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FACTC

FACTc: Financing, Resource Allocations (for full implementation of WHO-FCTC) and Cost of Tobacco Control.

 

The FACTc project aims to help policymakers establish sustainable mechanisms to fund and accelerate the comprehensive implementation of the WHO Framework Convention of Tobacco Control (FCTC).

The FACTc team

Anna Konstsevaya MD, ED, PhD

Email: koncanna@yandex.ru

 

Anna heads a research laboratory of economic analysis of epidemiology surveys and preventive technologies in the national research center for preventive medicine (Moscow, Russian Federation). Anna is also involved in the activities of the Russian Society of Cardiology (director of educational programs), which is a member of WHF. Her experience includes research in the field of cardiovascular prevention and health economics and practical work on the preventive program development and implementation in Sberbank of Russia. Economic results of her research were presented to the Ministry of health and were used as an argument for investment in CVD prevention, including antismoking measures.

Amit Yadav MPhil, LLM

Email: amit@hriday-shan.org

 

Amit Yadav joined HRIDAY in 2007 as a Legal Officer and since then have effectively contributed to the development and implementation of strengthened tobacco control through legal, policy, research and advocacy initiatives in India. He has completed the Global Tobacco Control Leadership Programme at the JHSPH in 2011 and is perusing his PhD on ‘Public Health, Tobacco and International Trade Treaties: A Constitutional Analysis’ from the National Law School of India University, Bangalore. He is engaged in liaising, assisting, advising, building capacity and advocating for advancing tobacco control and NCD prevention and control in particular and public health law in general. His areas of expertise include Public Health Law, Policy and Advocacy, Legal and Policy Research and Analysis. He has also been closely associated with and contributing to the global developments for accelerated implementation of the WHO-FCTC as an active member of the Framework Convention Alliance. He participated at two different sessions of the Conference of Parties of the WHO-FCTC (in 2007 and 2012) and attended the Working Group meeting on Article 6 of the WHO-FCTC in 2011. He has been elected to the Board of Directors of FCA to represent SEARO (2016-19). He was co-chair of the organizing committee of the Endgame Conference 2013 held in New Delhi and with the COP7 to be held in India on November 2016, he is keen to promote the global learnings and lessons to advance tobacco control in India and SEARO keeping with the CVD Roadmap on Tobacco Control. He is presently the Director, Public Health Law and Advocacy at HRIDAY.

Fabian Lewis PhD, MSc

Email: fabianlewis@hotmail.com

 

Fabian B. Lewis is Director of the Research and Analysis Unit at the Ministry of Finance and Planning, Jamaica. He holds a PhD in Economics from the University of Manchester. His research focuses primarily on applied public finance, empirical international trade, energy supply analysis, the development of labour market information systems and productivity measurement. He has written several pieces of research while working for the Jamaican Government (including the Planning Institute of Jamaica and the Ministry of Labour). Recently, his work has appeared in refereed economics journals including the International Trade Journal and the Electricity Journal. Dr. Lewis is also a graduate of the University of the West Indies (Mona Campus) and an active member of the Mamby Park Baptist Church, Jamaica.

Irene Reyes JD

Email: ipnreyes@gmail.com

 

Irene Reyes is a public health lawyer and has worked closely with government officials and legislators on the passage of key tobacco control laws. She provides technical assistance in the drafting of the bills, contributes with the research to support the legislation, and implements communications and media advocacy in order to gain public support for the policies. She has served as a legal consultant of the Philippines in international meetings, most recently at the 6th Meeting of the Conference of Parties for the Framework Convention on Tobacco Control (FCTC COP6).

Michal Stoklosa MS

Email: michal.stoklosa@cancer.org

 

Michal Stoklosa is a Senior Economist, Taxation & Health within the Economic and Health Policy Research Program at the American Cancer Society. Michal’s research focuses primarily on topics related to the economics of tobacco control such as tax policies, illicit cigarette trade, and the tobacco industry’s strategies to undermine tobacco control efforts. As economic arguments have become increasingly important to the formulation of health policies, Michal’s research projects aim to provide governments and health advocates with credible economic evidence to support health policy change. His time with the American Cancer Society has led to opportunities of sharing his research findings with policymakers, such as testifying before the Budgetary Control Committee of the European Parliament. His most recent research interests include the taxation of electronic cigarettes.

Adrian Pana MD, MPH

Email: doctorinth@yahoo.com

 

Adrian Pana, is a senior consultant physician with a background in public health, health policy, and management. Currently he is working as a health consultant, involved in several projects focused on health system governance, accountability and transformation, value-based health care services and their outcomes, burden of diseases studies and their impact on health system, reshaping & designing new models of delivery of healthcare services, multi-sectorial approaches on social determinants of health and health inequities, and evidence-based policies for assessment of new health technologies.

His professional background consists of over 15 years of working experience for the Romanian Government at the central level also for more than 5 years of work as a consultant in international projects on the health sector. He gained this, by working as a Secretary of State as well as a management executive in several departments for the National Health Insurance House and later on for the National Institute for Health Research and Development, the Ministry of Health, and for the Health Commission at the Romanian Parliament. During this period he had also the opportunity to be part of several projects in collaboration with international organizations (WHO, The World Bank, and the European Commission).

