Abstract
Transnational tobacco manufacturing and tobacco leaf companies engage in numerous efforts to oppose global tobacco control. One of their strategies is to stress the economic importance of tobacco to the developing countries that grow it.
We analyze tobacco industry documents and ethnographic data to show how tobacco companies used this argument in the case of Malawi, producing and disseminating reports promoting claims of losses of jobs and foreign earnings that would result from the impending passage of the Framework Convention on Tobacco Control (FCTC). In addition, they influenced the government of Malawi to introduce resolutions or make amendments to tobacco-related resolutions in meetings of United Nations organizations, succeeding in temporarily displacing health as the focus in tobacco control policymaking. However, these efforts did not substantially weaken the FCTC.
Malawi began exporting tobacco in 1893,1 and today it is the world's most tobacco-dependent economy. Tobacco accounts for 70% of Malawi's foreign earnings,2,3 and 600 000 to 2 million members of the country's total workforce of 5 million people are directly employed in the tobacco sector, which consists primarily of tobacco farming and factory processing jobs.4 US-based tobacco leaf–buying companies Universal Corporation and Alliance One International control tobacco prices and influence trade policies in Malawi, restricting competition, depressing tobacco prices for Malawi's farmers, and contributing to the country's poverty.5 Cigarette manufacturers and global leaf companies (merchant companies that buy tobacco leaf through prearranged contracts with manufacturers) fund child labor “corporate social responsibility” projects in Malawi to distract public attention from how they profit from low wages and cheap tobacco.6
In addition, British American Tobacco (BAT), other cigarette manufacturers, and the International Tobacco Growers’ Association (ITGA), an organization created by tobacco companies in 1984 to weaken global tobacco control activities,7–9 have used the governments of Malawi and other developing countries to lobby against global tobacco control efforts,7,10 particularly the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC; Table 1 ).11 The FCTC is an international treaty designed to reduce the health damage of tobacco by committing signatories to enact laws that control the tobacco industry's production and promotion of tobacco, increase taxes, and promote education about the dangers of tobacco use and secondhand smoke. The FCTC was passed in February 2005, and, as of April 2009, 164 countries (not including the United States) had ratified and were implementing the framework.
TABLE 1 Malawi, Global Tobacco Control, and the Framework Convention on Tobacco Control: Timeline
| Date | Event |
| June 19–23, 1983 | Nick Hauser meets with David C.W. Kambauwa in Italy to develop a program to work with Malawi to promote tobacco's economic importance. |
| March 29, 1985 | A Philip Morris official gives a speech to the company's executives and notes that the company lobbied Malawi to pressure the FAO to take a pro-tobacco stance in FAO publications on tobacco. |
| 1988–1992 | Hetherwick Ntaba successfully argues in WHO meetings that tobacco control negatively affects developing-country economies. |
| November 1992 | Allyn Taylor publishes article on WHO's power under Article 19 of its constitution to use international instruments to control tobacco. |
| November 3, 1993 | Martin Oldman states that tobacco industry reports will ensure that ITGA members are “singing off the same hymn sheet” to counter global tobacco control. |
| October 10–14, 1994 | WCTOH adopts recommendation (International Strategy for Tobacco Control) urging collective action on tobacco control. |
| May 1995 | World Health Assembly adopts Resolution WHA48.11, which integrates the recommendations of the WCTOH, to begin feasibility studies on the FCTC. |
| May 1996 | World Health Assembly adopts Resolution WHA49.17, requesting the director general of WHO to initiate the development of the FCTC in accordance with Article 19 of its constitution. |
| May 1998 | Gro Harlem Brundtland elected WHO director general and makes the FCTC one of her 2 top priorities (the other being malaria). |
| July 1998 | Tobacco Free Initiative is created. |
| May 1999 | World Bank publishes report Curbing the Epidemic: Governments and Economics of Tobacco Control; WHO presents the report to the 52nd World Health Assembly as a technical document providing economic justification for the FCTC. |
| May 1999 | World Health Assembly adopts Resolution WHA52.18, creating FCTC Working Group and INB to initiate negotiation of the FCTC. |
| October 1999 | Lome Declaration (no information available on whether Malawi signed the declaration) |
| October 25–29, 1999 | First session of the FCTC Intergovernmental Working Group |
| November 2000 | Tobacco Control Commission of Malawi argues that WHO tobacco control would reduce Malawi's tobacco earnings by 10% a year. |
| March 2000 | ITGA conducts road show media event in Malawi in an effort to discredit World Bank evidence of the public health benefits of tobacco control. |
| April–May 2000 | ITGA works through Malawi's task force on the FCTC to attempt to undermine and delay meetings of the FCTC Working Group. |
| March 27–29, 2000 | Second session of the FCTC Intergovernmental Working Group |
| May 2000 | British American Tobacco and ITGA lobbying of Malawi and other tobacco-growing countries contributes to FCTC draft treaty text in which protocol language is weaker than the language of the original proposal. |
| May 2000 | 53rd World Health Assembly adopts Resolution WHA53.16 to begin formal negotiation of the FCTC. |
| July 2000 | Yusuf Juwayeyi criticizes the WHO treaty process for lack of transparency, overestimation of tobacco-related death and disease in relation to HIV/AIDS and malaria, and underestimation of jobs generated by tobacco. |
| October 12–13, 2000 | FCTC public hearings in Geneva, Switzerland |
| October 23–28, 2000 | Malawi signs Nairobi Declaration at the Intercountry Meeting on Tobacco Control Policy and Programming. |
| October 16–21, 2001 | First meeting of INB |
| March 12–14, 2001 | Malawi signs Johannesburg Declaration at meeting of 21 countries from the WHO African Region. |
| April 30–May 5, 2001 | Second meeting of INB |
| October 2–4, 2001 | Algiers Declaration ratified at the consultative meeting of the WHO African Region; Malawi does not sign declaration. |
| November 22–28, 2001 | Third meeting of INB |
| February 26–March 1, 2002 | Malawi signs Abidjan Declaration at the consultative meeting of the WHO African Region on the FCTC. |
| March 18–23, 2002 | Fourth meeting of INB |
| September 2–6, 2002 | Malawi signs Lilongwe Declaration at the 4th subregional meeting of African countries on the FCTC. |
| October 14–25, 2002 | Fifth meeting of INB |
| 2003 | FAO releases report on the impact of tobacco control and the FCTC on world economies that notes Malawi's extreme reliance on tobacco. |
| February 18–27, 2003 | Sixth meeting of INB |
| May 21, 2003 | At the 56th World Health Assembly, 192 member states unanimously adopt Resolution WHA56.1 on the FCTC. |
| February 27, 2005 | FCTC becomes international law after 40 countries ratify it. |
| February 2006 | First Conference of Parties meeting |
| June 30–July 6, 2007 | Second Conference of Parties meeting |
| November 2008 | Third Conference of Parties meeting |
Note. FAO = Food and Agriculture Organization of the United Nations; FCTC = Framework Convention on Tobacco Control; INB = Intergovernmental Negotiating Body; ITGA = International Tobacco Growers’ Association; WCTOH = 9th World Conference on Tobacco or Health; WHO = World Health Organization. As of April 2009, Malawi had not signed or ratified the FCTC.
