The Framework Convention Alliance for Tobacco Control

The long road to Graphic Health Warnings in the Philippines

By Ulysses Dorotheo, MD, FPAO*New graphic health warnings in the Philippines.

Based on the three-year compliance deadline for Article 11 of the WHO Framework Convention on Tobacco Control (FCTC), the Philippines should’ve implemented effective health warnings on packages by September 2008. Nearly eight years later, graphic health warnings have finally arrived.

Ulysses DorotheoIn 2007, civil society and the Department of Health (DOH) sought to have legislation enacted that would require graphic health warnings (GHWs) and prohibit misleading descriptors (terms such as ‘light’ and ‘mild’) on tobacco packs. At that time, text warnings appeared only on the bottom 30 percent of the front of packages. Pro-health legislators filed bills to have GHWs cover 60 percent of the principal display areas of packages, but pro-industry legislators firmly blocked the bill from being discussed beyond the health committee, claiming that GHWs would kill the industry.

After the bill passed four committee hearings where many of them were absent, most of the 34 congressmen who attended a technical working group meeting (against their known practice of leaving technical staff to fine-tune bills) allegedly received bribes to oppose and kill the bill.

Industry challenge

Faced with this hurdle, the DOH issued Administrative Order 2010-13, requiring that graphic health information be printed on tobacco packages: 30 percent in front (in addition to the existing 30 percent text-only warnings) and 60 percent at the back. Almost immediately, the tobacco industry challenged the DOH with no less than five separate court cases, which doomed the measure to limbo.

Soon after the issuance of DOH AO 2010-13, the Aquino administration took the reins of government on a platform of good governance, providing the opportunity for much needed tobacco tax reforms. Another story in its own right, the successful passage of the Sin Tax Reform Act of 2012 paved the way for advocates to renew their efforts to have a law enacted that was fully compliant with FCTC Article 11.

In 2013, given the global trend for more effective larger graphic health warnings, pro-health legislators pushed for warnings on the upper 85 percent of the front and back of packs as recommended by civil society advocates, in addition to a ban on misleading descriptors. This time, the industry responded with its own GHW bill, proposing a 30 percent GHW on one side and a 30 percent text warning on the other side, as well as a second, alternate bill simply adding a text warning to the lower back in minimum compliance with the FCTC.

Scarred, but now law

Finally, on 15 July 2014, the GHW Law was signed into law, scarred but having survived the usual industry arguments. The law requires 12 rotating, full-colour, 50-percent GHWs (with accompanying texts in colours that contrast with the package design) that will be replaced every 24 months, additional text information on 30 percent of one side panel, and a ban on misleading descriptors.

Aside from the smaller GHW size, the law’s other concessions to the industry included: requiring the GHWs to be in the lower rather than upper portion of principal display surfaces of packages; giving the industry 20 months from publication of the GHW templates for full compliance, and requiring the Inter-Agency Committee-Tobacco (IAC-T) (set up by the Tobacco Regulation Act of 2003 and includes the Philippine Tobacco Institute as a member) to monitor compliance.

Seemingly unsatisfied with these concessions, the industry tried to weaken the implementing rules and regulations (IRR), such as by arguing for very narrow interpretation of the law and excluding products sold in duty-free stores. Consequently, it took more than a year for the IRR to be finalized due to many instances of tobacco industry interference.

Civil society now monitoring

Happily, with successful media advocacy for the industry to comply by the 3 March 2016 deadline, the new GHWs have begun appearing at points of sale, monitoring of which is being undertaken by civil society advocates.

The lessons learned for civil society are neither new nor unique:

  • Maintain a united position with explicit non-negotiables;
  • Anticipate and expose tobacco industry interference (and expect some TI tactics to change over time);
  • Educate policy makers and the public about international best practice;
  • Grab opportunities when they arise;
  • Be persistent.

What’s next? Larger GHWs, of course, and maybe even plain packaging.

* FCTC Program Director, Southeast Asia Tobacco Control Alliance (SEATCA), and Past Chair of FCA’s Board of Directors


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