Mbongwe - Sheer will to win the fight against tobacco use
It is not everyday that you meet someone whose commitment to a cause is never unshaken. Often times, people start something, then get derailed along the way and shift focus. However, that has never been the case for Ramotswa-born Professor Bontle Mbongwe, whose commitment to fight tobacco use is unrivalled. She has lost many of her relatives at a young age due to the use of tobacco. This has become her main drive to champion the campaign against tobacco use and she is in it to win. Mbongwe is living truth to the Setswana saying that ‘Mosadi ke thari ya sechaba’.
As the first woman in Botswana to have training in environmental health, a profession initially dominated by men, her fight against tobacco use comes a long way back since her days as a public health professional in the Ministry of Health and Wellness. She has gone on to set up the Anti Tobacco Network (ATN), and receive awards, including the recent one, in recognition of her sterling role in the fight against tobacco use. She said her first eye opener was back on April 7, 1988 when the first World No Tobacco day was first commemorated. “I still remember the theme and the colour of the T-shirts prints... it was blue, black and white. I took two T-shirts to my mum and Dad in Ramotswa. The T-shirts were themed ‘Tobacco or Health, Choose Health’.
My dad never wore his T-shirt until he quit. Unfortunately, he wore it for only three months and then he passed on from respiratory and heart diseases.
My dad brought hope to me that addictive as it is, with motivation and support quitting is possible! This is where my tobacco control journey began,” she revealed. In 2000, she was then assigned to be part of a delegation that negotiated the WHO Framework Convention on Tobacco Control and that is where she learnt a lot about tobacco control advocacy, programming and policy. It was at the end of the negotiations, where she got her first WHO Director General’s award for leadership in global tobacco control. Mbongwe said being the recipient of the recent award means the work that she and the organisation she leads, the ATN, does is reaching out to the international community, who in turn appreciate “what we do”. “I am greatly honoured by these recognitions from the international community.
I know there are many people out there in the international arena who are doing a great job. The current recognition is dedicated to the staff and volunteers of the Anti Tobacco Network, its Board of Directors, and my family, friends and the Government of Botswana. I am grateful to WHO and the tobacco control community nationally, regionally and internationally,” she said. Mbongwe stated that fighting tobacco use is not an easy thing, but thanked the government for listening to their calls, especially recently when the COVID-19 pandemic broke out. Mbongwe said had the government not listened to their calls to ban tobacco sales during the COVID-19 pandemic state of public emergency, the effort could have not been noticed as much as it did.
She also said the media, which for many years has been influential instrument in the tobacco control realm in Botswana, has also played its part as the powerful voice behind civil society listened to by thousands of Batswana as well as millions of people across the globe. She said as the tobacco industry sharpens its tools to recruit more smokers, particularly the young and to interfere with public health policy, the media is undoubtedly a powerful tool in getting tobacco control messages to the public and as people say “the engine by which public opinion is formed”. Mbongwe also expressed gratitude to her employer, the University of Botswana (UB), for supporting the campaign and accepting it as a community service initiative. She stated that UB currently hosts the Anti Tobacco Network and has made its resources available.
Mbongwe explained that at the time she left government in 2004 to join UB, (I was the then head of Environmental Health Unit in the Ministry), her team had started the amendment of the Control of Smoking Act to be aligned to the WHO Framework convention on tobacco control. She said they have successfully lobbied for a tobacco levy fund in 2014 and have recently scored a point when the government published the Tobacco Control Bill No. 9 of 2021 published on March 12, 2021. Mbogwe also said tobacco use rates are high given that Botswana is not even a country whose economy is dependent on tobacco farming.
She said that was reflected in the most recent national research, the Global Adult tobacco survey of 2017 which showed that 18% (240,000 adults) of Batswana use tobacco, making Botswana amongst the highest adult tobacco use rates in sub-Saharan Africa. The survey further shows that 12% (40,000) of adults who work indoors are exposed to tobacco. Further 67% (260,000) adults are exposed to tobacco smoke in bars and night clubs. The good news is that 84% of tobacco smokers planned to or were thinking about quitting. “Our current focus is on the published Bill. Our intention is to assist the government in making sure the Bill passes in Parliament without the interference of the Tobacco industry. We have to make sure the public, politicians and civil society understand the provisions provided in the Bill and how such provisions will save many lives from tobacco harms,” she said.
However, she said they still have a fight in their hands as the tobacco industry will use everything possible, including the use of poor people, to oppose the law as they believe it will deny them of income from the sale of tobacco products. She said, while the tobacco industry continues to fight for their income, they will not say how much losses the government incurs from treating Non Communicable diseases (NCDs), lost productivity due to sick people and absenteeism.
As it is, she said, their campaigns have canvassed enough support as the public knows about the dangers of tobacco including the majority of smokers 83% of whom are planning or thinking of quitting according to the 2017 survey.
“Ninety-five percent of adults believe smoking causes serious illness 91% of adults believe breathing other, people’s smoke causes serious illnesses. This is the evidence we have that Batswana are supporting the anti tobacco movement and Government initiatives to control tobacco,” she added. According to Mbongwe, NCDs are estimated to account for 31% of all deaths. She said there is need to reduce tobacco use because it is a common risk factor to the main NCDs such as cardiovascular disease, cancer, chronic respiratory disease, and other diseases including tuberculosis and neurological disorders. She called on the society to effect smoke-free environments and encourage use of plain tobacco packaging with large pictorial health warnings for all tobacco products.
For these to happen, she stressed, bold political decisions are needed to significantly increase real prices of tobacco products through taxes, ban added ingredients that are currently used to increase the attractiveness of tobacco products particularly to the youth and ban the tobacco industry’s corporate social responsibility initiatives.