By Mantoe Phakathi

Tobacco-related illnesses cost the economy of the Kingdom of Eswatini up to SZL684 million per year, equivalent to 1.1% of its GDP, a new report developed by the Ministry of Health, UNDP, the Secretariat of the Framework Convention on Tobacco Control (FCTC), and WHO has found.

The report, titled Investment Control for Tobacco Control in Eswatini – The case for scaling up WHO FCTC implementation, also found that tobacco-related illnesses kill more than 600 emaSwati, which accounts for 6 percent of the country’s total deaths annually.

The report demonstrates how tobacco use impedes Eswatini’s efforts to improve health and grow the economy, hindering the country’s broader development priorities within the country’s National Development Plan.

UNDP Eswatini collaborated with the partners to provide technical support to produce the study, which also revealed that the economic benefits of strengthening tobacco control in Eswatini outweigh the costs of implementation, which are estimated at SZL2.7 billion in economic benefits over 15 years, compared to only SZL183 million invested.

The report was launched on 21 May 2021 at the Hilton Garden Inn Hotel in Mbabane by the Minister of Health, Sen. Lizzie Nkosi, who was represented by the Principal Secretary, Dr Simon Zwane. Nkosi said tobacco poses a serious threat to public health due to the burden of diseases on users and non-users due to exposure to secondhand smoke. She said it is also the single highest risk factor for all non-communicable diseases, such as cancer, stroke, heart diseases, lung diseases, and other respiratory diseases.

“The importance of healthy respiratory systems has been emphasized during the current COVID-19 pandemic,” said Sen. Nkosi, adding, “We all know that all tobacco products contain a substantial amount of nicotine which is recognized as a drug of addiction.”

Therefore, she said, the public health and economic costs on the government cannot be ignored, further acknowledging the strong partnership on tobacco control in Eswatini through support by the FCFT Secretariat, WHO, and UNDP. She also expressed the government’s gratitude to the funders of the FCTC 2030 project – the governments of the United Kingdom, Australia, and Norway.

“We’re excited as a Ministry to receive the first-ever investment case for tobacco control in the Kingdom of Eswatini. We welcome the findings and recommendations of the investment case, which are meticulously articulated in the report,” she said.

Reading a statement by the UNDP Resident Representative, Rose Ssebatindira, UNDP Economic Advisor Mr. Juan Carlos Vilanova, said the investment case findings in the report demonstrate that enacting and enforcing the proven tobacco control measures would confer benefits to all, especially to the poor.

“To ensure that the next generation is not a generation of smokers, and to alleviate the current health and economic burden caused by tobacco, we hope to help Eswatini scale up these tobacco control measures,” said Ms. Ssebatindira.

She also said the fiscal gains projected in the report could be effectively reinvested in national development priorities to improve conditions for the poor.

“It can also be used to contribute to the COVID-19 response and improving future preparedness,” she said, adding: “High smoking rates lead to fragile populations that are susceptible to severe outcomes from COVID-19. For that reason, it is indispensable that national COVID-19 response and recovery plans integrate with interventions that address tobacco control.”

Speaking at the same event, the Acting British High Commissioner, Her Excellency Samantha Smith said while Eswatini has the lowest cigarette smoking prevalence in Southern Africa, continued low smoking rates are not guaranteed with tobacco companies devoting extensive resources to market expansion in sub-Saharan Africa.

“Evidence suggests that the Eswatini Government’s tobacco control efforts are making a material impact,” Smith said.

Acknowledging the Government of the Kingdom of Eswatini’s efforts, she said the Tobacco Products Control Act of 2013 contains provisions regulating smoking in public places; tobacco advertising, promotion, and sponsorship; as well as packaging and labeling of tobacco products.

"It is indeed pleasing that Eswatini has made strong progress in tobacco control since it became a Party to the WHO FCTC. Not long ago, the Government ratified the Protocol to Eliminate Illicit Trade of Tobacco Products in 2016, enacted the Alcohol and Tobacco Levy Act in 2019, and reaffirmed high-level commitment through the FCTC 2030 project in 2020,” she said. She said there is still room for improvement though and appealed for partnerships because the government cannot do it alone.  

Smith said the UK Government, as a global leader in tobacco control, has invested £15 million of Official Development Assistance funding in the FCTC 2030 project to support the implementation of tobacco control measures in low and middle-income countries in order to reduce the burden of tobacco-related death and disease, as well as to support the development of ODA recipient countries.

“We remain a world leader in international development, not only through the impact of our financial allocations but also through the Foreign, Commonwealth and Development Office (the FCDO), integrating diplomacy and development to deliver greater impact. This year, the FCDO will spend more than £1.3 billion on global health,” she said.

Other speakers at the event include Dr Adriana Blanco Marquizo, Head of the Secretariat of the WHO FCTC, and Dr Cornelia Atsyor, WHO Representative in Eswatini.

(Mantoe Phakathi is the Communication Specialist at UNDP Eswatini)