Ce Shang PhD

Email: cshang@uic.edu

 

Dr. Shang is a Senior Research Specialist in the Health Policy Center, Institute for Health Research and Policy at the University of Illinois at Chicago. She investigates the impact of various tobacco control policies including tobacco taxation, tax structure, smoke-free air laws and other tobacco control efforts on smoking behavior and consequences in the United States and in many low- and middle-income countries. She is the Principal Investigator of two pilot studies aiming to evaluate the effects of electronic nicotine delivery systems (ENDS) attributes on use behavior. She also serves as a key Co-Investigator of one ongoing Center for Tobacco Regulatory Science project. Her other research interests include evaluating policies related to alcohol consumption and physical inactivity. Dr. Shang earned her doctorate in economics from the City University of New York in 2011 and her BA from Fudan University in 2005.

Specific Aims

To help policymakers establish sustainable mechanisms to fund and accelerate the comprehensive implementation of the FCTC. Objectives: building a straightforward and user-friendly tool to help policymakers and advocates, including MOH officials, in at least 8 countries (and ideally most countries) to accelerate FCTC implementation in the next two years by:

  1. Identifying country-specific costs of implementing comprehensive tobacco control policies (costs of action) and the health costs of continued tobacco use (costs of inaction).
  2. Highlighting the need for accelerating the implementation of the evidence-based tobacco control measures (tax increases, smoke-free policies, package warnings, and advertising bans, etc.)
  3. Helping policymakers design strategies for the search and allocation of resources for tobacco control in their countries.

Background

Recognizing that tobacco control is a fundamental investment in human capital, an investment that not only directly leads to enormous public health gains, but also to long-term economic growth, Parties to the Framework Convention of Tobacco Control (FCTC) acknowledged the need for collective action to overcome obstacles that delay FCTC implementation. One of these obstacles is the lack of sustainable resources for FCTC implementation. According to the World Health Organization (WHO), the implementation of the four best buy tobacco control measures (tobacco tax increases, smoke-free policies, package warnings, and advertising bans) in all Low- and Middle-Income countries (LMICs) would cost a mere 11 US cents per year. The estimates include the human resources and physical capital needed to plan, develop, implement, monitor, and enforce the policies (WHO 2011). Currently, international funding (including private donors, aid agencies, and multilateral organizations such as WHO) is only about one US cent per person per year on tobacco control in LMICs. One other cent comes from governments of LMICs that provide funding for tobacco control programs in their countries. The total investment in tobacco control in LMICs at only 2 cents per person per year is, therefore, insufficient compared to current needs (Stoklosa and Ross 2014).

To address these issues, the Parties to the FCTC created a Working Group that convened for the first time at the Sixth Meeting of the Conference of the Parties (COP6) in October 2014. The title of the Working Group is Sustainable Measures to Strengthen Implementation of the FCTC. While the Group found the lack of resources, such as staff and funding, as the major obstacle to implement FCTC measures, the Group also stressed that the country-level information on the cost of the FCTC implementation and the cost of inaction (the current costs of the tobacco epidemic) is lacking. For example, in the FCTC needs assessment conducted on the Parties’ request, there are currently no questions on financial and other resource needs. Therefore, one of the key recommendations of this Group was to provide countries with estimates on the funds needed and the costs of the tobacco epidemic. This information regarding the resource gap between desired and existing funding, and the return on investment to countries that tackle the tobacco epidemic would tremendously support country-level efforts and strengthen capacities to implement the FCTC.

We find that this needs of the Working Group on Sustainable Measures, and eventually the Governments, can to the large extent, be fulfilled. Country-level information on both the funds needed and the cost of inaction for many countries exist. However, it is scattered in multiple literature and platforms and has never been combined in one comprehensive and compelling resource. Such resource could also help countries to identify potential sources of the funding needed to implement the key evidence-based provisions of FCTC, including tax revenues. This resource could also help to inform the work of the Sustainable Measures Group, and thus the Governments, by providing the countries with score cards and identifying countries that need the assistance the most.

Methodology

  1. Identify and consult with partners, explore available resources, assess needs, and review of the potential use of the tool.
  2. Review of available literature pertaining to the existing tax and economic tools determining various indicators like health cost, affordability, cost of implementation of FCTC, tobacco tax incidence, etc.
  3. Develop a comprehensive, comparable, cross-country tool to demonstrate key resources, actions, and costs required by each country to ensure sustainable funding for implementing comprehensive tobacco control. It is intended that the tool will be user-friendly and available to be utilized by the partners and key stakeholders.
  4. Develop the communication plan which will aim to share the results from the project with the target audience, e.g. media, global leaders in tobacco control, global tobacco control NGOs, World Health Organization, and representatives from the Ministries of Health and Finance in respective countries.
  5. Develop dummy factsheet/scorecards after iterations with the members of the Sustainable Measures Working Group and present to the Group Members and discuss the plan during COP7 with other member countries.
  6. Pilot the tool in eight selected countries and use the results to produce simple factsheet/scorecards for policymakers, and present them at the 2016 Asia Pacific Conference on Tobacco or Health (APACT) and at the 2017 Latin American and Caribbean Conference on tobacco or health.
  7. Pilot the use of the factsheet/scorecards for the selected countries: depending on the budget, the use of factsheet/scorecards can be piloted in the selected countries by leading tobacco control advocacy organizations or coalitions in that country, in partnership with the FACTc Project Team.
  8. Based on the experiences of pilot and explorations with potential partners, refine the tool and the factsheet/scorecards and develop strategies for wider dissemination of the tool among advocates and policymakers. Possibilities to explore include regional gatherings or mechanisms or references that engage finance ministries around taxation policies (World Bank meetings, taxation seminars, etc.). We will request all users to cite our tool or factsheets to monitor and document the use of our tool/factsheets.

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