The research in Lesotho shows that the effects of the “smokers’ pandemic” are already being felt.
Lesotho’s most important economic politician is sitting in the garden of a hotel and fears for his re-election. Mahooana Khati nervously slides back and forth on a white plastic chair. All morning the parliamentarian in the building next door debated with other parliamentarians about a law that he actually wanted to avoid. The tobacco tax should come. Finally – Lesotho is one of the last countries in Africa where cigarettes are sold without a separate tobacco tax and are therefore unusually cheap.
There is a simple rule in his country, says Khati, the chairman of the parliament’s economics committee. “Whoever makes cigarettes more expensive will not be elected.” It’s as simple as that. At the moment, the package costs the equivalent of around 1.50 francs, and they are often offered on the streets via criminal channels for only half the price.
Strong tobacco lobby
In the end, however, Lesotho’s lawmakers were left with no choice. The country has asked the International Monetary Fund for financial support during the pandemic. Its experts noticed that Lesotho largely neglected special taxes on tobacco as an important instrument for budget financing – and without further ado declared the introduction to be a condition.
A tobacco tax of 30 percent had been envisaged in an initial draft by the government. In the end it was only six percent. Why? Khati admits that there have been five meetings of the Economic Affairs Committee with representatives of the tobacco lobby in the past few months. He does not want to reveal details. On the other hand, there were no consultations with representatives of health organizations, although they had vehemently asked for it.
“Whoever makes cigarettes more expensive will not be elected,” says Lesotho parliamentarian Mahooana Khati.
A pack of cigarettes costs 1.50 Swiss francs in Lesotho – even significantly less on the black market.
The case shows that even in small African countries like Lesotho, with its two million inhabitants, big tobacco companies are trying hard to expand.
Africa is considered an important future market for cigarette manufacturers: the continent’s population is growing by 2.4 percent annually and is expected to double by 2050. While the sales market in the industrialized nations is shrinking, significant growth rates are enticing in Africa.
According to the World Health Organization (WHO), the number of smokers worldwide has fallen over the past twenty years and is now around 1.3 billion. In Africa, meanwhile, it rose from 64 million to around 73 million today. It is true that people on the continent still smoke less than in other regions of the world. But the trend is upwards – and many tobacco manufacturers see this as an opportunity.
“We’re heading for a deadly smokers’ pandemic”
Mphonyane Mofokeng has her office in a dilapidated building in Maseru, the capital of Lesotho. When her father, a chain smoker, died of cancer, she founded an NGO that aims to raise public awareness of the risks of tobacco use, among other things. The 60-year-old wants to achieve with young people in particular what she couldn’t achieve with her father: to protect them from the dangers of smoking.
She is in danger of losing her belief that this is possible these days. In vain she asked the economic committee in Lesotho for an appointment, hoping for higher prices and higher hurdles for access to cigarettes. She wanted to tell about the boy who came to the hospital at the age of eight – lung cancer, his parents had smoked in the house. She wanted to report on the countless shepherd boys for whom smoking in the fields is still part of everyday life. Vain.
It is true that people in Africa still smoke less today than in other regions of the world. But the trend is pointing upwards.
“We are heading for a deadly smokers’ pandemic if tobacco doesn’t become more expensive,” says activist Mphonyane Mofokeng from Lesotho.
At some point she invited herself and went to one of the meetings of the committee. It has been cancelled.
“We are heading for a deadly smokers’ pandemic if tobacco does not become more expensive,” says the activist. In addition, the existing laws must finally be enforced, such as smoking bans in public buildings or sales bans near schools. That hardly ever happens.
Allegations of corruption also in other African countries
When she finally found out that the politicians only wanted to introduce a fifth of the originally planned tobacco tax, she immediately thought of corruption. “Whenever something like this happens, there is something behind it,” she says. There is a certain way in Lesotho how the tobacco lobby handles it. Sometimes a plot of land is bought for a politician.
