Mail to Minister of Health

Impasse de Rosnay,

4, La Croix Street,

Forest Side,

Curepipe.

24 April 2015.

The Honourable Minister of Health and Quality of Life,

Emmanuel Anquetil Building

Port Louis.

Honourable Minister,

I am writing to you in my capacity as the President of VISA, a registered non-governmental organization established in 2001 and engaged in tobacco control.VISA works closely with the World Health Organization (WHO) and other international and regional agencies involved in tobacco control. It also has strong links with the Ministry of Health and Quality of Life (MOHQL) and contributes in the formulation and implementation of effective tobacco control legislation and policies.

Honourable Minister, tobacco use is one of the greatest public health challenges facing the world today.It is a global epidemicof unprecedented dimension with an estimated one billionpeople addicted to tobacco smoking in the world. Tobacco use is responsible for six million deaths annually and if the present trend continues, it is estimated that the death toll would rise to one billion in the 21^st century. Tobacco is the only consumer product that kills 50% of its users.

In Mauritius, the battle against tobacco use is far from being won: 40.3% of adult males are smokers, 28.4% of youth aged 13-15 years have ever tried cigarettes and 13.7% are current smokers. According to the WHO Global Report on Tobacco Attributable Mortality released in 2011, in Mauritius tobacco accounts for:

– 64% of deaths linked to cancer of the trachea, bronchus and lung;

– 17% of deaths linked to respiratory diseases;

– 8 % of deaths due to cardiovascular diseases;

– 7 % of deaths due to cerebrovascular diseases;

– 11 % of deaths among men;

– 4 % of deaths among women; and

– 8 % of all deaths attibuted to non-communicable diseases.

These figures confirm the seroius public health challenge that tobacco use represents to the Mauritian population and the necessity of adopting a more comprehensive and sustained national tobacco control strategy. Mauritius ratified the Framework Convention on Tobacco Control of the World Health Organization (WHO FCTC) in 2004 and has made appreciable progress in its implementation; yet there are still significant gaps that need to be addressed, some of which are:

• Delay in the introduction of a new set of images on cigarette packs. The existing images date back to 2009 and, according to the WHO, they should have been replaced after a maximum period of 3 years, that is, in 2012.Thus the degree of appeal and level of effectiveness of the images have declined with time.
• Delay in conducting the International Tobacco Control (ITC) survey. This survey is regularly carried out by the University of Waterloo and Mauritius Institute of Health in collaboration with the MOHQL. The next wave of the survey is being repeatedly postponed as it pre-requires that the new set of images on cigarette packs be introduced. You may wish to note that funding has already lapsed for one wave of the survey planned for 2013 and any further delay would jeopardize the organization of the next wave.
• Opening of waterpipebars.These bars, also known as shisha bars, are rapidly speadingover the island, in violation of the Public Health (Restrictions of Tobacco Products) Regulations of 2008.
• Smoking in nightclubs. This is still a common feature in Mauritius despite the existence of a smoke-free legislation in Mauritius. In 2011, VISA submitted to the Ministry a survey report (copy enclosed) indicating the very high level of non-compliance with the law.It is noted with concern that no action has been taken so far to enforce the law.
• Pending amendments to the tobacco regulations. Several meetings have been held at the level of the MOHQL in view of amending the existing tobacco control regulations and adapting them to the changing tobacco control landscape of Mauritius. VISA notes that no action has been taken up to now to formalize these amendments.
• Tax on tobacco products. The ITC report 2012 indicates that tobacco products are still highly affordable to smokers in Mauritius. In other words, there is still room for increased taxation of such products. According to the WHO, tobacco taxation is one of the most effective ways to reduce tobacco consumption. The Ministry of Health should ensure that government views tobacco taxation more as a health-promoting than an income-generating measure. VISA also notes with concern that the tobacco tax was not increased in the 2015 budget.

Honourable Minister, tobaccokills. It represents a major burden to the economy of our country and especially to the health sector. It is also a major risk factor for non-communicable diseases (NCDs) which have reached an epidemic proportion in Mauritius. The WHO states that NCD mortality cannot be reduced without substantially reducing tobacco use. In fact, the World Health Assembly (WHA) has endorsed a commitment to tackle the NCD epidemic by reducing the current global prevalence of tobacco use by 30 percent by 2025. Hence the implementation of the WHO FCTC, through a comprehensive tobacco control programme, should be an integral part of the development agenda of the government of Mauritius.

In view of the above, I would be gratefulif the above issues receive your kind and urgent consideration. I have no doubt, as Minister, you have the power and influence to save thousands of lives from tobacco consumption and mitigate its social, economic and environmental impact.

Mrs Veronique Le Clezio, the Honorary President of VISA, and I would be grateful to have a meeting with you to discuss further the tobacco control situation in Mauritius.

Yours sincerely,

Deowan Mohee

President

VISA

NB: Some recent publications of VISA are enclosed.