoke-free work, public spaces should be created, and prominent health warnings on tobacco packages should be enforced.[11]
However, this will not be an easy task and commitment for a country whose backbone is driven by agriculture development, tobacco production being the main.[12] It means that while the government plans to establish mega-farms for its economic development, invest almost half of its national budget in the Affordable Inputs Programme, and promote the production of industrial hemp as some of the strategies to boost the economy, more work has to be done to live up to the commitments and the aspirations prescribed in this Convention.
While there are alternatives and diversification campaigns against growing tobacco, which are also reflected as a strategy in the Convention through Article 17, attitudes and perceptions of farmers towards this are usually negative.[13] It will, therefore, be an uphill battle to live up to the aspiration of this Convention both at micro and macro levels, as, indeed, the wholesome implementation will be shooting oneself in the foot. Surely, there are public health benefits that will be borne from this Convention that might possibly surpass the economic benefits realised through continuous reliance on tobacco. While the campaign against smoking and the use of tobacco products is gaining momentum and intensity,[14] a more robust investment in alternative sources of revenue, which are sustainable and environmentally conscious, needs to be explored. At the horns of this dilemma is the decision on what is good in an economically vibrant nation that has citizens whose health status drains the same economy and threatens its future generations.
[1] Jack, W & Lewis, M., Health investments and economic growth: Macroeconomic evidence and microeconomic foundations (Washington, DC, USA: World Bank, 2009) 2.
[2] Smith, J., & Lee, K, ‘From colonisation to globalisation: a history of state capture by the tobacco industry in Malawi’ (2018) 45 (156) Review of African Political Economy, 186-202.
[3] Statista, Tobacco Products, Malawi < https://www.statista.com/outlook/cmo/tobacco-products/malawi> accessed 24 November 2023.
[4] World Health Organisation, WHO report on the global tobacco epidemic, 2023: protect people from tobacco smoke < https://escholarship.org/content/qt7x18m7f9/qt7x18m7f9.pdf> accessed 24 November 2023.
[5]WHO Framework Convention on Tobacco Control < https://iris.who.int/bitstream/handle/10665/42811/9241591013.pdf?sequence=1> accessed 24 November 2023.
[6] WHO FCTC, Art. 6 (2)a-b.
[7] WHO FCTC, Art. 16 (3).
[8] WHO FCTC, Art. 20 (1)a.
[9] ‘Malawi ‘s ratification of WHO’s Framework Convention on Tobacco Control comes into effect’. WHO 16 November 2023 < https://www.afro.who.int/countries/malawi/news/malawi-s-ratification-whos-framework-convention-tobacco-control-comes-effect?country=39&name=Malawi> accessed 24 November 2023.
[10] Eldring, Line, Sabata Nakanyane, and Malehoko Tshoaedi, ‘Child labour in the tobacco growing sector in Africa’ Elimination of Child Labour (2000) 40.
[11] WHO FCTC, Art. 11 (1)b.
[12] Lencucha, R., Moyo, T., Labonte, R., Drope, J., Appau, A., & Makoka, D. ‘Shifting from tobacco growing to alternatives in Malawi? A qualitative analysis of policy and perspectives’ (2020) 35 (7) Health Policy and Planning 810, 813.
[13] Josephine Chinele, ‘Malawi Finally Ratifies Tobacco Control Convention, But Many Farmers Are Loyal to the Crop’ Health Policy Watch 2023.
[14] WHO, World No Tobacco Day < https://www.who.int/campaigns/world-no-tobacco-day> accessed 27 November 2023.