Malawi is an extreme but not unique case of how transnational tobacco companies have used developing countries’ economic reliance on tobacco to oppose global tobacco control.11 As part of a broader strategy involving other tobacco-growing countries such as Argentina, Brazil, Turkey, and Zimbabwe, BAT and the ITGA sought the assistance of Malawi grower representatives and government officials in the Ministry of Foreign Affairs to argue tobacco's economic contribution in Malawi and pressure United Nations (UN) organizations involved in tobacco control to stress this contribution, diluting the health focus of tobacco control and delaying passage of the FCTC.
The tobacco industry's influence on health policymaking in Malawi involves relationships between institutions and power and between the global and local levels12: “the constellation of actors, activities, and influences that shape policy decisions and their implementation, effects, and how they play out.”13(p30) Researchers and social scientists have applied an anthropology of policy approach to the study of the influence of industrialized farming on communities,14 to discussions of language and power in written policy documents on economic development,15 and to the effects of contrasting meaning structures on environmental conflicts.16
Despite transnational tobacco manufacturing and leaf companies’ high level of influence on health policies and tobacco-growing societies, anthropologists and health researchers have ignored the policy chain from tobacco farmers (policy recipients) to tobacco companies (policy influencers) and government officials (policymakers) that shapes policy directions and relationships (Figure 1). We analyzed tobacco companies’ use of economic arguments regarding the benefits of tobacco in Malawi to obstruct the FCTC between 1992, when the idea of the framework first took shape, and the time at which the framework was passed. Our rationale is that if tobacco control efforts are to be effective in tobacco-growing societies, tobacco companies’ interference in health policymaking in those countries needs to be understood and ended.
FIGURE 1 Tobacco policy chain in Malawi.
The influence of transnational tobacco manufacturing and leaf companies on the creation and obstruction of Malawi's tobacco control policies, as well as the policies of WHO and other UN bodies, reveals the economic and political power of tobacco companies in the global health policy arena. At the same time, possible outcomes of the successful implementation of the FCTC were changes in social norms and health behaviors and reductions in the power of tobacco manufacturing and leaf companies to undermine health policies.
Between September 2006 and January 2007, we used standard approaches17–19 to search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) and the BAT Documents Archive (http://bat.library.ucsf.edu) for relevant documents. Our initial searches focused on the terms “Malawi,” “tobacco control,” “WHO,” and “Framework Convention on Tobacco Control.” We conducted follow-up searches that included the names of key individuals and organizations and adjacent page (Bates) numbers.
Using the snowball method, we identified key themes and terms (e.g., “health policy,” “policymaking,” “economic benefits,” and “tobacco growing”) in the initial industry documents we found that were consistent with the research on tobacco industry influence in Malawi. We conducted follow-up searches with these terms (as well as searches with the names of key individuals and organizations and adjacent page [Bates] numbers). Lexus Nexus, World Cat, the University of California's Melvyl library catalog, and Internet search engines—Google (http://www.google.com), Yahoo (http://www.yahoo.com), and Clusty (http://clusty.com) were used to obtain information that would corroborate findings from industry documents. We screened 1890 documents and used 35 in detailing the results of this study.
M. Otañez conducted semistructured interviews with 124 tobacco workers, farm authority representatives, trade unionists, government officials, and corporate executives from transnational tobacco leaf companies during 6 visits to Malawi between 1998 and 2006. These individuals were selected on the basis of their willingness to take part in the study, their knowledge of health policymaking in Malawi, and their experiences with influential organizations relevant to tobacco control and the tobacco industry in Malawi.
The question guide for interviews was developed in consultation with key informants (e.g., health policymakers and trade union leaders) and the experience gained from repeated visits to Malawi. As our knowledge of Malawi's tobacco sector deepened, we modified our questions to elicit a deeper understanding of the research themes and added new questions based on conversations with experts and in consultation with colleagues at the University of California. We cross-checked ethnographic information gathered from our primary interviews with observations and interviews with industry officials, tobacco workers, and government representatives over time as well as with tobacco-related newspaper stories, published and unpublished reports, archival material, scholarly literature, and corporate literature (e.g., tobacco industry documents).
