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College of Public Health

The Case of Malawi

American Journal of Public Health

JOHNSON CITY Philip Morris, British American Tobacco and other tobacco companies use numerous tactics to oppose global tobacco control and suppress health concerns related to tobacco production and use in developing nations, according to a new study by a faculty member in East Tennessee State Universitys College of Public Health.

ETSUs Dr. Hadii Mamudu co-authored the study, which is published in the October issue of American Journal of Public Health. Mamudu and two colleagues focus on Malawi, a nation whose economy is more dependent on tobacco than any other around the globe. It is also one of the worlds poorest countries.

In Tobacco Companies Use of Developing Countries Economic Reliance on Tobacco to Lobby Against Global Tobacco Control: The Case of Malawi, Mamudu and his co-authors, Drs. Stanton Glantz and Martin Otaez, note that tobacco accounts for 70 percent of foreign earnings in Malawi a landlocked country in southeastern Africa and between 600,000 and 2 million members of the countrys workforce are directly employed in the tobacco industry.

Malawi was the seventh largest global exporter of tobacco leaf in 2005 but ranked 14 th on the list of poorest nations, with some of the worlds lowest indicators for human development. For example, only 44 percent of the countrys people will survive to be 40, and 27 percent do not have access to clean water.

Mamudu, who has written a book on global tobacco control policymaking, said the situation in Malawi isnt unique as multinational companies expand tobacco production in developing nations. Malawi emerged as a major producer of tobacco in the 1970s.

Malawi isnt a unique case, but it is an extreme one, Mamudu said. Since Malawi is the seventh largest global exporter of tobacco leaf, the country should be a model for a tobacco economy. And if tobacco production is an economically viable activity, Malawi shouldnt be 14 th on the list of poorest nations.

Tobacco companies in the United States and other countries produced reports that described economic disaster in Malawi without tobacco, a tactic employed, Mamudu and his colleagues write, to thwart impending passage of the World Health Organizations Framework Convention on Tobacco Control. The Framework Convention on Tobacco Control is a global public health treaty that has been ratified by 167 nations, not including the United States.

Glantz is a faculty member with the University of California, San Francisco, and the Center for Tobacco Control Research and Education. Otaez is a faculty member with the anthropology department at University of Colorado in Denver.

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