Every day, more than 14,000 people die worldwide from tobacco use. Most tobacco-related deaths occur in low- and middle-income countries -- areas that are targets of intensive tobacco industry marketing. To reduce these preventable deaths, the tobacco control movement needed more and better funding, planning, technical capacity, and a coordinated strategy among stakeholders. Launched in 2007, the Bloomberg Initiative to Reduce Tobacco Use has changed the landscape of global tobacco control with a commitment of more than $600 million to combat tobacco use worldwide. The Bloomberg Initiative aims to reduce the global demand for tobacco through comprehensive, proven approaches of working with national bodies that combine policy change with increased public awareness. Key strategies of the tobacco control programs worldwide include creating smoke-free public places, banning tobacco advertising, increasing tax on tobacco products and requiring graphic pack warnings.
As one of the key global partners of the Bloomberg Initiative, The International Union Against Tuberculosis and Lung Disease (The Union) is at the forefront of this growing international effort to reduce tobacco use and lower cases of lung disease worldwide. Since 2007, with support from the Bloomberg Initiative to Reduce Tobacco Use, The Union designed a series of courses, as part of its flagship education program -- the International Management Development Programme (IMDP) -- and trained over 2,300 tobacco-control leaders from 150 non-governmental organizations (NGOs), and dozens of Ministries of Health around the world on how to develop and manage anti-tobacco programs for their respective countries. The IMDP's 10th anniversary seems like a good moment to reflect and answer the basic question:
Are tobacco control programs likely to succeed if they adopt good management practices?
The IMDP's management courses specifically target low- and middle-income countries, areas with the highest burden of tobacco use and tobacco-related deaths. In such low-resource settings, the ability of tobacco control program managers to respond effectively against the intensive tobacco industry marketing tactics, as well as rapidly changing political landscape, can be a crucial difference between more tobacco-related deaths or saving millions of lives through a smoke-free legislation, tobacco taxation and hard-hitting public health campaigns. Overall, we have learned three things at the IMDP:
- According to the participants' case studies and interviews, the majority of the tobacco control programs throughout the world are lacking basic management capacity, including project planning, leadership development and budget and financial management. Successful public health programs invest into developing management capacity, as well as more complex tools such as monitoring and evaluation.
- Based on the most recent 2013 IMDP alumni surveys, improvements in management competences are strongly correlated with measures such as productivity, return on training investments, and, ultimately organizational survival. Management training in public health strengthens health systems and saves lives.
- Individual program management makes a difference in shaping national performance. Our experience shows countries with the most progressive tobacco control policies are also the ones that received the most comprehensive management trainings.
Whereas the tobacco industry has millions of dollars devoted to the promotion of their harmful products, government and nonprofit tobacco control programs rely on the existing system-wide skills of their workforce to combat tobacco use. Despite these vast differences in financing, Bloomberg Initiative-supported country level tobacco control interventions, including The Union's training, have generated measurable results. Since the first WHO Report on the Global Tobacco Epidemic was released five years ago, the population covered by at least one effective tobacco control measure has more than doubled to 2.3 billion. Over the same period, 48 countries have taken critical action to put effective tobacco control measures in place. Low- and middle-income countries account for 39 of the 48 countries that have made progress on curbing tobacco use.
Reducing a personal tobacco addiction requires daily management of the habit and a strong support system; similarly, the human resources development and health systems strengthening are necessary to help to combat the global tobacco epidemic.