Tobacco control advocate Ulysses Dorotheo, MD
In defense of the PICTURE-BASED HEALTH WARNING LAW
By Perry Gil S. Mallari Reporter
The Philippines is in violation of an international treaty much of the world has been wise enough to heed. And with each day that we fail to comply more Filipinos spiral into addiction, die of debilitating diseases and cripple the economy. In September 5, 2005, the Philippines became a signatory to the Framework Convention on Tobacco Control (FCTC), the world’s first global health treaty signed by over a hundred nations.
As a party to this agreement, the Philippines is bound to implement its full measure come September 2008 including the passing of the Picture-Based Health Warning Law. The said bill when enacted would oblige tobacco companies to put graphic health warnings on cigarette packs.
The passing of the Picture-Based Health Warning Law is now stalled in the Lower House of Congress. Ulysses Dorotheo, MD, senior policy adviser of the Framework Convention on Tobacco Control Alliance, Philippines (FCAP), expresses his concern on the implications of the treaty violation both on public health and the country’s international reputation.
Strong opposition
Dorotheo blames the strong opposition by a number of lawmakers in the Lower House for the delay of the passage of the Picture-Based Health Warning Law. He narrates that trouble began after three public hearings when the Health Committee decided to put up a technical working group (TWG) to appease the two camps of lawmakers debating on the bill. “At that time, the goal of the TWG was to arrive at a consensus and determine revisions if there are any but what happened was there was no discussion of the law from the very beginning, the northern block of lawmakers was just there to kill the bill,” he bemoans.
Dorotheo named two congressmen—Rep. Eric Singson of Ilocos Sur and Rep. Vincent Crisologo of the First District of Quezon City—as the lawmakers who are foremost in opposing the Picture-Based Health Warning Law. “Their contention was that our six million tobacco farmers and their families in the Ilocos region would go hungry if the graphic health warning law was passed,” he points out.
Counterargument
Dorotheo admits that the number was quite sizeable so FCAP decided to determine the validity of the argument. “We went to the Ilocos region and talked to the farmers there and we found out that that was not the case. They are already starving and many are neck-deep in debts,” he relates. Dorotheo adds that a lot of farmers they interviewed were willing to shift from tobacco farming to cultivating other crops if only they have the technical know-how and resources. The reason behind this, the physician explains, is that cultivating tobacco is a very labor-intensive chore, “It usually involves the whole family from dusk till dawn robbing them of a quality life.”
Dorotheo reveals that a number of party-list organizations have already exerted efforts to help the impoverished tobacco farmers to make the shift from tobacco farming to cultivating alternative crops but their funds were not released until now. “I don’t know what these lawmakers opposing the graphic health warning bill are doing to address this problem,” he intones. Based on the FCAP’s investigation, Dorotheo is adamant that there is no correlation at all between the passage of the Picture-Based Health Warning Law and the economic condition of Filipino tobacco farmers.
Dorotheo says that 23 countries and territories in the Asian region including Thailand, Singapore, Brunei, Malaysia, Taiwan and Hong Kong have already required the graphic health warning law. “Many of these states have lots of tobacco farmers but none of them suffered economically because their countries implemented the picture-based health warning bill,” he stresses.
Regardless of the impact of the graphic health warning law implementation on local tobacco farmers, two facts are undeniable:
1. The tobacco industry does not benefit the common farmer beyond meager sustenance. Despite centuries of trade and the great wealth accrued by cigarette companies, tobacco farmers remain poor.
According to the Solidarity of Peasants Against Exploitation (Stop-Ex) in August of this year, former tobacco farmers in La Union have successfully farmed corn for the last five years and could harvest and earn more with technical assistance from the government. With tobacco farming, traders charge high interest rates and control the buying price as a loan condition.
2. The cost to the national economy in lost man-hours, health expenses and mortality far outweigh any benefit the tobacco industry may produce.
According to the World Health Organization’s Smoking Statistics of 2002, “About 200,000 Filipino men will develop smoking-related diseases in their productive years of age. To provide health care for these sick men and to cover the loss in productivity, it was estimated that it would cost Filipino taxpayers some P43 billion… Every year, there are about 20,000 smoking-related deaths in the country… Tobacco use will drain nearly 20 percent of the household income of smokers’ families.”
Plan of actions
Dorotheo announces that FCAP is currently gathering support from other public sectors like environmental and urban poor groups to rescue the Picture-Based Health Warning Law. “This is for the good of everybody because it’s all about informing the public and the consumers of the lethal dangers of smoking,” he says, continuing, “The citizens must also do their part by writing their lawmakers, their priests and their business leaders on their concern regarding the issue.”
While the Picture-Based Health Warning Law was given a hard time in the Lower House, Dorotheo believes that it would sail smoothly in the Senate. “The two authors of the bill are Sen. Aquilino Pimentel and Sen. Pia Cayetano, the doctor says, adding, “The other senators say they want some clarifications but express no opposition to the law unlike some lawmakers in the Lower House.”
The intrepid physician emphasizes that there is really no rationalization for opposing the graphic health warning bill because it’s pro-health, pro-poor and pro-Filipino. “The lawmakers who are opposing this law are therefore anti-health, anti-poor and anti-Filipino,” he explains.
Dorotheo intones that there is one intervention that can pull out the Picture-Based Health Warning Law from the quagmire fast and that is if President Gloria Arroyo certifies the bill as urgent. “That would put more weight on the law,” Doroteo narrates spiritedly.
While violation of the FCTC treaty would not result in harsh sanctions like trade embargo, such act leads to the erosion of national pride and international shame. Dorotheo relates that the Philippines was among the countries that developed the guidelines for the FCTC. “The Philippines then made strong recommendations to shift from text-based health warning to picture-based health warning on cigarette packs and now we are not following it. On an international level, this will put our country to shame,” Dorotheo cautions.
An advocate, plain and simple
Dorotheo, who started as an FCTC volunteer in 2001, credits his parents as his main inspiration in being a stern tobacco control advocate. “They are both religious and have a heart for the poor,” he beams. During his early practice as a physician, he witnessed firsthand how tobacco made the poor poorer after they contracted tobacco-related illnesses such as lung cancer and emphysema. Dorotheo also noticed the scarcity of physicians involved in tobacco control advocacy. This, he took as a challenge to carry on the fight against the evils of tobacco.
From being an FCTC volunteer, Dorotheo eventually became one of the founding members of FCAP, the organization highly instrumental in the country’s ratification of the FCTC treaty. Currently, the FCAP is headed by two women doctors—Marilyn Lorenzo, MD, as president and Maricar Limpin, MD, as executive director. Dorotheo relates that the FCAP will continue to exist even when the Picture-Based Health Warning Law is passed, “It also has a watchdog function,” he clarifies.
To convey the dire circumstances of stalling the graphic health warning bill, the FCAP has set up “death clocks” on various locations in the country. It displays a countdown stating that for every day that passed without the bill being passed, the Philippines lost 240 Filipinos to tobacco-related diseases. “That’s 10 lives every hour,” stresses Dorotheo, concluding, “That’s a grim reminder not only to our policy makers but to our whole country as well.”
Online at: http://www.manilatimes.net/national/2008/sep/28/yehey/weekend/20080928week1.html
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