African Scientists and Experts Call for the adoption of a Harm Reduction in approach in Public Health Strategies and Tobacco Control. Media have a critical role to play in accelerating Harm Reduction efforts by informing and sensitizing cigarette smokers on the availability and benefits of alternative, potentially lower risk products to cigarretes. Traditional cessation and smoking prevention norms are not the only ways that smokers who cannot or don’t’ want to quit can make healthier choices that cause less harm to themselves and those around them.
This was said during the 2nd Harm Reduction Exchange conference for African journalists held in Nairobi, Kenya on the 1st of December 2022. Speaking at the Harm Reduction Exchange Conference, Integra Africa Principal Dr. Tendai Mhizha emphasized the role that journalists and media houses should play in handling misinformation and disinformation in tobacco harm reduction discourse that is actually perpetuating the death and disease caused by people continuing to smoke combustible cigarettes. “There has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on public health.
This has led to policies that disfavour risk reduces products and narratives that completely deny their benefits. The media have the difficult responsibility to curb the scourge of disinformation and misinformation on harm reduction just like on other socio-political stances that are prescriptive and do not uphold consumers’ right to healthier lifestyle choices,” Dr Mhizha said.
The Harm Reduction Exchange cast a spotlight on alternative ways to reduce harm among tobacco smokers. Held under the theme Harm Reduction: Making a difference in Africa, the conference focused on the progress being made through harm reduction strategies in all fields related to public health such as drug and alcohol abuse, excessive sugar consumption, skin lightening and other addictive and behavioral practices. A wide array of harm reduction strategies and initiatives that are deployed towards reducing unnecessary deaths through non-communicable diseases were presented and discussed.
On his part, Prof. Abdoul Kassé, a world renowned and awarded Oncologist and a Professor of Surgery at the Cancer Institute in Senegal, said that Harm Reduction is a powerful public A Summary of the HR Exchange 30th November 1st December 2022 health tool that has the potential to reduce cancer by 30% and should be at the centre of all public health development strategies. Harm reduction, he said, has already benefited many people in public health and is the most viable alternative in tobacco control.
It applies to areas where there is a need to reduce the harm associated with a practice or consumption of a substance that is overused in society leading to increased morbidity and mortality. “Innovative Harm Reduction initiatives will help to keep more Africans alive. Tobacco Harm Reduction initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate a lot of misunderstanding in both the public health community and in the media. However, there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking.
Where cessation repeatedly fails, switching to less harmful products is expected to result in benefits for many smokers,” Prof. Abdoul Kassé said. Similarly, views were expressed by Kenya’s Dr. Vivian Manyeki who said tobacco Harm Reduction has a solid scientific and medical basis, and it has a lot of promise as a public health measure to assist millions of smokers. “Many smokers are unable, or at least unwilling, to achieve cessation through complete nicotine and tobacco abstinence. They continue smoking despite the very real and obvious adverse health consequences and against the multiple public health campaigns. Conventional smoking cessation proposals should be complemented with alternative but more realistic options through Harm Reduction,” Dr. Manyeki said.
Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smoking—the most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease. “Nicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality. Across the world, there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction,” Dr. Kgosi Letlape, an ophthalmologist and President of Africa Medical Association and the president of the Association of Medical Councils of Africa, said.
Tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer. Abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge amount of cases. This task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking. Thus, the development of novel strategies to reduce smoking is imperative. Moreover, the use of innovations in smoking products has been currently adopted by several smokers to reduce the health risks of smoking.
“The Harm Reduction approach prevents drug-related deaths and overdose fatalities and is the only way out for addicts. In the same way these alternative technologies can reduce tobacco harm and accelerate the journey to a smoke-free world as they reduce exposure to toxicants,” Bernice Apondi, A Policy Manager at Voices of Community Action and Leadership Kenya (VOCAL-Kenya), said.
