As is quickly evident to anyone who tries to compare tobacco control funding at the international level, it is virtually impossible. In countries like the U.S. it becomes of a daunting task of sorting out different levels of government, NGOs, foundations, research institutes etc. In other countries, there is little data available on smoking prevalence and tobacco prices, let alone tobacco control funding. For these two reasons, the WHO Tobacco Free Initiative gave up trying to collect the data.*

April’s question re: tobacco control funding in your country or state was meant to highlight the general range of funding available (or not available, as is often the case) to tobacco control advocates around the world. While the U.S. devotes much more money to tobacco control than do many countries, the amount varies dramatically from state to state. Of U.S. groups responding, California and Florida state governments spend the most (about $3.40 and $2.80 per capita) and Kansas the least ($0.19 per capita). But everything is relative. Kansas devotes an astronomically higher amount to tobacco control than do many national governments around the world. The Czech government, for example, spends only about $0.00079 per capita - a figure that also includes drug and alcohol control.

One frustration shared across borders -- from Kansas to Moldova -- was the lack of government will to devote an adequate portion of tobacco tax or settlement money to tobacco control efforts.

Perhaps the most striking finding, however, was the number of countries that do not devote any resources to tobacco control whatsoever. This is particularly true for many African countries where a number of our colleagues report that they are financing their organizations' activities out of their own pockets. While the cost of living is considerably lower in many of these countries, in comparison to the U.S., many basic items (phone service, fax, internet, international postage, computers etc) are of equal and sometimes greater cost. As Kamel Bereksi of Algeria stated, to fax a single page costs 100 dinars which is equal to 12 loaves of bread.

Certainly more money does not always translate into better or more effective tobacco control campaigning. Sometimes the competition for funding divides rather than unites groups that should be working together towards a common goal. And very often it is small, low-budget, grassroots organizations that exhibit, as we say in the U.S., “the most bang for the buck.” That said, it’s both clear and humbling, from many of your answers, that even the most basic levels of tobacco control funding are nonexistent in many places around the world.

But let none of us allow the paltry amount of funding available for tobacco control to serve as an excuse for inaction. Global Partnerships is about solidarity across borders. What we lack in financial
resources, we more than make up in other assets. Collectively, we are rich in human resources, creativity, and determination. And we have the truth on our side – something that is quite literally worth millions of dollars. If the tobacco industry had it, they wouldn’t need to advertise so much would they?

Indeed, as a biblical tale tells of a small stone that downed a giant, let us be very strategic in how we use our minimal resources. Let us also remember that many small entities working together are a force for even the most powerful to reckon with, as anyone has ever walked at dusk in a mosquito-infested area knows to be true!

Let us be innovative in stretching our financial resources. And let us find ways to support each other. As Alphonse Issi of Cameroon noted in a recent email, in order to get press coverage in his country, you need to pay journalists a fee -- money that his organization simply doesn't have. If BAT or Philip Morris does something outrageous in Cameroon, we can support Alphonse by publicizing the story through our own international networks and local media. Let us also look out for creative ways of piggybacking onto existing funding sources for health projects, international exchanges and technical transfers.

OUR "WALLETS" MAY BE THIN OR EMPTY,
BUT WE'RE RICH IN SPIRIT -- AND THE TRUTH

As some people supplied funding figures for their individual organization and others for their county, state or country, to fully compare the responses below would be a futile task. And probably not worth the trouble. Rather, the value in these responses are in the anecdotal evidence they provide of the range of funding available for tobacco control around the world. Please find below an example of one partnership's information exchange, followed by a summary of responses listed in alphabetical order by country

PARTNERSHIP EXAMPLE: Blue Cross of Democratic Republic of Congo and Alachua County Health Department (FL - USA)

Blue Cross wrote:
“[Our organization] is affiliated to the International Federation of Blue Cross - Switzerland. Blue cross is present in more than 40 countries around the world. Blue Cross of Congo is non-profit organization. We receive funding from the International Federation that allows us to realize activities, rent office space, etc.... But we must say that this money is really insufficient . This year the International Federation received only 39,000 CHF (swiss franc) for all Blue Cross societies around the world, and the International Federation urged all blue cross societies to look for funding from other partners or within their respective continents. So our Blue Cross Congo will be given only 2,000 CHF in funding this year, received in two parts (July & November). With this 2,000 CHF, 1,200 goes to renting an office and 100 for office supplies etc.”

