News analysis

AFRICA: SUCCESS AGAINST THE ODDS More than 100 people, mostly from Africa, joined by colleagues from the USA and Europe, gathered near Johannesburg in the first week of February for an important African tobacco control conference. This was the latest in the Africa Tobacco Situation Analysis (ATSA) series of meetings to share experience, learn from each other and refresh their energies for the continuing fight against 'Big Tobacco'. In addition to presentations from the ATSA country teams, delegates also heard from the most recent Gates-funded projects (the African Tobacco Control Consortium and the WHO knowledge hub and capacity building project). Furthermore, there were several interactive sessions for the African tobacco control participants, to identify key actions needed in research, advocacy and policy making and to make plans for the short-and longer term. What was learnt from the meeting? First, that some countries still have massive difficulties with tobacco industry interference in tobacco control. Several African countries struggle against the odds in this respect and in Africa, the difficulties often seem larger than those in other parts of the world due to the limited resources to fight such a wealthy and unscrupulous opponent. And while tobacco companies are by any measure the enemies of health, they still manage, through political and financial influence, to portray themselves as the 'good guys' who are trying to help. Second, and on a more positive note, successes continue to pile up and there is constant progress in most countries, even though this sometimes appears slow. However, some progress has been highly visible: Mauritius was the first African country to introduce large pictorial health warnings, which cover 65% of the pack surface. A highlight of the meeting was the announcement by the health ministry of the host country that it would soon join the ranks of countries with totally smoke-free public places. South Africa took an important lead in 2001 when it implemented a ban on smoking in public places, but enclosed, designated smoking areas were still permitted. However, the director general of health told the meeting that the health minister had now approved the principle of totally smoke-free public places and the necessary regulations were in preparation. They will include outdoor areas such as sports stadia, bus and train stations and other areas where people gather in close proximity to one another. Furthermore, the regulations will specify something absent from many countries' legislation: minimum distances …