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Malawi Urged to Recognise Importance of Tobacco Harm Reduction for Global Health

The Global State of Tobacco Harm Reduction 2020 (GSTHR) conference took place virtually from the 4th to 6th of November. The conference hosted several panel discussions with renowned leaders in Tobacco Harm Reduction (THR) and Global Health to discuss the and importance of THR for global Health.

One of the speakers at the event was local THR Advocate Chimwemwe Ngoma who urged the Ministry of Health to make THR products more accessible. Ngoma recommended that deliberate efforts can be made to manufacture and retail low-tech THR products in Low and Middle Income Countries (LMICs).

“Many LMICs are not sufficiently resourced to implement and adopt THR measures. The situation is further complicated in countries like Malawi where the economy is reliant on the income from tobacco cultivation. Government policies and regulation are being unduly influenced by flawed science and anti-harm reduction lobbying,” Ngoma told the over 1300 participants who joined the conference from different parts of the world.

Ngoma, who runs an information dissemination project on THR and nicotine science, THR Malawi, also added that there is a huge a lack of knowledge and limited access to THR products among the local smoking population and that in Malawi, like other LMICs, THR products are very expensive compared to easily accessible combustible cigarettes.

One of the participants of the conference, Martin Cullip who is based in the USA, pointed out that the west was facing similar challenges in the fight for THR sighting that it is documented that Michael Bloomberg invested $160 million for research designed to make a case for banning flavours in e-cigarettes and worried that public health professionals who accept such grants for research in turn negatively affect consumers.

Commenting on the remarks made by Ngoma, President of the society of Medical Doctors in Malawi, Dr. Victor Mithi, said the society is aware of the lobbying against tobacco harm in other countries and fully acknowledges the dilemma that THR incites as many rely on the crop for income. He however alleged that whilst noting an increase in the number of cancers of the oesophagus, which is associated with smoking, there isn’t substantial local data available to assess the impact of tobacco smoking. He indicated that it could be possible that Malawi could simply be exporting a disease causing product (tobacco). He urged that the topic needs to be further explored should there be opportunities for funding for local studies.
The World Health Organisation (WHO) seems to be taking a precautionary approach to THR campaigns. The international regulator has pledged support for THR only it it involves medical evidence and additional science.
The THR campaign has seen the world’s largest tobacco manufacturing companies like Phillip Morris International (PMI) invest millions in research and innovation that have yielded the introduction of smokeless cigarettes that can be offered to smokers as less harmful alternatives. The THR lobbying has been challenged by anti-THR campaigns from organisations that suggest that smokers must be encouraged to quit instead of being offered less harmful alternatives. In Malawi, THR products are sold at $10 and above whilst combustible cigarettes are sold at a mere $0.10.

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