By James Zeere:

As a consequence of an on-going advocacy process to regulate tobacco consumption and to ratify the provisions of the World Health Organisation’s (WHO) Framework Convention for Tobacco Control (FCTC), the Tobacco Control Bill has been presented before parliament of Uganda.

The WHO FCTC sets the minimum global standards for all its signatories to implement in the control, production and distribution of tobacco and its products. Introduced by Hon Chris Baryomunsi as a private members Bill, the Tobacco Control Bill prescribes standards to be adopted by the Government of Uganda to regulate the production, supply and consumption of tobacco products in Uganda.

The key objects of the Bill are built around controlling consumption, demand and supply of tobacco products by the public, protecting the environment from effects of tobacco and promoting the health of persons by reducing tobacco related illness among others. It is not only the duty of every citizen of the republic of Uganda to create a clean and healthy environment under Article 17 (j) of the constitution but it is also the right of every citizen to enjoy a clean and healthy environment under Article 39.

The personal right to consume tobacco products cannot be completely ruled out but the constitution permits the limitation of the enjoyment of any right in public interest under Article 43. It is on this basis that Tobacco Control Bill proposes among others that a person should not be allowed to smoke in an outdoor space within 100 meters of any public place or transport, or any window or air intake mechanism of a public place, or any place for service of food or drink or any designated non-smoking area.

The Bill confronts the tobacco control fight by going after the public demand for consumption of tobacco products. It has always been alleged that most consumers of tobacco products have no idea what they are consuming and barely understand the addictive nature of tobacco products.

To deal with this, the Bill places restrictions on advertisement, promotion, packaging and labeling of tobacco products so as to eliminate any aesthetic appeal the tobacco industry may attach to tobacco products through either advertisement or packaging. Tobacco control advocates insist that the public should be empowered with information about the effects of tobacco consumption which the tobacco industry has conveniently omitted to provide so that when a person consumes a tobacco product they do so knowingly; a form of informed decision making.

By eliminating the demand for tobacco products, it is envisaged that tobacco consumption will drop and without a sustainable market, production will make no business sense for the tobacco industry. It is not in contention however that the tobacco industry is a major player in Uganda’s economy and not only gives the government a significant amount of revenue but also provides jobs for a lot of people in the country.

Should the Tobacco Control Bill achieve its objectives, the tobacco industry could be pushed out of the country and so will all that revenue and employment. This is not something the government will take lightly when assessing the relevance of the Bill.

From a public health perspective however, it is in the interest of the government to control how tobacco is consumed in Uganda because despite all the revenue that may reaped from tobacco production, the cost of treating the diseases burden created by tobacco far outweighs all the revenue that tobacco contributes to the government.

The World Health Organisation (WHO) has reported that for every dollar tobacco contributes in revenue three dollars are spent on treating related illnesses. Tobacco farming has however has been documented to have a negative effect on not only farming but also forestry because being highly labour intensive farmers cannot engage in other income generating activities yet a lot of firewood is needed for curing the tobacco respectively.

Kyankanzi district and Arua district which rank among the poorest districts in the country have paid the heaviest prices nationally for concentrating on tobacco farming which has reaped very low yields and thus income for them compared to other farmers who have abandoned tobacco for other food stuffs.

Cumulatively speaking there is no benefit either the government or the public derives from production or consumption of tobacco. The tobacco industry has repeatedly masked this fact behind the smoke screen of revenue and employment opportunities but the bigger picture reveals that more harm than good is being done. From increasing the incidence of non-communicable diseases to deforestation to soil degradation to perpetuating poverty among rural households, the tobacco industry is damaging several lives and households across Uganda.

The Tobacco Control Bill is as such a timely intervention and it is only imperative as it is its duty that the government gets behind the Tobacco Bill to protect the public from the negative effects of tobacco production and consumption.

Zeere James Samuel is a Human Rights Lawyer working with Human Rights Documentation and Advocacy at the Center for Health, Human Rights and Development (CEHURD)
Email: james.zeere@gmail.com Twitter: @james_zeere

By Juliana Nantaba:
The Institute of Tropical Medicine in Antwerp, Belgium (ITM) is one of the leading institutes for training, research and assistance in tropical medicine and health care in developing countries. Through my work as a project officer on CEHURD’s GO4HEALTH research project collaborated by ITM, I was informed about the 7 week specialization short course on Health Policy for health professionals and researchers involved in health systems.

