Fighting tobacco without tears

Sustainability issues are becoming important in the agricultural sector and are also being raised from an international angle. It would no...

Sustainability issues are becoming important in the agricultural sector and are also being raised from an international angle. It would not do to ignore them altogether and say that our programmes are only national. The only sensible approach is to project India8217;s own susceptibility concerns and negotiate within that framework.

Last week there were two major developments in tobacco field. A global conference was held on tobacco or health8217; and the surgeon-general of the USA issued a far-reaching report on reducing tobacco use. The conference pushed the Framework Convention on Tobacco Control FCTC. The World Bank hadlast year published a report on curbing the epidemic which had underlined theeconomics of reducing the demand for cigarettes through taxation policies. The WHO strongly supported the argument and its director-general, the influential Gno Harlem Brundtland, was at her persuasive best in pushing it. The 400-page report on reducing tobacco use released by David Satcher is easily the most comprehensive study of its kind and is in the tradition of Luther Terry who started this whole game with the famous surgeon-general8217;s report in 1964. Terry left the government after releasing what was in those days a very controversial report and joined the University of Pennsylvania as the vice-president of its famous medical school. For him, this was a moralmission and I still remember him rebuking me for chainsmoking, sitting next to him, in a fund-raising dinner for the university where I was to speak for an international house and he for the medical school. A brash, 25-year-old, I went at him, but he was right and I wrong and it took many years for me to kick the addiction. Tobacco is the only major crop where there is an adjustment problem, both on the demand and supply side, like opium, but the scale is much larger.

Satcher8217;s work lives up to its claim, in the sense that it is truly a comprehensive framework that the surgeon-general has developed. Unlike other studies which highlight only the medical or pharmacological side of the problem recent drugs to fight nicotine craving or more recently the demand economics high taxes to reduce consumption, the surgeon-general8217;s report has a full state-of-the-art discussion of educational as well as media strategies and pharmacologic approaches combined with behavioural interventions, regulatory methods, social and community strategies and economic instruments. It is a model for us to adopt. Like us, the Americans grow tobacco and have a serious problem of adjustment.

Apart from the US, the dual problem of demand and supply control is a problem for India and other developing countries like China, Brazil and some countries in Africa. This aspect is missed out or lightly skimmed over in the developed country agenda setting on the issue. In a policy debate at the global conference chaired by US Health Secretary Donna Shalala, with whom I had signed a biotechnology agreement three years ago, I had to emphasise the poor country8217;s viewpoint, when the others present were Dr Brundtland, Mamphela Ramphele, the South African managing director of the World Bank and Paul Isenman of the OECD. Tobacco consumption in the rich world which stood at two kg per capita in the eighties had gone down to 1.5 kg and will decline further to one kg by 2010. Ninety per cent of the world8217;s tobacco consumption would be in the poor countries then. The strategies suggested by Satcher would make it go down further. But, in the poor countries, consumption at 1.1 kg per person would go up to 1.4 kg by2010, with the devastation it causes and the expense on health facilities. At present less than half the deaths due to it are in the poor countries, but these would go up to 70 per cent.

The agricultural adjustment problem is not emphasised in the rich countries at all: apart from the US, they import tobacco and so the affected labour is low. But this is a major problem in the Third World. The notion that less than three per cent of the labour force is affected needs scrutiny. In the regions in which tobacco is grown, percentages could be much higher. With Gujarat, Maharashtra, Andhra and Karnataka in mind, I had to point out that tobacco went with water harvesting and soil management in poor agroclimatic regimes. The adjustment problems were severe and needed programmatic assistance. As you harvested the rain and managed the soil better, you replaced a low-yielding cereal with tobacco in many cases. Alternative crops,technology, and work with markets and farmers were then needed.

Satcher to whom I posed the problem was clear that the US would work with uson the agriculture and trade adjustment required. His agriculture chapter reads like our APC report. In the main debate, Donna Shalala fully endorsed my view that agriculture adjustment must go parri passu with demand curtailment. The US is a logical ally of China, Brazil, India, South Africa and others in this case. Another case where we should get our act together, before they start calling us the bad boys of the block.

The agricultural adjustment problem is not emphasised in the rich countries at all