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