The right to life – Bangladesh’s tobacco control laws designed to uphold a fundamental principle

Syed Mahbubul Alam is The Union’s technical advisor on tobacco control for Bangladesh. He began his battle for tobacco control in the late 1990s when he became involved in a campaign against a British American Tobacco promotion.

Alam was volunteering for the Work for a Better Bangladesh Trust (WBB) – a dynamic civil society organisation involved in many issues, including public health. In 1999 the WBB Trust discovered that British American Tobacco (BAT) planned to hold the grand finale of their 17-country ‘Voyage of Discovery’ promotional tour in Bangladesh. In light of escalating tobacco-related illness, WBB Trust set about trying to prevent the BAT event. It formed the Bangladesh Anti-Tobacco Alliance (BATA) made up of the country’s leading tobacco control organisations, to build a united front against tobacco industry marketing.

“We found that there was no specific law to prevent this promotion of deadly products. Although Bangladesh had some of the highest rates of tobacco use in the world – and colossal social and financial losses as a result – there was nothing legal to help us block this lethal marketing stunt. Regardless, BATA filed a writ petition with the high court, on the grounds that allowing the campaign was a contravention of the government’s fundamental obligation to uphold the right to life. To our absolute surprise, the court ruled in our favour!”

On the strength of this victory Alam realised that much could be achieved to protect public health with a strong legal framework in place -- and that his legal training could be instrumental in this project.

“I had very limited public health knowledge. But I could see that legal skills were needed to advance tobacco control at the national level. There were lots of doctors and medical experts advocating for this cause, but we needed to think and work differently. As civil society organisations we had held many events to educate people about the harms of tobacco use, but they were having little impact. So I decided to invest my career in tobacco control.”

During his early research Alam was shocked to discover how much Bangladesh was spending on treatment for people who became sick through tobacco use, and realised that the preventive approach was the highest impact and most cost-effective.   

“Big Tobacco promotes their deadly products, gets people addicted and makes huge profits as a result. If we can prevent this happening we can save millions of lives. Legal frameworks are the best tools for controlling the industry. This remains hugely motivating for me.”

Alam first became involved with The Union’s Department of Tobacco Control while working for the WBB Trust -- as Union grantees under the Bloomberg Initiative to Reduce Tobacco Use, the organisation received funding and technical support for its tobacco control projects. In 2015 Alam joined The Union and became its technical advisor to Bangladesh.

Day-to-day he works with grantees, government and policymakers to guide and support implementation of tobacco control laws, and to advise and build momentum for progressive new policies to protect health. The Union currently works with six grantees in Bangladesh. 

“Since 2005, significant advances have been made. Then, people would smoke everywhere, and it was just tolerated. Now, because people know they have the backing of a well-implemented law, if someone smokes where they shouldn’t, people feel happy to ask them to stop. Behaviours have changed. The law gives you the power to do these things.”

“Graphic health warnings on cigarette packaging have also had a huge impact. Many people in Bangladesh can’t read, so graphic warnings are especially important for getting this life-saving information to all. Also, you used to see lots of adverts for tobacco products everywhere – no more! We now have laws that prevent the promotion, advertising and sponsorship of tobacco.”

Supporting development of sustainable funding for tobacco control and other public health projects has been one of Alam’s greatest achievements to date. The Health Development Surcharge – unique to Bangladesh – puts one percent from all tobacco sales directly into the national health budget. In 2017, this was around Tk 250 crore, or US$31 million.

“We are now working on building a tobacco tax structure, tailoring it to become a tobacco control measure as well as an additional source of health funding. This will be included in our national tobacco control framework that we hope will be enshrined in law by the end of this year.” 

“The Union is one of the world’s leading public health organisations, and I’m proud to be part of it. Our approach is unique in several ways: it supports initiative-building; it builds capacity for local experts and leadership; it supports country-level policy and legal framework-building. These three things together mean that the work is sustainable. The Union builds ownership and expertise in-country, for permanent structures that ensure the work is continued and developed into the future.”

“In life I always think – what would happen if I wasn’t here? I need to do something that will make a difference and will keep having a positive impact after I am gone. And with tobacco control, I believe it will. It’s all an investment for the future. My hope is that fewer and fewer people in Bangladesh will use tobacco, and as a result fewer lives will be wrecked by this addiction.”

 

 

 

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