She has no evidence of this. But there are no new allegations against the cigarette industry in Africa. In 2015 published the BBC a post about Paul Hopkins. The Brit had worked for the tobacco company British American Tobacco in Kenya for 13 years – and then became a whistleblower. “BAT bribes people and I organized it,” he said in an interview. “If you have to break the rules, then break the rules.”
Many smokers in Africa start smoking as children.
Africa is considered an important future market for cigarette manufacturers: the population of the continent is expected to double by 2050. Pictured: young smokers in Diepsloot Township in Johannesburg.
Hopkins presented documents that the BBC believes show the company made illegal payments through him to country representatives of a WHO anti-tobacco campaign. In Burundi, a high-ranking official was said to have been bribed in hopes that an anti-smoking law would be weakened.
The broadcaster also released a secretly made audio recording that allegedly shows a BAT lawyer approving bribes. BAT denied the allegations, but last year, after a long investigation, the responsible British law enforcement agency found that there was not enough evidence for an indictment.
Significant health effects
The health consequences of increased tobacco consumption in Lesotho can be observed in the hospital in Mafeteng, a small town 80 kilometers south of Maseru. Here doctor Waheeba Madani is again dealing with patients with lung problems. She has just treated 71-year-old Moshao Setlaba, who smoked every day for almost 50 years. Not a lot, he says, five to ten cigarettes a day. Even when the miner fell ill with tuberculosis twice, he didn’t stop – tobacco was part of everyday life in the mines. Some time ago he gave up cigarettes after all. “I cough all night and have chest pains,” complains the emaciated pensioner.
Eighty percent of Doctor Madani’s male patients are active or ex-smokers – among women, as in most countries, the figure is significantly lower. Overall, Lesotho’s government currently puts the proportion of smokers at an enormous 47.9 percent of adults. For comparison: 23.8 percent smoke in Germany and 27 percent in Switzerland.
Moshao Setlaba smoked for 50 years. “I cough all night and have chest pains,” he says today.
Doctor Waheeba Madani with a patient.
“We have more and more patients with severe respiratory diseases,” says Madani. “People start smoking as children and it often makes other diseases worse, such as tuberculosis, HIV or the consequences of malnutrition.”
In the past, doctors in Lesotho would have automatically attributed lung diseases in miners like Setlaba to the difficult conditions underground. “It is now clear that smoking is the most important factor for most patients,” says Madani. For the population, this is one of the greatest health risks – far more than cardiovascular diseases, which dominate the causes of death in industrialized nations.
However, the Mafeteng hospital lacks the means and equipment for an accurate diagnosis. The doctor will therefore send Setlaba to the capital Maseru. But even there, the options are limited. Ultimately, the patient must hope for an appointment in a state hospital in neighboring South Africa, which occasionally admits patients from Lesotho. So weeks will pass before the exact diagnosis is made. At least.
“They are too powerful, too big, too well connected”
Southern Africa is only slowly developing into a relevant tobacco sales market – its history as a cultivation location, on the other hand, goes back centuries. In this area, too, the reputation of the industry is dubious, to say the least. Released a few months ago the BBC documents, which suggest that British American Tobacco employees paid bribes to Zimbabwe’s ruling party, Zanu-PF. It is about payments of $ 300,000, with which the closure of cigarette factories of the competition should have been obtained. In addition, the British company had other manufacturers spied on.
Mafeteng Hospital: Many patients are current or ex-smokers.
Johann van Loggerenberg says about the tobacco companies: “They are too powerful, too big, too well connected.”
Johann van Loggerenberg is not surprised. For a long time he investigated for the South African tax authority against smugglers and tobacco companies who avoid taxes. “There will be no consequences, I can assure you,” said the 52-year-old in a conversation in Johannesburg, “such scandals and negative PR are factored into the business model of these corporations. A bad day at work, then it goes on.”
Even in industrialized nations, high-ranking managers are not held personally accountable, says van Loggerenberg. The worst that could happen would be penalties for the group – “then life goes on”. If it works like that in the industrialized nations, then one can imagine how it works in developing countries. “They are too powerful, too big, too well connected.”
This research was funded by the European Journalism Center (EJC) through the Global Health Journalism Grant Program for Germany.