Stephen Langer of Alachua County responded:
“A Swiss franc is currently worth about .58 American Dollar. If you can imagine, my program last year was funded at about 112,000 CHF, or $65,000. This funding is strictly for programming. This is for prevention efforts in a county with a population of 212,000 people, including 35,000 children. This does not include my salary or administrative expenses. What is special about our funding is that the money comes right from the tobacco companies themselves. The State of Florida settled a lawsuit with the major American tobacco companies in 1997. The State currently receives about $650 million each year, of which $39.1 million funds our program throughout the State, in 67 counties. This is justice, according to me. Make them pay for the thousands who have died.”

MORE RESPONSES FROM AROUND THE WORLD…

ALGERIA – Kamel Bereksi, sous-secteur Jean Kraft
The youth make financial contributions to pay for the rent of the room and materials for our activities. We possess a TV, a video recorder, an overhead projector only. I work at home with my personal computer, the telephone expenses I pay, I transport with my personal car (etc.). We cannot go on like this for a long time if there is no concrete support. We cannot content ourselves any more with words. We are capable of creating a strong national tobacco control association. The tobacco multinationals are not yet in Algeria, but they are getting ready to break. And when they come, it will be a whole new affair! The fight is uneven, but we have our conviction and especially the young people who did not fall in the “nets” yet. We have a reservoir of incredible action-oriented youth. But a minimum of means is necessary.

BELGIUM – Bérengère Janssen, FARES
In 2000, the tobacco industry earned 72,323 million Belgian francs, while only 7 million francs were spent on tobacco control in the country. Per capita, this represents a stark different ratio or 7200 to 0.7, in other words, for every 10,000 earned, the Belgian government devotes only 1 franc to prevention. A survey of 679 smokers earlier this year found that six out of ten smokers responded affirmatively to the questions: Would you be prepared to pay 2 francs extra per cigarette packet to help young people not to start to help smokers to quit?

CAMBODIA – Greg Hallen, TFI – WHO Cambodia
Some countries include funding for a number of activities with the assumption that the people carrying things out are on a base salary that is not included in the budget. This would not be the case in Cambodia. Basically all funding so far is coming from external donors while there are about 3 people who receive approx $15 per month to do their jobs in the tobacco or health unit. Therefore any funding that comes in must include salaries or salary subsidies of some form. This is the sad case for all health projects in Cambodia.

CAMEROON – Alphonse Issi, Mouvement National des Consommateurs
There is no funding in our country available for NGOs working on tobacco control. So, it is very difficult for us to find local funding to realize our activities.

CZECH REPUBLIC –Jiri Kozak, Czech Committee of EMASH & Eva Kralikova, Institute of Hygiene and Epidemiology
The smoking control in the Czech Republic had been organized by the Health Education Institute since 1988 and thereafter by the National Center for Health Promotion (NCHP) since 1990 or 1991. As I was informed at that time by the director Dr Kucera, the smoking control budget which
was covered by the Ministry of Health, was 3 mil. Czech Krowns, i.e. $79,000. When the NCHP was cancelled in 1996 by the Ministry of Health, all antismoking activity was transferred to the National Institute of Health (NIH), the state institution, where the tobacco control is organized till present time together with alcohol and drugs control. The whole budget for all three control activities is 300 000 CK, i.e. ten times less!! Czech Republic has 10 millions inhabitants! There is not any official responsible person regarding tobacco control at the Ministry of Health and many activities are organized by enthusiastic persons from the NGOs. [$.00079 per capita]

HUNGARY – Tibor Szilagyi, Health 21 Hungarian Foundation
Unfortunately, we have no exact data on the amount spent in a year for tobacco control in Hungary, because there are many sources and nobody takes care of their use later. It could be expected that this could be about $80,000 for 2000. [Hungary’s population = ~10,300,000]

INDONESIA - Tjandra Y Aditama, Indonesian Smoking Control Foundation (LM3)
Agencies related to tobacco control are: 1. Ministry of Health & Welfare, especially Food and Drug Administration and Health Promotion Division. They lead tobacco control activities, dealing with other sector, implement law & regulation and make health education activities. 2. Ministry of Education, but only minor activities in health education to pupils 3. Non Govermental Organization, such as Indonesian Smoking Control Foundation (LM 3), Indonesian Cancer Foundation etc., which run advocacy activities, perform health education, seminars etc, smoking cessation and other related tobacco control program. 4. Medical Profesional Organization, such as Indonesian Association of Pulmonologist, Indonesian Cardiologist Association etc. which perform research, health care for smoking related diseases and health education.

KENYA – Oongo Elisha, Social Needs Network
Unfortunately in this country there is no funding allocation for tobacco control. If anything, the Gov is reluctant to curtail the tobacco use in the country because of revenue received from this dangerous weed. We need support from you! So far it is only the Kenya Medical Association that is trying to push tobacco control activities in the country and some small organizations like ours. Otherwise tobacco control in the country is not really organized.