M. G. Otañez used the standard anthropological method of participant observation, wherein researchers immerse themselves in a particular social environment over a long period of time in an attempt to gain an understanding of the behaviors and perspectives of the people residing in that environment.20 Participant observations were conducted in union meetings on tobacco farms, foreign-donor–funded union workshops and training sessions held in urban hotels, the headquarters of the tobacco workers’ union, the Malawi Congress of Trade Unions (Limbe and Lilongwe), the Tobacco Association of Malawi, the Tobacco Export Association of Malawi, the Tobacco Control Commission, and auction floors in Lilongwe and Blantyre.
In 2005, Malawi was the 7th largest global exporter of tobacco leaves and the 12th largest producer of tobacco leaves.21 The growing, marketing, and selling of tobacco accounts for 23% of Malawi's total tax base22 and 61% of the country's exports, with tea, sugar, textiles, and cotton representing its other major exports (Table 2 ).23 Malawi is the 14th poorest country in the world and has some of the world's lowest human development indicators: 65% of the population is below the national poverty line, the adult illiteracy rate is 36%, 27% of the country's residents do not have access to clean water, and 44% will not survive to the age of 40 years.24 The smoking rate among adults older than 18 years is 12.7%.25
TABLE 2 Labor Force Sizes and Export Percentages Associated With Various Crops in Malawi, 2006
Since the initiation of tobacco growing in Malawi in 1893, representatives of transnational tobacco manufacturing (and, later, leaf) companies and Malawi's government have exhibited a shared interest in sustaining a profitable and expanding tobacco sector in the country, despite labor, economic, and environmental practices that harm many of the country's citizens.1,26,27 At the same time, however, tension has existed between the tobacco industry and the government over tobacco pricing and quality, as well as industry control over processing and distribution.5,28,29
Transnational tobacco manufacturing and leaf companies developed an interest in the government of Malawi as an ally against tobacco control in the 1970s, when Malawi emerged as a major tobacco-producing country30 and was the focus of 1978 British media accounts reporting that BAT profited from the country's poverty and government corruption.31,32 According to a BAT report, the negative media attention of 1978 raised “doubts in the minds of the uninformed by the anti-smoking lobby about the ethical stance” of BAT, forcing the company to rethink “the fairly low profile which [BAT] has until now adopted.”33 From that point on, BAT would play a prominent role in the industry's efforts to lobby government and tobacco farming officials in Malawi, arguing that tobacco control would cut jobs, increase dependence on foreign aid, and worsen the poverty experienced by the country's citizens.
In 1983 BAT, which dominates the cigarette market in Malawi and is the second largest buyer of Malawi tobacco from leaf processing companies, and Philip Morris, which has a small share of the cigarette market in Malawi but is the largest buyer of Malawi tobacco from leaf processing companies,5 identified the Malawi government as a key ally in the struggle against WHO's tobacco control efforts. In June 1983, Nick Hauser, a consultant paid by the International Consortium of Tobacco Companies (later renamed International Tobacco Information Inc), an organization created to coordinate the tobacco industry's response to political challenges worldwide,11,34 met in Rome, Italy, with D. C. W. Kambauwa, the undersecretary of the Malawi Ministry of Agriculture.35 Hauser arranged the meeting prior to a UN Food and Agriculture Organization (FAO) council session as part of a series of meetings he held with senior FAO officials from developing countries to establish a program in which he would work with them to promote tobacco's economic importance.35,36
In particular, Hauser wanted to discuss a 1983 FAO report37 that concluded that tobacco is so valuable that it is unlikely to be replaced by other crops. (In 1985, an unnamed Philip Morris official, in a speech presented to top executives of the company, noted that Philip Morris lobbied Malawi to pressure the FAO to take a protobacco stance in FAO publications and positions on tobacco.11,38) Reporting on his meeting with Kambauwa to BAT, Hauser noted, “the Malawi government can definitely be gained [as an ally to BAT] to oppose WHO recommendations, guidelines or resolutions.”35 Hauser's statement proved correct when, in the 1990s and early 2000s, transnational tobacco manufacturing and leaf companies obtained support from the Malawi government to oppose global tobacco control policies.
