The Case Study focuses on the history of tobacco use and control, the affects of apartheid and national level tobacco control initiatives in South Africa. Interestingly, Dr. Zuma, Minister of Health took a multifaceted approach to tobacco control seemingly before this type of approach was recognized at a global level. Based on findings emerging in the 1950’s, tobacco took its place on the global health agenda as a disease risk factor as early as 1967 at the First World Conference on Tobacco which spurred the need for international collaboration on the subject.³ The World Health Organization (WHO) Tobacco Free Initiative emerged in 1998 purporting to aid member states in developing laws and to advocate for policies aimed at lowering tobacco use (enacting laws requiring warning labels be put on ciggarrette cases, banning smoking in public places) and also to help governments battle the harmful practices of tobacco industries (enacting laws to stop industries from false advertising, etc.). ¹
South Africa’s national level initiatives according to the case study started on a small scale as early as 1970 with the ban of tobacco in cinemas, a strategy now used globally.³ The case also describes how South Africa battled with the Tobacco Industries who had ties to the national government, making thier early initiatives towards tobacco control even more difficult. In 1994, over 20 years after the first anti tobacco initiatives, governmental alliances with the South African Tobacco industries were broken with the end of apartheid, resulting in a restructuring of their health care system that focused on prevention strategies including tobacco control.³ South Africa took approaches in the mid 90’s toward tobacco control (requiring warnings on cigarette cases, raising taxes etc.) that would become the same strategies the globe is refocusing on today with the shift toward Non Communicable Diseases (NCD’s).
The September 2011 UN General Assembly meeting was a marker in the global shift of focus from communicable disease to NCDs. At this meeting four main NCD’s that represent the major global burden of diseases and death were established to include diabetes, cardiovascular disease, cancer and respiratory disease.² To combat these four major NCDs four major modifiable risk factors (MMRs) were identified as the focus for developing prevention strategies including tobacco, a well known culprit of all four major NCDs and responsible for one in every six NCD deaths.¹ As part of the new initiative on battling NCDs, Tobacco seems to be receiving ample attention in part because strategies focused on this modifiable risk factor have proven to be affordable, measurable and effective.²
¹Lien G, DeLand K, Translating the WHO Framework Convention on Tobacco Control (FCTC): Can we use tobacco control as a model for other non-communicable disease control?, Public Health (2011), doi:10.1016/j.puhe.2011.09.022
³Bitton, Talbot, Clarke and Kadarfor (2011). Tobacco Control in South Africa. Harvard Business Publishing. http://harvardbusiness.org/