Woelk G, Mtisi S, Vaughan J P
Department of Community Medicine, University of Zimbabwe, Box A178 Avondale, Harare, Zimbabwe.
Health Policy. 2001 Sep;57(3):179-92. doi: 10.1016/s0168-8510(01)00126-9.
Using a historical and political economy perspective, this paper explores the prospects for tobacco control in Zimbabwe, the world's sixth largest producer and third largest tobacco exporter. Tobacco production, which first began in the former Rhodesia in the early 1900s, is closely associated with colonial history and land occupation by white settlers. The Zimbabwe (formerly Rhodesia) Tobacco Association was formed in 1928 and soon became a powerful political force. Although land redistribution has always been a central issue, it was not adequately addressed after independence in 1980, largely due to the need for Zimbabwe to gain foreign currency and safeguard employment. However, by the mid-1990s political pressures forced the government to confront the mainly white, commercial farmers with a new land acquisition policy, but intense national and international lobbying prevented its implementation. With advent of global economic changes, and following the start of a structural adjustment programme in 1991, manufacturing began to decline and the government relied even more on the earnings from tobacco exports. Thus strengthening tobacco control policies has always had a low national and public health priority. Recent illegal occupation of predominantly white owned farms, under the guise of implementing the former land redistribution policy, was politically motivated as the government faced its first major challenge at the general elections in June 2000. It remains unclear whether this will lead to long term reductions in tobacco production, although future global declines in demand could weaken the tobacco lobby. However, since Zimbabwe is only a minor consumer of tobacco, a unique opportunity does exist to develop controls on domestic cigarette consumption. To achieve this the isolated ministry of health would need considerable support from international agencies, such as the World Health Organisation and World Bank.
本文运用历史和政治经济学视角,探讨了世界第六大烟草生产国及第三大烟草出口国津巴布韦的烟草控制前景。烟草生产始于20世纪初的前罗德西亚,与殖民历史以及白人定居者的土地占有密切相关。津巴布韦(原罗德西亚)烟草协会成立于1928年,很快便成为一股强大的政治力量。尽管土地重新分配一直是核心问题,但在1980年独立后并未得到充分解决,这主要是因为津巴布韦需要赚取外汇并保障就业。然而,到20世纪90年代中期,政治压力迫使政府以一项新的土地收购政策应对主要为白人的商业农场主,但国内和国际上的强烈游说阻碍了该政策的实施。随着全球经济变化的出现,以及1991年结构调整计划的启动,制造业开始衰退,政府更加依赖烟草出口收入。因此,加强烟草控制政策在国家和公共卫生层面的优先级一直较低。近期,以实施先前的土地重新分配政策为幌子,对主要为白人所有的农场进行的非法占领具有政治动机,因为政府在2000年6月的大选中面临首次重大挑战。目前尚不清楚这是否会导致烟草产量的长期下降,不过未来全球需求的下降可能会削弱烟草游说团体的力量。然而,由于津巴布韦只是一个烟草消费小国,确实存在一个对国内卷烟消费进行管控的独特机会。要实现这一点,孤立无援的卫生部将需要世界卫生组织和世界银行等国际机构的大力支持。