Controlling Non Communicable disease
Tobacco Control@ SPC
Presentation to Pacific Tobacco Control
Smokefree Oceania Conference
5th September 2007
Controlling Non Communicable disease
Challenges and Limitations• Variable levels of political will and commitment to long
term planning and funding• Tobacco Control often funded at a low level, without
specified in country budget• Limited workforce capacity in PICTs - few people, ‘multi-
tasking’• Many countries, distributed across a large geographical
region• Some countries population (especially young) numbers
falling through migration, out of country education• Transport/ travel/ communications, can be prohibitive
and creating barriers to networking
Controlling Non Communicable disease
Controlling Non Communicable disease
Further Challenges and Limitations
• Concerns over inadequacy of evidence base for effective interventions in the Pacific
• Data for measuring standard tobacco control indicators e.g. smoking prevalence, other performance indicators for monitoring and evaluation - variable.
• Role clarification of different regional/ bilateral and other agencies required – need for alignment and harmonization
Controlling Non Communicable disease
% of people who smoke daily (Selected - 7 Pacific countries)
Nauru 48.2%
Tokelau 46.4%
Fiji 43%
Samoa 34.6%
Cook Islands 33.3%
American Samoa 29.9%
Marshall Islands 20.8%
Source (Available WHO STEPS Surveys as at 2007)
Controlling Non Communicable disease
SPC’s Response
Controlling Non Communicable disease
SPC has developed a Integrated and comprehensive (NCD) Plan for the Pacific
Tobacco & Alcohol
Nutrition/ Overweight/
ObesityPhysical Activity
Controlling Non Communicable disease
SPC’s Strategy• Has been developed with country
consultation• Is focused on, and supported by, our
member countries in the Pacific• Is to be undertaken in collaboration with
regional stakeholders (WHO), PICTS, key donor agencies and other regional partners
• Adopts a multi-sectoral approach, based on internationally agreed frameworks and strategies
• Is evidence based and cost effective
Controlling Non Communicable disease
Key objectives for SPC strategy
• Strengthen the development, implementation and evaluation of national tobacco action/ public health /NCD plans
• Assist PICTs with the adoption and implementation of international and regional agreements and x country issues
• Develop capacity and skills in tobacco control through targeted workforce training
• Expand the use of fiscal measures and develop sustainable funding mechanisms
• Strengthen tobacco control surveillance systems, research and application of data in conjunction with PICTs and regional partners
• Strengthen tobacco control networks in the Pacific Region
Controlling Non Communicable disease
Objective 1: Strengthen the development, implementation and evaluation of national tobacco
action/ public health /NCD plans
Examples• Work with PICTs to develop and implement long
term, comprehensive, evidence based, tobacco control strategies (usually as part of a comprehensive NCD Plan)
• Assist PICTs to develop shorter term action plans, where required
• Assist with implementation of specific key tobacco control initiatives/projects
Controlling Non Communicable disease
Objective 2: Assist PICTs with the adoption and implementation of international and regional
agreements and x country issues
Examples• Work with PICTs to assist them meet FCTC obligations• Develop policy/ position papers on issues affecting the
region – tax, trade• Identify technical assistance requirements e.g. planning,
program implementation, resource development, external technical expertise – legislation, health economics
• SPC has worked extensively for continued exclusion of tobacco (and alcohol) from PICTA. Further 2 years exclusion of tobacco until 2009 recently announced
Controlling Non Communicable disease
Objective 3: Develop capacity and skills in tobacco control through targeted workforce training
Examples• Planned ‘in country’ provision of NCD coordinator
position (role would include tobacco control)• Skill based training – Social Marketing/ Behavioural
change training, workshops• Short term placements/attachments assistance to
provide external expertise e.g. cessation • Regional and sub regional to regional centres, academic
institutions or to SPC• Assistance with regional media advocacy
Controlling Non Communicable disease
Objective 4: Expand the use of fiscal measures and develop sustainable funding mechanisms
Examples• Develop comprehensive position paper on
sustainable funding mechanisms for NCD prevention and tobacco control
• Promote the development of fiscal policies/legislation to fund tobacco control and NCD prevention to ensure sustainable funding mechanisms and Health Promotion Foundations
• Provide a means through which Pacific countries can obtain funding from International, Regional & Bi-lateral agencies and global donor initiatives
Controlling Non Communicable disease
Objective 5: Strengthen tobacco control surveillance systems, research and application of data in conjunction with PICTs and regional partners
Examples• Encourage the uptake of regular surveillance through
STEPS, GYTS, Adult Smoking Survey (WHO)• Encourage collection of other data providing key
indicators for tobacco control e.g. compliance with FCTC provisions; enforcement of, smokefree legislation, advertising, sales to minors
• Undertake specific research projects – economic burden of tobacco related disease, specific project evaluations
• Encourage utilisation of survey and research findings for media advocacy tool, to raise public and key stakeholder awareness
Controlling Non Communicable disease
Objective 6: Strengthen tobacco control networks in the Pacific Region
Example
• In consultation with PICTS develop a funding proposal for a Pacific Tobacco Control Network, and as part of the Network, auspice an biennial/annual face to face meeting for tobacco control
Controlling Non Communicable disease
Summary of the role of SPC
At Regional level SPC can strengthen;• Regional cooperation and funding streams
e.g. develop partnerships and increase harmonization between technical agencies, donor/development partners & PICTs
• Regional approaches, x country issues e.g. cross border issues, smuggling, advertising and promotion, Trade issues – PICTA,
• Capacity to meet international/ regional requirements e.g FCTC, Tobacco network (or NCD network and annual Pacific meeting)
Controlling Non Communicable disease
Summary of the role of SPC
Within countries SPC can strengthen;• Development of comprehensive, relevant,
appropriate national tobacco /NCD Strategies and Action Plans – thereby building commitment ‘in country’ for sustainable funding mechanisms
• Existing work in the Pacific, through provision of evidence based approaches/ best practice and appropriate policy/ positions for the Pacific
• Surveillance, M&E, Research • Workforce capacity and development – provision of
capacity within country for NCD prevention – including tobacco control
• Provide a coordination role to establish a Pacific regional tobacco control (NCD) network