As early as 1979, ITGA, BAT, other transnational manufacturing companies, and the Tobacco Institute, the US tobacco industry's lobbying arm, were publishing reports discrediting WHO and promoting the economic benefits of tobacco to counter global tobacco control. Tobacco companies and their surrogate groups generally produced these reports after public health researchers and organizations released reports on the economic harm of tobacco to developing countries. Martin Oldman, a BAT consultant and the head of ITGA activities (through his industry-funded United Kingdom consultancy group Agro-Tobacco Services),39 wrote in November 1993 to ITGA's Henry Ntaba, the brother of Malawi Health Minister Hetherwick Ntaba, that the industry would ensure ITGA members were “singing off the same hymn sheet” to counter global tobacco control.40
At the first WHO All-Africa Conference in Harare, Zimbabwe, in November 1993, the aim of which was to promote global tobacco control, ITGA organized a press conference to launch the ITGA publication Tobacco Trade or Aid?41 This document argued that tobacco control would threaten tobacco production and deepen developing countries’ economic dependency on foreign aid.42 The report concluded that, in the case of Malawi, the loss of ten percent of projected tobacco export earnings in 1995 would increase its deficit on the current account by more than 30 percent and would be equivalent to 6 percent of the aid received in 1991.42
In a joint 2000 study of Malawi's tobacco industry, the Tobacco Exporters’ Association of Malawi, a group of tobacco leaf-buying companies that promote industry trade interests, and the Tobacco Control Commission of Malawi, the governmental regulatory body for the local tobacco sector, used the ITGA report to argue that “WHO's global campaign would chop at least 10 percent off Malawi's tobacco earnings every year.”43 However, the FCTC's effects on global tobacco demand and on employment and farmers in Malawi will occur over several decades,44,45 ensuring that tobacco will remain central to Malawi's short- and medium-term economic growth.4,46 Tobacco industry circulation of industry publications and lobbying helped position ITGA as a “credible (i.e., non-manufacturer) front end for the battle over the TFI [WHO Tobacco Free Initiative] and the Tobacco Control Convention [the FCTC, which was then being developed]” to “help co-ordinate the response of the industry [to WHO tobacco control efforts] without individual major manufacturers falling over each other.”47
In March 2000, Hallmark Public Relations, acting on behalf of ITGA, organized a 2-week “road show”—a media event involving presentations by economic consultants working for the industry and tobacco farmers’ representatives to promote the economic benefits of tobacco growing—in Malawi, Zimbabwe, South Africa, Kenya, and India. The goal of the road show, financed by BAT and other transnational tobacco manufacturing companies,48 was to encourage governments and opinion leaders in key developing countries to stand up for the interests of their nations’ tobacco growers in international forums such as the World Health Assembly, UN organizations and other international assemblies, and regional economic groupings.49
Hallmark worked with the Tobacco Association of Malawi (TAMA), which represents farmers responsible for 85% of the tobacco cultivated in Malawi,50 to coordinate the events.51 (TAMA is also an international private company with revenues from sales of raw tobacco of US $1.2 billion in 2008.52)
ITGA used the road show as its major public relations effort in 2000 to: get major messages [on the negative economic consequences of tobacco control for growing countries] to opinion leaders directly, in a year when FCTC is under intensive development.53
The road show was a key vehicle for transnational manufacturing companies to promote pro-tobacco positions in Malawi.
ITGA reported that, during the road show, representatives of the association met with representatives from Malawi, including the minister of agriculture; the minister of industry and commerce; the minister of forestry; the minister of gender, youth, and community services; a governor of the Reserve Bank of Malawi; and a number of Parliament ministers.54 ITGA concluded that, in Malawi, the road show served to initiate [a] multi-sectoral discussion process to be organised by TAMA in order to develop a government position [on the FCTC]. Meetings between TAMA and Ministers are paving the way for [a] multi-sectoral committee [on the FCTC]. Position paper established and regional links being forged. Media coverage on TV and in press before, during and after the event in the two main national newspapers.48
National and regional newspapers covered the road show, and the resulting headlines55–58 reflected the anti-FCTC stance of the tobacco companies, ITGA, and TAMA.48 TAMA executive secretary Gabert Thyangathyanga, a participant in the road show and the industry's key contact in Malawi in terms of tobacco control opposition,59,60 reported to ITGA his belief that the road show was a success, and he noted that the Malawi “government has presently instituted a Task Force” on the economic benefits of tobacco growing to weaken or delay the FCTC.48
ITGA worked through Malawi's task force on the FCTC to try to undermine and delay meetings of the FCTC Working Group, the body created to prepare technical background papers and the text of the framework in May 1999.49,61,62 In a report to BAT on the working group's meeting in March 2000, Antonio Abrunhosa, ITGA's chief executive, noted that WHO tried to have only one meeting of the Working Group, but grower countries required a second meeting, in order to take the proposed measures to their governments, to have national positions discussed by the ministries whose activities would be impacted by those measures.54
Also, according to Abrunhosa, The unfolding of the second meeting was in great part a consequence of the strategy and the action taken by ITGA from the very beginning of the WHO decision on the FCTC: to have its proposals discussed by everyone who could be hit by its measures.54
BAT's and ITGA's lobbying of the government of Malawi and other governments in tobacco-growing countries contributed to draft treaty text that public health civil society groups involved in the FCTC process called “watered down” relative to the original FCTC proposal; however, this language was not adopted.63,64 Public health advocates pointed to a 2000 report of the UN Task Force on Tobacco in which it was concluded that the effects of tobacco control policies on farmers’ livelihoods and on job losses would occur over several decades and “that land-use and deforestation patterns linked to tobacco production represented another feature of the crop substitution debate that required attention.”65
An outcome of the FCTC Working Group meetings in 1999–2000 was that the FAO was required to conduct research on agricultural production and employment in Malawi and 6 other tobacco-growing countries.66,67 This requirement allowed the industry to draw policymakers’ attention to tobacco economics. In 2003, FAO released 2 volumes of a report on the effects of tobacco control and the FCTC on world economies that noted Malawi's extreme reliance on tobacco.4,68 The industry's pressure on FAO to conduct research on the economics of tobacco farming represented a tactical victory, delaying the FCTC process; however, no additional economic studies were conducted, and thus the final impact of this report on the FCTC is not clear.
In addition to WHO and FAO, the tobacco industry attempted to influence the Economic and Social Council of the United Nations (ECOSOC), the key UN forum for discussions of global economic and social issues and the creation of policy recommendations.69 In July 2000, tobacco companies conducted a meeting with Malawians to formulate the Malawi government's position in support of the economic contribution of tobacco for that month's ECOSOC meeting on the FCTC in New York (R. Sandramu, General Secretary of the Tobacco Tenants and Allied Workers' Union, oral communication, July 2000).11,70 Between 1993 and 2000, ECOSOC was the focal point of UN research on tobacco crop substitution and the economic impact of tobacco control.
