Article 5 of the WHO FCTC

2nd Meeting of the United Nations Interagency Task Force on the Prevention and Control of

Noncommunicable Diseases Geneva, 30 January 2014

Dudley Tarlton UNDP Geneva

UNDP Responsibilities in the Interagency Task Force

Following ECOSOC resolution E/2013/L.23, UNDP convenes the work of the UN to “to strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for the prevention and control of NCDs”

Article 5 – General Obligations

5.1 National strategies/action plans/programmes to implement WHO FCTC

5.2 (a) Multisectoral National Coordination Mechanisms

5.2 (b) Tobacco Control Legislation

5.3 Protecting Health Policies from Industry Interference

Article 5 – 2012 Country Reporting

UNDP and the FCTC – substantive contributions

Current work

• FCTC Needs Assessments and follow-up

• FCTC regional implementation meetings

• Analysis of FCTC integration in development planning and assistance frameworks

• Review of Article 5.2 (A) in Africa• Article 5 analysis

UNDP and the FCTC – substantive contributions

Other potential contributions

• UN system coordination, UNDAF integration

• Post-2015 development agenda

• Integration into national development planning

• Support to national, local governance structures

• Anti-corruption and regulatory independence

• Strengthening law enforcement, justice

• CSO engagement

Country Needs Assessments

Discussion Paper: Development Planning and Tobacco Control

Implications for broader response

UNDAF Roll-Outs, 2014-15

2014 = 40 countries 2015 = 34 countries

Paper objectives and methods

• Articulate for FCTC integration into national development plans and UN Development Assistance Frameworks (UNDAFs)

• Assess current integration; identify challenges, good practices and recommendations

• Identify key themes on Article 5 implementation from FCTC needs assessments

120 countries reporting

48 sampled

Desk review (28 NDPs, 46 UNDAFs)

10 case studies

Article 5.1 Globally

Of the 120 of the 174 FCTC parties for whom data was available from the 2012 reporting cycle: • 74/120 (62%) indicated a comprehensive

multisectoral national tobacco control strategy• 43 (36%) Parties reported tobacco control being

incorporated in national health plans and • 21 (18%) Parties reported including tobacco control

in other national plans.

National development plans NCDs > tobacco > FCTC

NCDs Tobacco FCTC0

5

10

15

20

25

30

22

9

1

6

19

27 Not mentionedMentioned

n = 28

UNDAFs show similar trend

n = 45

NCDs Tobacco or FCTC

Tobacco FCTC0

5

10

15

20

25

30

35

40

45

50

2115

114

2430

3441 Not mentioned

Mentioned

Emerging Lessons: Inclusion in NDPs

• Health and development priority • Policy advocacy should present:

– Relationship to poverty reduction– Impact on other development priorities– Inter-relationships with existing health MDGs (and

emerging post 2015 development agenda).

Emerging Lessons: Inclusion in UNDAF

UNDAFs should support:• achieving NDP priorities • delivery of international treaty obligations • coordination of UN agencies actions.

Recommendations

• Support country-specific stakeholder analysis to identify the governance structures to mobilize multisectoral engagement and resources

• Resource and deliver a capacity-building strategy to support the integration of WHO FCTC implementation into development planning mechanisms

• Generate disaggregated data and analysis that provide evidence of tobacco use trends as well as the impact of tobacco use on socio-economic development.

Recommendations

• Continue advocacy efforts to make the case for tobacco control as an issue that should be integrated as a priority into development planning

• Adopt a more proactive approach to integrating the WHO FCTC into UNDAFs.

Joint Country Needs Assessments

Discussion Paper: Development Planning and Tobacco Control

Implications for broader response

Joint Country Needs Assessments

• Request from MoH/Government to Convention Secretariat

• Convention Secretariat organizes• UNDP is present at each, as is WB• UNCT members participate at country level• Output: report identifying gaps and to address

them, recommendations listed by FCTC Article.

Joint Country Needs AssessmentsArticle 5 Summary

• Analysis of 24 joint needs assessment reports on FCTC implementation

• All 24 assessments identified existing gaps related to Article 5

Article 5.1 National Tobacco Control Strategy

Meeting obligations; 6

Partly meeting obligations; 5

Not meeting obliga-tions; 13

Article 5.1 National Tobacco Control Strategy

• Emerging issues - non-health sector involvement- Convention often absent from UNDAFs & NDPs.

• Recommendations- develop a multisectoral tobacco strategy - involve other sectors into the strategy- make FCTC and tobacco control a priority in

NDP/NHP/UNDAFs- sub-national levels.

Article 5.2 (a) National Coordinating Mechanism

Meeting obligations; 5

Partly meeting obligations; 10

Not meeting obliga-tions; 9

Article 5.2 (a) National Coordinating Mechanism

• Emerging issues- Insufficient involvement of non-health sector - Often unfunded by MoH

• Recommendations- establish a national coordinating mechanism; replicating

same at sub-national level - create a separate budget line for the national focal point

team to ensure that secure and sustainable resources - mandate national focal point team to coordinate FCTC

work within the government

Article 5.2 (b) Legislation Meeting obligations; 1

Partly meeting obligations; 22

Not meeting obligations; 1

Article 5.2 (b) Legislation

• Recommendations - review and amend the legislation to comply with

the Convention - enforce law and regulations - allocate sufficient human and financial resources

to enforcement- train and sensitize health inspectors and other law

officers

Awareness of Article 5.3 on Industry Interference

Aware of the article; 1

Lack of awareness of article; 17

Article 5.3 Industry Interference

• Recommendations- develop policy and disseminate information in line

with Article 5.3 to all branches of the government - link this Article to the general requirements under

the Code of Conduct for all public officials - limit and eliminate the interaction with tobacco

industry.

Country Needs Assessments

Discussion Paper

Implications for broader response

Key messages

• Article 5 matters most fundamentally; implementation needs to be accelerated

• Framing tobacco as development issue, mainstreaming, evidence and political positioning

• UN has proactive and reactive (demand-driven) ways of providing support

• UNDP is eager to help, but this is new terrain – we have institutional capacity development needs

Four Possible Models for National Coordination

• FCTC-specific coordination mechanism

• Expand existing multisectoral body

• Create an NCD-specific body that has a focus on FCTC implementation

• Refrain from advocating for one model and let every country find its own way.

Discussion Questions

• Country Level Role for IATF members?• Role for UNCT? WHO Reps? UN Res Coordinators?• Challenges for integration of FCTC into development in

the post-2015 agenda? • Do we build NCD responses on FCTC model?

Incorporate NCDs into it?• Article 5 type guidance for NCDs?• Normative guidance for NCD/FCTC integration into

UNDAFs?

Article 5 of the WHO FCTC and the work of the UN-IATF on NCDs

2nd Meeting of the United Nations Interagency Task Force on the Prevention and Control of

Noncommunicable Diseases Geneva, 30 January 2014

Dudley Tarlton UNDP Geneva

Vijay Trivedi,FCTC Convention Secretariat