After undertaking this short course, it is a hard task to write about the experience in only age, so I will only give you a glimpse. The course kicked off in March 2014 with a class of about 20 participants with various backgrounds including political science, psychology and sociology, economics and medicine.

Even though I was the only lawyer among the participants, their diverse backgrounds and work experience from different low and middle income countries in Africa, Asia and Latin coupled with that of faculty professors gave me a memorable, productive and invaluable understanding on various public health issues.
Through out the course period, we progressively navigated through different health policy issues in public health. These were covered under three modules titled; 1) health policy analysis, 2) right to health and 3) Health System Reform.

These were covered through lectures, group work, and use of case studies and innovative methods like “fish bowls” with the support of resource persons. Within each module we analyzed various aspects in health systems, their challenges and also drew examples from various country contexts on strategies to address the problems as well as possible solutions.

Interestingly and also very relevant for me, was the fact that all the discussions were also done in-light of current global health and global issues like the move towards Universal Health Coverage, realizing the right to health, access to medicines issues, post 2015 MDGs Agenda and Sustainable Development Goals(SDGs) and roles of various stake holders.

As such, the course did not only tackle issues theoretically but gave me an opportunity to apply available theories to practical situations and health system challenges from all over the world and most importantly to my research as a lawyer working in the public health environment in Uganda. Another valuable element of this course entailed attending various seminars and public defenses for PhD students.

At this point you are wondering, “was it all work and no play?” of course not! The ITM student service organized various activities to enable the students visit various places including the city of Antwerp, Brugge, Amsterdam and my personal adventure with friends to Gent and Paris.

Special thanks to the various GO4HEALTH partners especially in work package 2 for your effort and interest in building capacity of young researchers who are part of the project, to the office of the Director  General for Development cooperation, Belgium for the study scholarship and to the CEHURD staff for their support through out the course.

After my ITM experience, I feel very energized, equipped and ready to take on health system research and advocacy and contribute to litigation for realizing the right to health in Uganda. All this I am ready as a lawyer with a perspective appreciates various public health issues.

By Anthony Wesaka

A group of Mukono residents has sued a stone quarrying firm – China Communications Construction Company for allegedly violating and depriving them of their rights to a “clean” and “health” environment.

The residents from the villages of Bumutakkude and Kiryamuli, are represented by a civil society group, Centre for Health, Human Rights and Development (CEHURD).

Also sued are, National Environment Management Authority and the Mukono District Local Government.

Nema and Mukono District Local Government have been sued for alleged failure to protect the environment.
In the complaint filed yesterday, residents claim that in 2012, the firm was licensed by Nema to commence stone quarrying in their villages.

The quarry blasts rocks and grades land, which processes, resident say puts them in harm’s way since they emit dust into space
Through their lawyers, Kabanda and Co Advocates, residents want a declaratory judgment that omits the acts of the firm.
They also want court to issue an injunction restraining the firm from carrying out any activities alienating in any way the natural water stream serving the two villages.

Court is yet to summon any of the defendants.
The suit further read: “The third defendant (Chinese firm) has started grading the landscape surrounding the natural water stream which has led to the contamination of the natural stream with mud and rendered the stream inaccessible especially during rainy season.”

Residents also say as a result of stone quarrying, they are suffering health complications resulting from inhaling dust and drinking the contaminated water.

http://www.monitor.co.ug/News/National/Mukono-residents-want-quarry-company-closed/-/688334/2334940/-/4d0pkoz/-/index.html

It is evident that Non Communicable Diseases (NCDs) are rapidly becoming a major cause of preventable and premature death and illness in Uganda. According to the study, the four NCD-related diseases share common risk factors that include tobacco use, unhealthy diets, physical inactivity, and harmful use of alcohol, as well as high blood pressure and cholesterol.

Today Shisha is the most commonly used tobacco product among youths other than cigarettes and it is more prevalent among females than males. This therefore calls for universities and other tertiary institutions to set up effective mechanisms to help students wishing to stop smoking to do so, and also to expand smoke-free environments. READ FULL STUDY REPORT