Hallmark Public Relations provided the funding for TAMA's Thyangathyanga to attend the industry meeting and the ECOSOC meeting in New York (R. Sandramu, oral communication, July 2000).11,70 Thyangathyanga and 4 other Malawians drafted the statement submitted by Yusuf Juwayeyi, Malawi's ambassador to the UN, to the ECOSOC meeting. In that statement, Juwayeyi criticized the WHO treaty process because it lacked transparency, overstated tobacco-related death and disease in relation to HIV/AIDS and malaria, and understated tobacco-generated employment.70 Juwayeyi's remarks were nearly identical to the statements of ITGA,71 BAT,72 and Philip Morris73 on the social and economic consequences of the FCTC. According to ITGA, As a result of support from the [ITGA] PR program, delegations from Zimbabwe (including the UN Ambassador) and Malawi attended the ECOSOC meeting in New York. Following their intervention, decisions to endorse the FCTC were postponed until 2002, when the FAO study of the impact of the FCTC on tobacco growing is completed. FAO made a valuable statement that the importance of tobacco leaf to developing country economies must be recognized and studied further.74
With the Malawi government supporting tobacco industry activities designed to undermine the FCTC, BAT and ITGA were able to use Malawi's situation to influence the first meeting in October 2000 of the WHO Intergovernmental Negotiating Body (INB), created to write the FCTC text.
In August 2000, Charlie Graham, managing director of Limbe Leaf (a subsidiary of US-based Universal Leaf that purchases 50% of Malawi's leaf crop) and chairman of the Tobacco Exporters’ Association of Malawi, revealed details of the company's position on the FCTC in Malawi: [WHO was] fighting for tobacco control in relation to the health side. Now without tobacco in Malawi there isn't going to be any health side anyway. Nobody is going to have any money to buy medicine. Nobody is going to have any money to pay the bills, to run the little hospitals in the districts. You know, the infrastructure is going to take a serious knock if tobacco is reduced. (Graham, oral communication, August 2000)
Graham (oral communication, August 2000) agreed with the notion that it was “Malawi's intention is to be the country that produces the last leaf of tobacco.” With the government of Malawi securely on board with tobacco industry activities designed to undermine the FCTC, BAT and ITGA used the government's stance to influence the first meeting of the INB.
In October 2000, WHO launched the first of 6 INB meetings to complete the FCTC. The government of Malawi sent delegations to all of the INB meetings conducted in Geneva, Switzerland, between October 2000 and February 2003. Table 3 presents the names of government officials who promoted the development of the tobacco industry, demonstrating the multifaceted strategy of transnational tobacco manufacturing and leaf companies to influence policymaking in Malawi. Each of Malawi's INB delegations averaged 7 members, with 5 working for the tobacco industry.
TABLE 3 Members of Malawi's Delegation to World Health Organization (WHO) Meetings of the Intergovernmental Negotiating Body (INB)
| Meeting | Members of Malawi's Delegation | Title and Organization | Known Links to Tobacco Industry | No Known Links to Tobacco Industry |
| First INB meeting (October 16–21, 2000)116 | C. J. Kambauwaa | Assistant director, Department of International Cooperation, Ministry of Foreign Affairs and International Cooperation | X | |
| C. B. Chizonda | Controller, agriculture services, Ministry of Agriculture and Irrigation | X | ||
| H. L. Ng'ombe | Secretary, National Economic Council | X | ||
| T. O'dala | Principal secretary, Ministry of Tourism, Parks and Wildlife | X | ||
| P. M. Liabuba | First secretary (tourism), Malawi High Commission, London | X | ||
| G. Hiwa | Parliamentary draftperson, Ministry of Justice | X | ||
| G. M. Chapola | General manager, Tobacco Control Commission | X | ||
| G. H. Chaongola | Technical and operations manager, Tobacco Control Commission | X | ||
| H. M. Mbaleb | General manager, Tobacco Exporters’ Association of Malawi | X | ||
| J. Kapitob | Executive secretary, Consumers’ Association of Malawi | X | ||
| W. Sangala | Chief technical advisor, Ministry of Health and Population | X | ||
| Second INB meeting (April 30–May 5, 2001)78 | W. Sangalaa | Chief technical advisor, Ministry of Health and Population | X | |
| G. M. Chapolac | General manager, Tobacco Control Commission | X | ||
| E. Chizonda | Controller, agriculture and extension services, Ministry of Agriculture and Irrigation | X | ||
| I. Y. M. Mbelwa | Chairman, Tobacco Control Commission | X | ||
| G. Thyangathyanga | Chief executive, Tobacco Association of Malawi | X | ||
| H. Mbale | General manager, Tobacco Exporters’ Association of Malawi | X | ||
| K. S. A. Moyo | Deputy director, Department of International Cooperation, Ministry of Foreign Affairs and International Cooperation | X | ||
| E. M. Makawa | Treaties officer, Ministry of Foreign Affairs and International Cooperation | X | ||
| Third INB meeting (November 22–28, 2001)79 | W. Sangalaa | Chief technical advisor, Ministry of Health and Population | X | |
| G. M. Chapolac | General manager, Tobacco Control Commission | X | ||
| E. Chizonda | Controller, agriculture services, Ministry of Agriculture and Irrigation | X | ||
| I. Y. M. Mbelwa | Chairman, Tobacco Control Commission | X | ||
| G. Thyangathyanga | Chief executive, Tobacco Association of Malawi | X | ||
| H. Mbale | General manager, Tobacco Exporters’ Association of Malawi | X | ||
| E. M. Makawa | Treaties officer, Ministry of Foreign Affairs and International Cooperation | X | ||
| Fourth INB meeting (March 18–23, 2002)80 | W. Sangalaa | Chief technical advisor, Ministry of Health and Population | X | |