MOLDOVA – Lilia Vrabie, CONTACT
In our country there is no anti-tobacco funding. Our government is interested in tobacco import and export. The total sum of excises and of the selling of cigarettes constituted about $3 millions in the first quarter of this year. In our republic the duty paid for importing cigarettes is of $2.5 for 1000 pieces, which represents with $0.5 more than last year. Our government intends to increase this sum to $5 for 1000 pieces. They say it will be beginning with 2002 or during this year, it depends on the profit they will have from the import of cigarettes and the [privatization] of its market.

NEW ZEALAND – Shane Bradbrook, Aparangi Tautoko Auahi Kore (ATAK) - Maori Smokefree Coalition
Approximately $12 million available for tobacco control. [Population=3,846,000]

PAPUA NEW GUINEA – Colin Richardson, Adventist Health Department
In Papua New Guinea, there are no active tobacco control programs beyond the 1987 Tobacco Control Act, which is defective and weak. There is a person in the Ministry of Health who has been working on the subject for 10 years, and who has planned a consultative committee which has yet to meet. I have no access to information on his budget, and he does have other responsibilities. The Seventh-day Adventist Church Health Ministries Dept is in the formative stages of putting together a broad-based coalition to promote tobacco control with a seed-grant of $10,000 from the American Cancer Society. Full text

RUSSIA – Vladimir Levshin, Russian Cancer Research Center (Moscow)
Unfortunately, as far as I know there is no any special resources for tobacco control in my country and community. There are no government or non-governments programs related to tobacco control. Despite the enormous human toll caused by tobacco efforts, tobacco control is an uphill battle in the country with tiny groups of people challenging enormous corporate interests -- with no interest from the government or even the general population at this time. Thus only isolated tobacco control activities appear in separate regions. They are provided by tiny groups of people from some research institutes without any special funding. Meanwhile, cigarette advertisement is now the most profitable kind of advertisement in the country. One more typical example: last year excise-duty for tobaccoproducts was increased on 100%, but not one ruble of this money was returned for tobacco control or health activities.

- Natalia Alexeeva, Institute of Internal Medicine (Novosibirsk)
The only funding I have is the grant money received from the American Cancer Society.

SENEGAL – Medard Bassene, Mouvement Anti-Tabac du Senegal
[Medard reports that it is his own salary that is keeping his organization afloat]

UGANDA – Phillip Karugaba, The Environmental Action Network Ltd. - Actions Against Tobacco
The Ministry of Health did not include tobacco in its latest donor approved 5 year plan.

USA – Stephen Hansen, Californian Medical Association (CA)
California is currently 12th among the states in spending based on CDC's nine points. However, the Calif. Med. Assn. recently voted on policy to increase that spending to the 50th percentile of the CDC's recommended spending range. This would approximately double the current expenditures. In the current fiscal year (July 1, 2000 to June 30, 2001) California is spending $86,539,000 million on tobacco control. This is the funding that is assigned to the Department of Health Services. The Department of Education also receives funding to implement school-based programs ($28,038,000). The 2000 census indicates that California has approximately 34 million residents. [$3.37 per person]

USA – Brenda Olsen, American Lung Association of Florida (FL)
Florida allocates approx. $45 million for tobacco control activities. This figure on includes the amount budgeted by the State for the tobacco control program. It does not include the amount allocated by the through other State programs and private organizations like the American Lung Association. Florida's total population id approx. 16 million [$2.81 per person]

USA – Barbara Patterson, Northwest Oklahoma Tobacco Free Coalition (OK)
I took estimated budgets allocated to tobacco control in our area since July of 2000 (4-6 counties in northern Oklahoma) and divided it by our population. It amounts to around $1.50/capita in our region. Sadly, there are many counties in our State that have virtually no funding allocated to their citizens. In 1999-2000 it was about $1.25/capita and prior to that almost nothing. With a portion of the tobacco settlement money somewhat protected by a trustfund set up by our state legislature in 2000, we are hopeful that there will be additional funding beginning 2002. It could still be a tough battle with tobacco having such a strong political hold in our State.

USA – Ted Collins, Red Ribbon Coalition (KS)
Only a pittance is spent in my little town on preventing tobacco use compared to what big tobacco spends. $6,500 were spent this past year in our little county. Most went for salary of a prevention worker through the County Health Dept. For a recent story on the sad funding situation go to:
http://kansascity.bcentral.com/kansascity/stories/2001/04/09/story4.html Last year $500,000 was allocated for tobacco control, about $0.19 per capita.