The third edition of the World Health Organization WHO report on trends in prevalence of tobacco use says tobacco kills and sickens millions of people every year. Around 8 million people died from a tobacco-related disease in 2017. According to the report, the number of annual deaths can be expected to keep growing even after rates of tobacco use start to decline, because tobacco-related diseases take time to become apparent.
A global commitment to reversing the tobacco epidemic was made in 2003 when member states of the World Health Organization adopted the WHO Framework Convention on Tobacco Control, which lays out specific, evidence-based actions that all parties to the convention should take to effectively reduce demand for tobacco. World Health Organisation says in 2000, around a third, or 33.3% of the global population both sexes combined and aged 15 years and older, were current users of some form of tobacco.
By 2015, this rate had declined to about a quarter, or 24.9 per cent of the global population. Assuming that current efforts in tobacco control are maintained in all countries, the rate is projected to decline further to around a fifth (20.9%) of the global population by 2025. It was further shared that in the same year 2000, around half of men aged 15 years and older were current users of some form of tobacco. By 2015, the proportion of men using tobacco had declined to 40.3%.
By 2025, the rate is projected to decline to 35.1 per cent. Around one in six women or 16.7 per cent aged 15 years and older were current users of some form of tobacco. In 2015, the proportion of women using tobacco had declined to under one in ten. By 2025, the report says the rate will decline to 6.7%. In 2000, according to WHO report, the proportion of males using any form of tobacco was three times the proportion of users among women. By 2015 the rate for males was more than four times the rate of females.
By 2025, the rate for males is expected to be five times the rate of females. The 2025 target set under the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases 2013-2020 specified that countries should strive to achieve a 30 per cent reduction in tobacco use prevalence using 2010 level as baseline. This translates to a maximum total tobacco use prevalence rate of 19.1 per cent for the total population aged 15 years and older, 30.2 per cent for males and 8.0 per cent for females.
The trend analyses undertaken for this report indicate that the reduction target will not be met for males but will likely be met for females. The projected 2025 prevalence rate of 35.1 per cent for males would be short of the target by an absolute 4.9 per cent. The projected 2025 prevalence rate of 8.0 per cent for females would exceed the target by 1.3 per cent.
Overall, the report indicated that the global target for the total population will fall short of meeting the overall global target of 19.1 per cent by 1.8 per cent. Instead of achieving the 30% relative reduction globally called for in the NCD target, the relative reduction likely to be achieved based on current efforts is 23.4 per cent (18.8 per cent and 41.2 per cent for males and females respectively)
Further, the report noted that there has been a steady decline in any tobacco use for both males and females in each age group over the observed period 2000-2015. The age-specific rates are projected to continue declining to 2025 for both males and females. The age-specific rates peak at age group 45-54 for men and, for women, at age group 55-64 in some years and 65-74 in others. The report said the absolute prevalence levels have been consistently higher for males than those for females in each age group.
Among young people aged 15-24 globally; the average rate of tobacco use has declined from 22.6 per cent in the year 2000 to 17.0 per cent in 2015. The rate in 2025 is projected to be 14.2 per cent. Among men in the age group 15-24, the report stressed that tobacco use has declined from 35.3% in the year 2000 to 27.6 per cent in 2015. The rate in 2025 is projected to be 23.6%. Among women in this age group, the 2000 rate of 9.3% reduced to 5.6% by 2015, and is projected to continue downwards to 4.2% by 2025.
The age-standardized tobacco use prevalence rates are declining in all WHO regions, the report claims. In the year 2000, it is estimated that the South-East Asia region had total tobacco use rates at around 47%. This was the highest average rate of any WHO region. The lowest average rate was estimated to be 18.5% in the African region. These two regions have continued to be the regions with highest and lowest average rates respectively, but the gap between them have narrowed and are expected to keep narrowing to 2025. The South-East Asia region is tracking towards an average prevalence rate in 2025 of 25.1 per cent and the African region is tracking towards 11.2 per cent.
Focusing on the period 2010-2025- the period of interest for monitoring reduction targets under the WHO Global Action Plan for Prevention and Control of Non-Communicable Diseases 2013-2020- the only WHO region expected to achieve a 30 per cent relative reduction in prevalence of current tobacco use by 2025 is the Americas region.
The average rate of current tobacco use in Americas region is expected to fall from around 23% in 2010 to 15% in 2025, assuming tobacco control efforts in Americas region countries are maintained at current levels. Western Pacific is the region expected to experience the least decline in the average prevalence rate- a relative reduction of around 12% between 2010 and 2025. The other region with a relatively slow rate of decline is the European region, currently tracking towards an 18% relative reduction between 2010 and 2025.
According to this report, in 2000, the highest average prevalence rates among males were in the South-East Asian region (62.5%), followed by the Western Pacific region (55.6%). The trend in these two regions crossed over in 2014 and the Western Pacific region is now projected to have the highest rates among males in 2025, averaging 46.4%. The South-East Asian region average is projected to reach 42.9%.
The report said the Eastern Mediterranean and European regions are in the middle ground, with very similar prevalence levels and trends among men in all years, from 46-47% in 2000 to 30-31% in 2025. The African region is the region with the lowest average rates for males, and is projected to remain lower than other regions until 2025, when the rates for the Americas region to around the same level (20.4%).