| E. Chizonda | Controller, agriculture services, Ministry of Agriculture and Irrigation | X | ||
| G. M. Chapola | General manager, Tobacco Control Commission | X | ||
| G. Thyangathyanga | Chief executive, Tobacco Association of Malawi | X | ||
| H. Mbale | General manager, Tobacco Exporters’ Association of Malawi | X | ||
| G. Msonthi | Group general manager, Auction Holdings Limited | X | ||
| Fifth INB meeting (October 14–25, 2002)81 | W. Sangalaa | Chief technical advisor, Ministry of Health and Population | X | |
| G. Thyangathyangac | Chief executive, Tobacco Association of Malawi | X | ||
| G. M. Chapola | General manager, Tobacco Control Commission | X | ||
| H. Mbale | General manager, Tobacco Exporters’ Association of Malawi | X | ||
| G. Msonthi | Group general manager, Auction Holdings Limited | X | ||
| H. H. S. Chanza | Deputy controller of agricultural services, Ministry of Agriculture and Irrigation | X | ||
| Sixth INB meeting (February 17–28, 2003)82 | W. Sangalaa | Chief technical advisor, Ministry of Health and Population | X | |
| G. Thyangathyangac | Chief executive, Tobacco Association of Malawi | X | ||
| G. M. Chapola | General manager, Tobacco Control Commission | X | ||
| H. Mbale | General manager, Tobacco Exporters’ Association of Malawi | X | ||
| G. Msonthi | Group general manager, Auction Holdings Limited | X | ||
| H. H. S. Chanza | Deputy controller of agricultural services, Ministry of Agriculture and Irrigation | X |
Note. Links to the tobacco industry refer to individuals being employed with a government or commercial organization that promotes the tobacco industry.
a Chief delegate.
b Advisor.
c Deputy chief delegate.
According to John Kapito, executive director of the Consumers Association of Malawi (CAMA) and advisor to the Malawi delegation to the first INB meeting (INB1), BAT succeeded in appointing tobacco growers to Malawi's INB1 delegation to obstruct the FCTC.75 The WHO office in Malawi funded Kapito to participate as an advisor to the delegation in INB1 (J. Kapito, written communication, March 2007). (CAMA is a member of the Framework Convention Alliance, a network of health organizations supporting a strong FCTC,76 and represented the only significant group in Malawi opposed to tobacco industry interference in the FCTC.) In April 2001, CAMA organized a public demonstration in Blantyre, Malawi, in support of a strong FCTC.77 With the exception of INB1, the association did not participate in Malawi's delegations to the INB meetings.78–82
Given that some members of the Malawi INB1 delegation represented health interests and others represented industry interests, these individuals issued contradictory statements on the FCTC (J. Kapito, written communication, March 2007). During that meeting, Wesley Sangala, the Ministry of Health's chief technical advisor and an advisor to the INB1 Malawi delegation, noted that the Malawi delegation welcomed the FCTC and that the treaty would help local farmers find alternative crops to tobacco.83
In fact, the governments of Malawi and Zimbabwe, as tobacco-growing developing countries, were not always entirely supportive of the tobacco manufacturers. In April 2000, Eugene Philhower, an aide in the US trade mission in Geneva, Switzerland, reported to James Regan, a tobacco industry consultant, that the governments of Malawi and Zimbabwe were “somewhat conflicted”: While they sympathize with the developing countries on bashing the multinationals and criticizing the industrialized world, they also want to protect their own domestic industries.61
Philhower added that “there is a remote chance that Zimbabwe and Malawi will object or try to slow down” the FCTC negotiations.61
Other members of Malawi's delegation to INB1 argued that “the treaty might not be in the best interest of Southern African tobacco growing countries.”84 Such statements did not satisfy the tobacco industry; in an internal brief on the outcome of INB1, Andreas Vecchiet, BAT's manager of international political affairs, reported that “Malawi was next to hopeless in that they did not show up for the hearings and possibly at least the first day of the INB as they had planned.”85 Malawi's delegation did not always act in a manner that pleased transnational tobacco manufacturing companies.
The Malawi presence at the remaining 5 INB meetings better suited BAT and other transnational tobacco manufacturing and leaf companies. TAMA's Thyangathyanga attended these meetings and was a leading spokesperson on the benefits of tobacco growing in Malawi. In 1999, Thyangathyanga advised the Malawi government “that the Tobacco Industry in Malawi should accompany all delegations discussing Tobacco in the UN regardless of the agency.”60
In an August 2001 BAT Web site news report (Malawi Says No Economic Life Without Tobacco86), Thyangathyanga noted that 90% of Malawi's development budget is dependent on donor handouts and that any losses of income from global restrictions on tobacco would further exacerbate the situation. In October 2001, 1 month before the third INB meeting, Bakili Muluzi, Malawi's president from 1994 through 2004, reinforced Thyangathyanga's views and assured TAMA and ITGA that the government would “continue promoting the production and marketing of tobacco until viable alternatives are found.”87
Malawi's industry-stacked delegation to the INB meetings had little influence on the tobacco control positions of the WHO African Region, a group consisting of 46 African countries. The African Region advocated that evidence-based policies be included in the FCTC and issued 6 declarations between October 1999 and September 2002 promoting a strong version of the framework.88–93 The African Region's participation in the FCTC negotiations as a single block blunted Malawi's impact on the discussions and the text of the treaty.