During the Harm Reduction Exchange, journalists drawn from Southern, West and East African countries, including: Nigeria, Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Eswatini, Tanzania, Uganda, South Africa, Zambia, and Zimbabwe debated and set forth several resolutions in regards to the present and future as well as the challenges and progress made in Harm Reduction,and science-led regulation.
The Harm Reduction Exchange brought together high-level policy makers, physicians, scientists and health policy experts with media stakeholders from Africa in a lively mix of speeches, presentations, and panel discussions. The key note speakers included Prof Abdoul Aziz Kasse, Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr. Kgosi Letlape, Dr. Vivian Manyeki and Dr. Tendai Mhizha.
The Minister of Foreign Affairs, Dr. Lemogang Kwape says Botswana has not taken any position regarding the killing of a renowned human rights lawyer, Thulani Maseko, who was gunned down at his house in Mbabane, Eswatini.
In a brief interview with WeekendPost, Dr Kwape said Botswana has not yet taken any position regarding his death. He said the purported incident should be thoroughly probed before Botswana can form an opinion based on the findings of the inquiries.
“Botswana generally condemns any killing of human life by all means,” says Dr. Kwape. He wouldn’t want to be dragged on whether Botswana will support the suspension of Eswatini from SADC.
“We will be guided by SADC organ Troika if they can be an emergency meeting. I am not sure when the meeting will be called by Namibian president,“ he said.
However, the Namibian president Hage Geingob notes with deep concern reports coming out of Eswatini about the killing of Mr. Maseko. In a statement, he called upon the “Government of the Kingdom of Eswatini to ensure that the killing of Maseko is swiftly, transparently and comprehensively investigated, and that any or all persons suspected of committing this heinous crime are brought to justice.”
Maseko was chairperson of the Multi-Stakeholder Forum which was established as a coalition of non-State actors to advocate for a process of national political dialogue aimed at resolving the security and political challenges confronting the Kingdom.
“SADC expresses its deepest and heartfelt condolences to the family of Mr. Maseko, his friends, colleagues, and to the people of the Kingdom of Eswatini for the loss of Mr. Maseko. In this context, SADC further calls upon the people of the Kingdom of Eswatini to remain calm, exercise due care and consideration whilst the appropriate structures conduct the investigations and bring the matter to completion,” the statement says.
Geingob reiterated the need for peaceful resolution of the political and security challenges affecting the country.
Meanwhile political activists are calling on SADC to suspend Eswatini from the block including the African Union as well.
State prosecutor, Seeletso Ookeditse revealed before the Broadhurst Magistrate Jobbie Moilatshimo that the third accused involved in the murder of Barulaganye Aston, has interfered with the State witnesses again.
The second and third accused (Lefty Kosie and Outlwile Aston) were previously accused of interference when they were caught in possession of cellphones in prison. They were further accused of planning to kill the deceased’s brother, who is currently the guardian to the children of the deceased.
Ookeditse indicated that Outlwile had earlier went to challenge the magistrate’s decision of denying him bail at the High Court before Judge Michael Motlhabi.
“The third accused approached the High Court and made a bail application, which was dismissed on the same day,” Ookeditse said.
However, even after the High Court verdict on their bail application, the duo (Kosie and Aston) has once again applied for bail this week.
Ookeditse plead with the court to stop the accused from abusing the court process.
“Yesterday, Directorate of Public Prosecutions (DPP) received papers of his bail application filed before the Broadhurst Magistrates Court. However, the papers do not speak to changed circumstances, therefore this back and forth about bail must be put to a stop,” said the State prosecutor.
While giving evidence before court, the Investigations Officer, Detective Inspector Quite Zhalamonto, said his investigations have proved that there is interference continuing regarding the accused trio.
He told the court that on the 12th of January 2023, he received a report from Thato Aston, who is the son of the accused and the deceased. The son had alleged to the Investigation Officer that he received a call from one Phillip Molwantwa.
According to Zhalamonto, Thato revealed that Molwatwa indicated that he was from prison on a visit to the Outlwile Aston and went on to ask where he was staying and where his siblings (Aston’s children) are staying.
