Tobacco Economics in Myanmar

This study is based on various sources but mainly on the Myanmar Study on Tobacco Economics 2001. Recent trends in the price of tobacco products show that the real prices of all tobacco produts have been declining. In order to effectively reduce tobacco consumption, real prices of tobacco products need to be increased through heavier taxation, and other proven tobacco control measures need to be strengthened

Social, economic and legal dimensions of tobacco and its control in South-East Asia region

This paper examines the social, cultural, economic and legal dimensions of tobacco control in the South-East Asia Region in a holistic view through the review of findings from various studies on prevalence, tobacco economics, poverty alleviation, women and tobacco and tobacco control laws and regulations. Methods were Literature review of peer reviewed publications, country reports, WHO publications, and reports of national and international meetings on tobacco and findings from national level surveys and studies. Tobacco use has been a social and cultural part of the people of South-East Asia Region. Survey findings show that 30% to 60% of men and 1.8% to 15.6% of women in the Region use one or the other forms of tobacco products. The complex nature of tobacco use with both smoking and smokeless forms is a major challenge for implementing tobacco control measures. Prevalence of tobacco use is high among the poor and the illiterate. It is higher among males than females but studies show a rising trend among girls and women due to intensive marketing of tobacco products by the tobacco industry. Tobacco users spend a huge percent of their income on tobacco which deprives them and their families of proper nutrition, good education and health care. Some studies of the Region show that cost of treatment of diseases attributable to tobacco use was more than double the revenue that governments received from tobacco taxation. Another challenge the Region faces is the application of uniform tax to all forms of tobacco, which will reduce not only the availability of tobacco products in the market but also control people switching over to cheaper tobacco products. Ten out of eleven countries are Parties to the WHO Framework Convention on Tobacco Control and nine countries have tobacco control legislation. Enforcement of control measures is weak, particularly in areas such as smoke-free environments, advertisement at the point of sale and sale of tobacco to minors. Socio-cultural acceptance of tobacco use is still a major challenge in tobacco control efforts for the governments and stakeholders in the South-East Asia Region. The myth that chewing tobacco is less harmful than smoking tobacco needs to be addressed with public awareness campaigns. Advocacy on the integration of tobacco control with poverty alleviation campaigns and development programs is urgently required. Law enforcement is a critical area to be strengthened and supported by WHO and the civil society organizations working in the area of tobacco control

WHO framework convention on tobacco control and its implementation in South-East Asia region

The birth of the WHO Framework Convention on Tobacco Control (WHO FCTC) took place in response to the global tobacco epidemic and it became the most important global tobacco control instrument. Duly recognizing tobacco use as an important public health problem and in the wake of rising prevalence of and mortality related to tobacco use, almost all Member States of the South-East Asia Region signed and ratified the WHO FCTC. Following the ratification, Member countries have enacted comprehensive national tobacco control laws and regulations. Most countries have covered some important provisions, such as tax and price measures, smoke-free places, health warnings, a ban on tobacco advertising and promotion, and a ban on tobacco sales to minors. In spite of innumerable constraints and challenges, particularly human, infrastructural and financial resources, Member countries have been doing their best to enforce those legislations and regulations as effectively as possible. In order to educate the general public on the harmful effects of tobacco, mass health campaigns have been organized which are being continued and sustained. However, some of the important areas that need attention in due course of time are tax raises, illicit trade, tobacco industry interference and alternate cropping systems. All Member States in the Region are striving harder to achieving the goals and provisions of the Framework Convention through actively engaging all relevant sectors and addressing the tobacco issue holistically, and thus protecting the present and future generations from the devastating health, social, economic and environmental consequences of tobacco consumption and exposure to tobacco smoke

Strengthening smokeless tobacco control in Myanmar: challenges and the way forward

Background and challenges to implementation Smokeless tobacco (SLT) use is highly prevalent in Myanmar, particularly among women and youth. Ministry of Health and Sports has established and strengthened smokeless tobacco control programme at national and subnational level by adopting comprehensive policy of tobacco control since 2012, with the support of WHO and The UNION. Intervention or response These key policies are inclusion of SLT as an integral part of the national and local tobacco control frameworks, Raising public awareness on the adverse health and social consequences of SLT use, banning smokeless tobacco in public places, workplaces and public transport , Strengthening SLT Free Youth Programme, Inclusion of SLT use into regular Global Tobacco surveillance mechanisms and preventing tobacco industry interference on SLT. Results and lessons learnt Key policy achievements were made i)adopted a smoke free national regulation which bans smoking in all public places, work places and public transport; ii)adopted a pictorial health warning regulation that mandates tobacco industry to print at least 75% pictorial health warning on all tobacco pack including smokeless tobacco both in front and back on upper part. In addition we have built capacity of national and sub-national tobacco control cell and officials from health, NGOs and media. Tobacco control Policy awareness was built among member of parliaments and inter-ministerial departments. According to 2016 Global Youth Tobacco Survey (GYTS), current smokeless tobacco use among students aged 13-15 years had declined from 9.8% to 5.7% between 2011 and 2016. Conclusions and key recommendations Misconception of SLT use as less dangerous than smoking products is a big challenge to the tobacco control measures added by ease of purchase and low prices of SLT products. Efforts should be prioritized on law enforcement as well as amendment of existing national law to include the control of SLT products and illicit trade of tobacco in Myanmar

An approach to health system strengthening in the Union of Myanmar

Objectives In 2007 and 2008, Myanmar developed a health system strengthening (HSS) strategy and proposal through funding support from the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to identify critical success factors in the development of the HSS strategy in Myanmar.Methods The main source of information for this review includes international and national literature, and participant observation by the authors in the health systems analysis and HSS strategy development in Myanmar between 2007 and 2009.Results Critical success factors in the development of the HSS strategy included evidence-based development of the strategy through a sector analysis, and a long-term approach to strategy development with wide stakeholder participation. This contributed to important strategy breakthroughs in the areas of health planning, health financing, human resource management and civil society partnerships.Conclusion Implementation of the HSS strategy in Myanmar should position the MOH and partners well to implement challenging system reforms in the areas of health planning, financing and human resource management in the coming years, as well as support more coordinated efforts for relief and recovery effort following the Nargis natural disaster in 2008. These innovations in Myanmar, with evidence of similar breakthroughs in other countries of the Asian region including North Korea, Cambodia, Nepal and Sri Lanka, provides promising evidence of the potential of the HSS approach as an emerging health development paradigm, particularly in relation to responding to the issue of "within country" inequities in access to health care.Health system strengthening Myanmar Health sector planning Maternal and child health GAVI