After the final INB meeting in February 2003, the tobacco industry in Malawi concluded that the draft FCTC did not represent an immediate threat to the country's tobacco sector. According to Graham (oral communication, March 2003), I think by virtue of the fact that they [Malawians] haven't had an imposition of ‘you will stop growing tobacco in ten years’—if it [FCTC] doesn't state that, in other words if [Malawians] are not given a timeframe within which they must stop growing tobacco, then I think it is a victory.
Although the tobacco industry and the national media in Malawi reported that the FCTC would establish a deadline to end tobacco growing,29 it was never the intent of the FCTC to establish such a deadline.
Government officials, tobacco farmers, trade unionists, and health advocates in Malawi have had both oppositional and supportive relationships with the tobacco industry. In an April 2003 interview, in response to a question about the belief that the FCTC would have a negative impact on Malawi's, tobacco sector, Wesley Sangala, chief technical advisor for the Ministry of Health and population, noted: That was our fear as we started negotiating from INB1 through [the fourth INB meeting]. But [at the sixth INB meeting] a new aspect has come up. I understand there has been a study [Curbing the Epidemic94] by the World Bank which has shown that in fact the demand is going to increase because the population overall will increase, [as will] the population of prospective tobacco smokers. Therefore, the demand for tobacco leaf is still going to be there. But at the beginning our view was that there would be a drastic reduction in the demand for the tobacco leaf and therefore our economies would suffer. We therefore put in the Convention programs that would assist countries like Malawi to diversify away from [the] tobacco industry to possible alternative crops or possible economically viable options. (W. Sangala, oral communication, February 2003)
When asked whether the Malawi Ministry of Health would push for stronger tobacco legislation as a result of the FCTC, Sangala stated that “[w]e will be putting in place the legislation as articulated in the Convention and within our means that we can enforce in this country” (W. Sangala, oral communication, February 2003). Sangala's statements illustrate the limits of the influence of transnational tobacco manufacturing companies in Malawi's health policymaking process.
In April 2003, TAMA president Albert Kamulagu noted that “[w]e're now comfortable with this FCTC version because it does not force us to accept tough restrictions”95; he also expressed satisfaction that “much of the [draft convention] has been watered down” (A. Kamulagu, oral communication, February 2003). In June of that year, in an attempt to assign more credit than was actually due to Malawi with respect to its opposition to the FCTC, Kamulagu stated: We [Malawi tobacco industry] strongly believe that the joint opposition to [the FCTC] by the key members of the ITGA forced the authors of this convention to soften their stand, making it a bit weaker than the original one.96
Despite the view that the treaty was ineffective, Gwanda Chakuamba, Malawi's minister of agriculture, noted in February 2005 that “[t]obacco is running the country's economy, and Malawi will not ratify the [WHO] convention.”97
Godfrey Chapola, the general manager of the Tobacco Control Commission of Malawi and a delegate at all 6 INB meetings, observed in March 2006 that “I don't believe [the FCTC] will affect … Malawi tobacco in the near future.” According to Chapola, the impact of the FCTC in Malawi would be to “keep or maintain the present levels of production and consumption or to slow down the rate of increase of consumption and production. Or at best keep the status quo as it is now” (G. Chapola, oral communication, March 2003). As of April 2009, Malawi had not signed or ratified the FCTC, and there was no indication that the country would do so (R. Sandramu, written communication, February 2008; J. Kapito, executive secretary, Consumers' Association of Malawi, written communication, February 2008).
Transnational tobacco manufacturing and leaf companies and the government of Malawi are concerned with decreases in the global demand for tobacco after the implementation of tobacco control measures. Jacobs et al. noted that Malawi, relative to countries that are not major producers and net exporters of tobacco, “would have higher transition costs if global demand falls.”98 A global decrease in demand for tobacco would create high transition costs and short-term job losses in Malawi, resulting in a need for financial assistance so that the country can pursue crop replacements and nontobacco jobs.4,99 FAO projected an annual growth in total tobacco leaf exports of 0.8% between 1991 and 2010.68 Tobacco leaf production in Malawi and other developing countries increased from 76% in 1991 to 90% in 2006.68,100
As mentioned, the FCTC's effects on global tobacco demand will occur over several decades, not in the short term, and the impact on jobs and farmers will occur in future generations.44,45 Richard Tate, the ITGA president and the president of the Zimbabwe Tobacco Association, agreed with the belief of WHO representatives at a meeting in March 2000 that tobacco control measures would not create a significant drop in consumption of tobacco products in the short or medium term.101 The FCTC in Malawi might reduce growth in the global demand for tobacco products rather than cause a sharp decline in tobacco use.102
To our knowledge, the potential short- and long-term effects of a global decline in tobacco consumption on Malawi's domestic economy have not been studied. In a draft study on tobacco control policies and employment, World Bank economist Ping Zhang suggested that threats to jobs from trade policies governing Malawi's export markets overshadow the threat to jobs in the country's tobacco sector from tobacco control policies.103
Beginning in the 1980s, transnational tobacco manufacturing and leaf companies and surrogate groups used government and farming representatives in Malawi and other developing countries to weaken and delay global tobacco control efforts and influence the FCTC negotiations.11 They used health policies as a vehicle to assert tobacco industry power and encourage the Malawi government to promote industry arguments about the economic benefits of tobacco to undermine the FCTC. In these efforts, the tobacco industry invoked a strategy similar to its 1980s argument that tobacco is not a Third World problem. However, the industry was unable to portray Malawi and other tobacco-growing developing countries as free from health and socioecological problems caused by tobacco use and tobacco farming.