“Thato revealed that Phillip went on to ask if he or his siblings saw their father murdering their mother, and he was referring to the crime scene. Thato told me that he, however, refused to answer the questions as he was afraid especially because he was asked about where him and his siblings stay,” said Zhalamonto.
Zhalamonto alluded to the court that he then went to Orange to confirm the communication between Thato and Molwantwa where he found the case.
“I have arrested Philip yesterday and when I interviewed him, he did not deny that he knows Aston and that he has indeed called Thato and asked questions as to where him and his siblings resides even though he failed to give reasons for asking such questions,” Zhalamonto told the court.
He further revealed that Molwantwa indicated that he had received a call from an unknown man who refused to reveal himself.
“Phillip told me that the unknown man said he was sent by the accused (Aston), and that Aston had instructed him to tell me to check if there was still some money in his bank accounts, and he also wanted to know where the kids were residing, the unknown man even asked him to meet at Main Mall” the Investigation Officer told the court.
He further informed the court that he is working tirelessly to identify the “unknown caller” and the route of the cell number.
Furthermore, the fourth accused, Kebaleboge Ntsebe, has revealed to the court through a letter that she was abused and tortured by the Botswana Police Services. She wrote in her letter that she suffered miscarriage as a result of being beaten by the police.
Ntsebe is on bail, while a bail ruling for Aston and Kosie will be delivered on the 6th of next month
Cattle farmers from Eretsha and Habu in the Ngamiland district, supported by the Community Based Trade (CBT) project, recently generated over P300 000.00 for sales of 42 cattle to the Botswana Meat Commission (BMC) in Maun. This milestone was achieved through support from various stakeholders in conservation, commodity-based trade and the government, in collaboration with farmers. Ordinarily, these farmers would not have made this direct sale since the area is a designated Foot and Mouth Disease (FMD) Red Zone.
Traditional livestock farming contributes toward livelihoods and formal employment in the North-West District (Ngamiland) of Botswana. However, primarily due to the increase in FMD outbreaks over the past two decades and predation by wildlife, the viability of livestock agriculture as a source of income has declined in the region. This has led to a greater risk of poverty and food insecurity. Access across the Okavango River (prior to the construction of a bridge) restricted access for farmers in Eretsha. This lack of access hampered sales of cattle beyond Shakawe, further discouraging farmers from investing in proper livestock management practices. This resulted in negative environmental impacts, poor livestock health and productivity.
To address this challenge, farmers are working with a consortium led by Conservation International (CI), with funding secured from the European Union (EU) to pilot a CBT beef project. The project focuses on supporting and enabling communal farmers to comply with standards and regulations that will improve their chances to access markets. An opportunity to earn higher income from cattle sales could incentivize the adoption of restorative rangelands management practices by farmers.
“We spend a lot of money getting our cattle to Makalamabedi quarantine site, the herder spends on average two months taking care of the cattle before they are taken into quarantine – that needs money. All these costs lead to us getting less money from BMC,” said one of the farmers in the programme, Mr Monnaleso Mosanga.
Farmers that participate in the project agree for their cattle to be herded and kraaled communally by fulltime professional herders (eco-rangers). At the core of this pilot is the use of predator-proof bomas (cattle kraals), planned grazing systems and mobile quarantine bomas (electrified enclosures) for the cattle, facilitated in support with the Department of Veterinary Services. The first successful exit from the mobile quarantine bomas in the Habu and Eretsha villages, in December 2022, saw cattle quarantined on-site and directly transported to BMC in Maun. Farmers received almost double the average sales within this region, as costs including transportation to quarantine sites, herder’s fees and other associated costs incurred before qualifying for BMC sales were no longer included.
“This pilot mobile quarantine is leveraging the techniques and protocols we are using at our current permanent quarantine sites, and we are still observing the results of the project. The outcome of this pilot will be presented to the World Organisation of Animal Health to assess its effectiveness and potentially be approved to be used elsewhere,” said Dr Odireleng Thololwane, the Principal Veterinary Officer (Maun).