After reading the case on tobacco control in South Africa, I realize how difficult it is to fight for implementation of anti-tobacco policies, especially when the industry is the powerful and well poetically connected, and the government permits targeting vulnerable people. It takes personal courage and political will to do so. Dr. Zuma, being an active member of a political party, didn’t switch sides, as many politicians do, to get political capital or gain support from powerful industries. She never betrayed the cause to improve the population’s health by fighting for tobacco control. As anti-tobacco advocate, Priscilla Reddy said, “Apartheid was one poison; tobacco was another poison, but all the growers were the same.” After the collapse of apartheid, many South Africans started to return to the country, and because they had been involved with the NAC, received positions in the new government. Reddy and Dr. Zuma, working on health promotion and prevention, started the anti-tobacco campaign. With the support of President Mandela, Dr. Zama and other activists took control of tobacco regulation and in 1994; the Tobacco Control Advisory Committee was created. The media took tobacco’s side and pointed out revenue losses. The economist of the Tobacco Project showed that tax increases for the purchase of tobacco would result in 400,000 fewer smokers and USD 174 million in revenue.
In 1995, the newly appointed Minister of Health for South Africa, Dr. Zuma, started restructuring the national health system by focusing on primary health care. The new constitution states that the government must use available resources to develop access to health care services and create an environment for individuals that favor one’s health and well-being. During apartheid, everything in the society and healthcare was provided unequally among racial groups. For example, in the time of shortage in hospital beds were among the black populous but a surplus fir the white populous (1).
One of the main issues on Dr. Zuma agenda was tobacco control. During the time, South Africa had the highest smoking rate among developing countries, with 25,000 people died yearly due to tobacco use. Secondly, the Rothman, a giant company, represented the industry, the biggest in South Africa and fourth largest in the world. There were millions of dollars being spent to promote tobacco. Furthermore, its predecessor company was established in 1948, the year the National Party came to power and started apartheid. At the time, President Botha personally couldn’t stand smoking and banned it at meetings, but never pushed the issue beyond that (2). Consequently, the former government had tight and longstanding connections with the tobacco industry that led to little or no anti-tobacco policies. The tobacco industry used all the tools available to stay that way after the NAC came to power. The Tobacco Institute was founded to represent companies and individuals involved in the industry. Since the early 1970, there were some attempts to control the tobacco industry such as banning the advertisement of cigarettes on TV, placing warning labels on packs of cigarettes and prohibiting sales to minors. Nevertheless, promotion of smoking was in full speed on the radio, magazines and newspapers, that all profited from the industry. Lack of tobacco control in South Africa was called “a crime of apartheid” (2). To realize how suspect the approach on tobacco control was among politicians, President EW de Klerk once sad he couldn’t participate in the World No Tobacco Day because he couldn’t go a day without smoking (1). On the other hand, President Mandela called for “world free of tobacco”, and was later awarded medals for his anti-tobacco movement.
1. Tobacco control in South Africa. Bitton, A. Rosenberg, J. Clarke, L.
2. De Beyer, J. Brigden, L. Tobacco Control Policy. Strategies, Successes, and Setbacks (2003).