Transnational tobacco manufacturing and leaf companies used farmers and high-level officials at each end of the policy chain continuum to undermine measures designed to regulate tobacco production and consumption. BAT and other cigarette manufacturers, through ITGA, produced and disseminated reports on tobacco's contribution to Malawi's economy predicting that job losses would occur and foreign earnings would decrease with the passage of the FCTC.104
Industry representatives on Malawi's delegations to WHO meetings introduced resolutions or made amendments to tobacco-related resolution in UN organizations focused on tobacco control to delay the policy process through research on the economic implications of tobacco control in tobacco-growing countries. The FCTC negotiations primarily focused on health; however, the industry, through the Malawi government, lobbied to keep economic issues in the FCTC negotiations and argued for consideration of more research on tobacco economics. This focus on economics probably delayed the FCTC and contributed to weakening efforts to place public health considerations above trade.105
As a result of Malawi's economic reliance on tobacco, the country is vulnerable to tobacco industry arguments that tobacco control contributes to job losses, foreign earnings reductions, and poverty. Although tobacco is cultivated in more than 130 countries,106 only Malawi and 7 other small countries (Zimbabwe, Bulgaria, Moldova, the Dominican Republic, Macedonia, Kyrgyzstan, and Tanzania) derive at least 1% of their export earnings from tobacco.94,98 BAT and Philip Morris, through ITGA, formed the main opposition to the FCTC and other tobacco control efforts, placing Malawi at the center of improbable disaster scenarios to argue the negative consequences of such efforts.96 By lobbying government and TAMA officials in Malawi, transnational tobacco manufacturing and leaf companies and ITGA diverted policymakers’ attention from health issues to economic issues in attempts to derail the FCTC.
In 2004, the Ministry of Health's Sangala noted that although the Malawi government had not signed or ratified the FCTC for “technical reasons,” he believed that the country should do so because it “could take advantage of this framework to diversify our economy,”107 opening up monetary and technical assistance from the FAO, the European Union, and other sources of multilateral and bilateral aid to wean the country off tobacco.108,109 In May 2007, a WHO ad hoc study group on agricultural diversification and crop alternatives to tobacco reported that Philip Morris, BAT, and ITGA continued to undermine and confuse tobacco control discussions and policies on crop diversification schemes in Malawi and other tobacco-growing countries.110 The WHO study group recommended that more research be conducted on tobacco cultivation and economically viable alternatives and noted that countries must “protect their domestic policies to promote economically viable alternatives to tobacco cultivation from industry influence.”110
In a June 2008 meeting of the ad hoc study group in Mexico City, Mexico, government leaders, policy experts, and civil society representatives agreed on a draft progress report on Article 17 of the FCTC, which focused on creating funding mechanisms to pay for crop substitution and alternative livelihood schemes in Malawi and other developing countries. The report was sent for comment to parties of the study group, revised, and presented at the Third Conference of the Parties in Durban, South Africa, in November 2008 (countries that are parties to the FCTC are members of the Conference of the Parties). Parties at that conference established a working group on economically sustainable alternatives to tobacco growing to replace the study group and to draft guidelines for the implementation of Article 17.
The working group, made up of representatives from Brazil, Greece, India, and Mexico, was mandated to submit a progress report and, if possible, policy recommendations at the Fourth Conference of the Parties in Uruguay in 2010. Article 17 implementation guidelines as well as the guidelines adopted at the Third Conference of the Parties for FCTC Article 5.3,111 which limits tobacco industry interference in tobacco control policymaking, will be used to promote nontobacco crops and limit tobacco companies’ influence in crop replacement schemes. Through concerted efforts to reduce the lobbying power of tobacco companies and grower organizations in Malawi, health researchers and policy advocates could prevent the undermining of funding schemes and other efforts to diversify Malawi's economy that emerge from discussions on economically sustainable alternatives to tobacco growing.
In conclusion, BAT, Philip Morris, and ITGA attempted to weaken the FCTC through a proxy country, Malawi, and diverted the attention of tobacco control policymakers from health concerns to the framework's economic implications, particularly with respect to tobacco-growing countries. Transnational tobacco manufacturing and leaf companies and their surrogate groups (through TAMA) succeeded in influencing the government of Malawi to recommend that UN organizations involved in tobacco control conduct research on the economic contributions of tobacco to developing economies.
Despite evidence of the economic benefits of tobacco control, Malawi has been vulnerable to the economic arguments of the tobacco industry because of the country's extreme reliance on tobacco growing. As a result of the influence of BAT and Philip Morris, ITGA, and TAMA on health policymaking in Malawi and the country's dependence on tobacco growing without reliable substitutes or alternative livelihoods to tobacco in sight, Malawi represents a valuable case study through which tobacco control policymakers and educators can further their understanding of the obstacles involved in implementing effective tobacco control policies in developing economies.
Transnational tobacco manufacturing and leaf companies’ efforts to influence Malawi government representatives and farming officials serve as an example of the ways in which the tobacco industry attempts to undermine global tobacco control policies. Through health policymakers’ attention to tobacco industry influence in tobacco-growing societies, it might be possible to end industry interference and promote economically sustainable alternatives to tobacco growing, as envisioned in the FCTC. Despite the industry's success in mobilizing Malawi to oppose the FCTC, these efforts did not substantially weaken the framework or the implementing protocols that have been developed to date.
Acknowledgments
This article was produced with the support of a postdoctoral fellowship from the American Cancer Society (to M. G. Otañez) and research and training grants (CA-87472 and CA-113710) from the National Cancer Institute.
Note. The funding agencies played no role in the conduct of this research or the preparation of the article.
Human Participant Protection
The institutional review boards of the University of California, Irvine, and the University of California, San Francisco, approved the interview protocols used in this study.