Among males, only countries in the Americas region will collectively achieve a 30% relative reduction in the average prevalence by 2025, the report said. All other regions except the Western Pacific region are on track to reduce male prevalence rates between 19% and 22%. Western Pacific region countries are likely to achieve close to a 10% reduction between 2010 and 2025.
Government is currently sitting on 4 400 vacant posts that remain unfilled in the civil service. This is notwithstanding the high unemployment rate in Botswana which has been exacerbated by the recent outbreak of the deadly COVID-19 pandemic.
Just before the burst of COVID-19, official data released by Statistics Botswana in January 2020, indicate that unemployment in Botswana has increased from 17.6 percent three years ago to 20.7 percent. “Unemployment rate went up by 3.1 percentage between the two periods, from 17.6 to 20.7 percent,” statistics point out.
Leading commercial bank, First National Bank Botswana (FNBB), expects the central bank to sharpen its monetary policy knife and cut the Bank Rate twice in the last quarter of 2020.
The bank expects a 25 basis point (bps) in the beginning of the last quarter, which is next month, and another shed by the same bps in December, making a total of 50 bps cut in the last quarter. According to the bank’s researchers, the central bank is now holding on to 4.25 percent for the time being pending for more informed data on the economic climate.
An audit of the accounts and records for the supply of food rations to the institutions in the Northern Region for the financial year-ended 31 March 2019 was carried out. According to Auditor General’s report and observations, there are weaknesses and shortcomings that were somehow addressed to the Accounting Officer for comments.
Auditor General, Pulane Letebele indicated on the report that, across all depots in the region that there had been instances where food items were short for periods ranging from 1 to 7 months in the institutions for a variety of reasons, including absence of regular contracts and supplier failures. The success of this programme is dependent on regular and reliable availability of the supplies to achieve its objective, the report said.
There would be instances where food items were returned from the feeding centers to the depots for reasons of spoilage or any other cause. In these cases, instances had been noted where these returns were not supported by any documentation, which could lead to these items being lost without trace.
The report further stressed that large quantities of various food items valued at over P772 thousand from different depots were damaged by rodents, and written off.Included in the write off were 13 538 (340ml) cartons of milk valued at P75 745. In this connection, the Auditor General says it is important that the warehouses be maintained to a standard where they would not be infested by rodents and other pests.
Still in the Northern region, the report noted that there is an outstanding matter relating to the supply of stewed steak (283×3.1kg cans) to the Maun depot which was allegedly defective. The steak had been supplied by Botswana Meat Commission to the depot in November 2016.
In March 2017 part of the consignment was reported to the supplier as defective, and was to be replaced. Even as there was no agreement reached between the parties regarding replacement, in 51 October 2018 the items in question were disposed of by destruction. This disposal represented a loss as the whole consignment had been paid for, according to the report.
“In my view, the loss resulted directly from failure by the depot managers to deal with the matter immediately upon receipt of the consignment and detection of the defects. Audit inspections during visits to Selibe Phikwe, Maun, Shakawe, Ghanzi and Francistown depots had raised a number of observations on points of detail related to the maintenance of records, reconciliations of stocks and related matters, which I drew to the attention of the Accounting Officer for comments,” Letebele said in her report.
In the Southern region, a scrutiny of the records for the control of stocks of food items in the Southern Region had indicated intermittent shortages of the various items, principally Tsabana, Malutu, Sunflower Oil and Milk which was mainly due to absence of subsisting contracts for the supply of these items.
“The contract for the supply of Tsabana to all depots expired in September 2018 and was not replaced by a substantive contract. The supplier contracts for these stocks should be so managed that the expiry of one contract is immediately followed by the commencement of the next.”
Suppliers who had been contracted to supply foodstuffs had failed to do so and no timely action had been taken to redress the situation to ensure continuity of supply of the food items, the report noted.
In one case, the report highlighted that the supplier was to manufacture and supply 1 136 metric tonnes of Malutu for a 4-months period from March 2019 to June 2019, but had been unable to honour the obligation. The situation was relieved by inter-depot transfers, at additional cost in transportation and subsistence expenses.
In another case, the contract was for the supply of Sunflower Oil to Mabutsane, where the supplier had also failed to deliver. Examination of the Molepolole depot Food Issues Register had indicated a number of instances where food items consigned to the various feeding centres had been returned for a variety of reasons, including food item available; no storage space; and in other cases the whole consignments were returned, and reasons not stated.
This is an indication of lack of proper management and monitoring of the affairs of the depot, which could result in losses from frequent movements of the food items concerned.The maintenance of accounting records in the region, typically in Letlhakeng, Tsabong, and Mabutsane was less than satisfactory, according to Auditor General’s report.
In these depots a number of instances had been noted where receipts and issues had not been recorded over long periods, resulting in incorrect balances reflected in the accounting records. This is a serious weakness which could lead to or result in losses without trace or detection, and is a contravention of Supplies Regulations and Procedures, Letebele said.
Similarly, consignments of a total of 892 bags of Malutu and 3 bags of beans from Tsabong depot to different feeding centres had not been received in those centres, and are considered lost. These are also not reflected in the Statement of Losses in the Annual Statements of Accounts for the same periods.