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Civil society groups in Pakistan have issued a high court petition to prevent the Ministry of National Health Services Regulation and Coordination from withdrawing life-saving legislation to reduce tobacco use. The new law – which was due to come into force on 31 July – required 85 per cent of the surface area of all tobacco packaging to be covered with harrowing photos of the health consequences of smoking.

Now, after months of delay, the warnings could be diminished in size to just 50 per cent.
The legal intervention from the Coalition for Tobacco Control Pakistan (CTC-Pak) blocks the immediate watering-down of the law and calls health and finance ministers to account for reneging on a policy proven to protect public health. Tobacco industry pressure to weaken and delay the measure has been intense since the law was announced by Health Minister Saira Afzal Tarar in February 2015, because graphic health warnings encourage smokers to quit and discourage non-smokers from starting.

“This case has international significance, because a reversal in the size of the pack warnings could have a domino effect on countries taking on this work, including our neighbour India, who announced their 85 per cent law at the end of last year,” said Khurram Hashmi, National Coordinator for CTC-Pak. ”The government needs to prioritise health over any perceived short-term economic gains.”

The writ issued by CTC-Pak was upheld on the grounds that rescinding the law constitutes negligence by causing harm to public health and that the re-formulated law has been influenced by the Federal Board of Revenue, whose mandate does not cover health. Pakistan’s health and finance ministers must respond within 10 days from the date the petition was filed.

“Pakistan’s 85 per cent warnings were set to hit shelves way back in March this year,” said Dr Ehsan Latif, Director of The Union’s Department of Tobacco Control. “Now we hear they will be reduced to just 50 per cent, increasing by 10 per cent year-on-year thereafter – an unworkable proposal that will have negligible impact. This law was introduced to protect public health, specifically the health of children. What has changed?”

British American Tobacco has strongly lobbied health and finance ministers in Pakistan, claiming the bold new warnings exceed World Health Organization requirements – the Framework Convention on Tobacco Control [WHO FCTC] recommends 50 per cent minimum coverage. Pakistan, India and Nepal (which introduced 90 per cent warnings) have received international acclaim from the public health community for introducing the world’s most stringent directives on tobacco packaging, bar Australia’s “plain” or standardised packaging. Pakistan’s health minister received the WHO award for leadership in tobacco control in June this year.

Tobacco control experts at The Union have worked with Pakistan since 2008 and are supporting CTC-Pak with legal and technical advice. Pakistan has one of the highest burdens of tobacco-related disease in the world, accounting for 110,000 deaths each year.

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