Physician criticizes Ethiopia’s ex-health minister over state tobacco deal

The physician who leads the Africa Tobacco-Free Initiative has criticized Ethiopia’s former health minister Dr Tedros Adhanom Ghebreyesus over the country’s tobacco policies.

Dr. Frank Ashall, in an open letter published online Friday in the British medical journal The Lancet, raised questions about the Ethiopian government’s deal-making in the tobacco sector.

“In 2016, the Ethiopian Government sold 40% of the shares in its tobacco monopoly, National Tobacco Enterprise (NTE), to Japan Tobacco International (JTI) for US$510 million. The deal was attended by two ministers from the Ethiopian Government’s cabinet,” Ashall said.

“The deal will likely lead to the expansion of tobacco farms, increased cigarette production, and an increase in the number of smokers in Ethiopia,” he added.

Japan Tobacco Inc announced at the time of the 2016 deal that it would work with the Ethiopian government to expand the reach of the state tobacco firm through improved distribution, manufacturing and marketing of the locally made Nyala cigarettes.

Dr. Ashall says that Dr. Tedros — who also served as foreign minister — failed to speak out against the deal even though tobacco is a major cause of death in Africa and more specifically also an acute threat to tuberculosis-control programmes in Ethiopia.

“Smoking increases the risk of a person developing latent tuberculosis, active tuberculosis, and recurrent tuberculosis, and also increases the death rate from tuberculosis,” wrote Ashall. “By making deals with the tobacco industry that may well increase smoking prevalence in Ethiopia, the Ethiopian Government is, therefore, jeopardising its tuberculosis-control programmes.”

For this reason, the anti-tobacco campaigner expressed concerns about the candidacy of Tedros for the position of director-general of the World Health Organization. The WHO is expecting to hold an election this coming month at its general assembly in Geneva. By some measures, Tedros has been considered the frontrunner in the contest.

“At the time of the (tobacco) deal, Tedros was Ethiopia’s Foreign Minister. Because he was Health Minister from 2005 to 2012, and aims to be DG of WHO, I believe that he should have spoken out publicly against the tobacco deal,” Ashall says.

The open letter in The Lancet also alleged that Tedros was involved in talks between Ethiopia and British American Tobacco (BAT), and that his government illegally allowed advertisements for Rothmans cigarettes in Ethiopia’s capital city Addis Ababa in 2013.

‘I believe that he should have spoken out publicly against the tobacco deal.’

“At that time, Tedros, as Foreign Minister, did not appear to speak out publicly against this advertising. Indeed, not long after he became Foreign Minister, Tedros attended a meeting in London with the UK’s then Secretary of State for Foreign and Commonwealth Affairs, William Hague, encouraging BAT, among other UK businesses, to invest in Ethiopia.”

This letter marks the second time in as many weeks that the candidacy of Tedros for the World Health Organization post has been challenged. Last week he was accused of withholding information about deadly cholera outbreaks in Ethiopia a decade ago.

On the other hand, African Union ambassadors to the United Nations in Geneva have picked Tedros as their preferred candidate, saying in a statement that the former Ethiopian health minister was a transformational leader during his time in office.

“Dr Tedros is the best candidate for the next WHO Director-General because he is the only one who has designed, implemented and led the reform of an entire health system and in addition to his transformative leadership, he is a man of integrity and humility,” said Jean-Mari Ehouzou, Ambassador of the AU to the United Nations’ office in Geneva.

According to the AU statement, child mortality declined by two-thirds in Ethiopia during Dr. Tedros’ tenure as health minister from 2005 to 2012 and HIV infections declined by 90%, malaria mortality by 75% and mortality from tuberculosis by 64%.


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