Kenya and other developing countries have been urged to consider scientific-driven regulation in policy-making when it comes to harm reduction in Africa, in order to benefit from a public health and diversified revenue streams.
This is on the back of growing debt burdens in poor countries, which are widening the gap between health sector needs and spending, with governments facing pressure to reduce deficits and fund other priorities.
In the financial year 2024025, Kenya allocated Sh127 billion towards the health sector, which was a reduction from Sh141.2 billion the previous year, as Treasury faced a tough balancing act.
According to experts, stringent policies have seen continued wide-spread use of more harmful products, such as cigarettes, with the black market thriving with other detrimental drugs.
Harm reduction refers to interventions including policies, programmes and practices aimed at minimising the negative effects to one’s health, social and legal impacts associated with the use of various substances that cause a negative impacts such as tobacco, alcohol and opioids.
Science-led studies and evidence suggests that while there are no safe tobacco products, safer alternatives have a positive impact on reducing smoking-related mortality.
For instance in Sweden, daily smoking prevalence declined from 27 per cent in 1981 to 5.3 per cent in 2022, while daily snus (a swedish alternative tobacco product) use rose to 20.2 per cent from 14 per cent.
The rate of lung cancer cases amongst Swedish men in 2022 was less than half the European average, a time when countries like Kenya are hard-pressed on cancer treatment expenses, with households being pushed to poverty by hospila bills.
“Nicotine vapes are legally available to 54 per cent of the global adult population, HTP (heated tobacco product) to 36 per cent , snus to 58 per cent and nicotine pouches to 35 per cent, but the deadliest nicotine delivery system of all, the combustible cigarette, is legal everywhere on earth,” Chimwemwe Ngoma, Malawi-based sociologist and citizen journalists, posed during a presentation at the Harm Reduction Exchange 2024, in Nairobi.
Kenya recently banned nicotine pouch brand Velo, but similar products are available in the black market.
Over 100 countries have now adopted at least one form of harm reduction, Global Initiative on Substance Abuse (GISA) foundernd executive director, Martin Agwogie, noted.
Kenyan households spent up three per cent of their total expenditure on health, with households also spending billions of shillings out-of-pocket on health services each year: Meanwhile, Kenya continues to grapple with illicit trade with these products exposing consumers to health risks while denying government revenues.
Speaking during the fourth edition of the harm reduction exchange, themed “enabling innovation in harm reduction through science-led regulation and policy making” – Wilson Cox, Projects Executive Director for Zimbabwe Civil liberties and Drug Network noted that some nations have implemented comprehensive tobacco control measures aligned with the WHO Framework Convention on Tobacco Control (FCTC).
However,
others struggle with enforcement
and regulatory capacity.
“The regulatory landscape in Africa is particularly diverse, with
countries adopting different approaches based on their specific
contexts and capabilities. High-income countries often have the resources to implement and enforce
sophisticated regulatory frameworks, while low- and middle-income countries may face resource
constraints that limit their ability to
effectively regulate novel nicotine
products,” Cox said.
