Relative — Wara Alderete

January 26, 2011
Nadine Robitaille

Ethel “Wara” Alderete believes that success, no matter how small, should be celebrated.

The tobacco control advocate and Director of Argentina’s Instituto de Ciencia y Tecnología Regional has been working to limit smoking and its impact on the health of citizens in her country.

Wara was in Ottawa recently with dozens of international tobacco-control researchers, specialists, and activists to attend a series of workshops and meetings hosted by IDRC’s Research for International Tobacco Control (RITC) program.

Smoking prevention campaigns are a tough sell in Argentina where more than one in three people smokes.

Though they account for only roughly 7% of the total population of Latin America, it is estimated that Argentines are responsible for 15% of total tobacco consumed in the region.

Matters are further complicated in the tobacco-producing province of Jujuy where Wara lives and works. Tobacco is this northwestern province’s second-largest crop after sugarcane.

“At the local level, tobacco is one of the main economic activities,” explains Wara. “And at the national level…several tobacco growers are legislators in the national congress. They develop strategies with the tobacco industry that are very effective in lobbying against tobacco control and that is the biggest barrier to passing legislation.”

Argentina has been slow to ratify the World Health Organizations’ Framework Convention for Tobacco Control (FCTC), the global health treaty that commits ratifying governments to meaningful action on tobacco – invoking new laws and price measures, investing in public education and cessation programs, and promoting alternative livelihoods for tobacco growers (see sidebar for more information).

But facing tough obstacles is nothing new to Wara.

Argentina and Tobacco Control

A nationwide survey published in 2006 showed overwhelming support for laws that establish “smoke-free spaces” in public buildings such as offices, factories, shopping malls, and banks (93.4% overall support, 85% among smokers), and that completely forbid smoking in schools, universities, and hospitals (97%).

 
More than three quarters of those surveyed (including almost two thirds of the smokers) also supported smoking bans for bars and restaurants.
 
The cost of the treatment of tobacco-related diseases amounts to 4 300 million Argentine pesos (roughly US $1.4 million) per year, which is 15.5% of the total public expenditure on health care. In contrast, the government only collects 3 500 million pesos per year from cigarette taxes.
 
According to Argentina’s National Program on Tobacco Control, tobacco use causes more than 40 000 deaths a year, 6 000 of those due to secondhand smoke.

A future interrupted

In the late 1970s, Wara was studying chemical engineering when, after years of dictatorships, political violence, and revolt led by left-wing organizations, a military junta seized power and invoked martial law in Argentina.

Thousands of liberal and left-wing supporters “disappeared” during the dictatorship’s seven-year rule. Human rights groups now estimate that as many as 30 000 people — more than 20% of them students — may have been tortured and killed during the “Dirty War.”

“It was a massive persecution. It was havoc everywhere,” Wara recalls. “It was not safe to stay there, so I had to leave my country,” she says. “Exile is something you never fully recover from.”

Forging ahead

While difficult, Wara admits that her exile did lead to positive experiences.

She settled in the United States where she met her husband, raised her family, and then returned to school, enrolling in the University of California, Berkeley, where she earned a PhD in public health.

During her studies in the early 1990s tobacco control began to emerge as a critical international public health issue. As the evidence of the impact of smoking on health mounted, tobacco use began to slowly decline in rich countries, where the tobacco industry made most of its sales.

“It seemed obvious to me that, with fewer people in developed countries smoking, tobacco companies would soon start trying to increase tobacco consumption in developing countries,” Wara says.

“I thought that this was going to be one of the main problems we’d be facing in terms of health in developing countries in the near future.”

Unfortunately, statistics now support Wara’s prediction.

Tobacco consumption in most high-income countries — such as Britain, Canada, the United States, Australia, and most northern European countries — has fallen over the past 20 years. Meanwhile, smoking levels are increasing in poorer regions, especially among young people, as tobacco firms and cigarette manufacturers push into new markets.

The World Health Organization predicts that by the mid-2020s, 85% of all smokers will be in developing countries.

Returning home

Although circumstance had brought her far from home, Wara always knew she’d be back.

“I was always convinced that I’d return to Argentina at some point,” she says. “I’m back in my country, and I’m trying to give back some of the knowledge, the tools, and the resources I was able to acquire in the States.”

She has been heading the Instituto de Ciencia y Tecnología Regional (ICTER) in San Salvador de Jujuy since 2002. Through its smoking prevention mandate and activities, ICTER strives to inform and encourage people to live and work in healthy, smoke-free environments.

In 2000 Wara discovered IDRC and its RITC program. She wrote a project proposal and was awarded a RITC small research grant. Since then she has received continued funding from RITC.

“The support from RITC was the starting point,” she says. “That was the first tool we had.”

When attempts to effect change at the national level proved largely unsuccessful, ICTER adopted a bottoms-up approach for their fight for comprehensive anti-tobacco legislation: community awareness and mobilization.

Using community-based interventions, including involving youth in developing and implementing of tobacco control actions, and holding a “quit and win” contest for cash prizes, ICTER has raised awareness about the health effects of tobacco, and their rights to smoke-free public spaces.

“The important thing is that we see social change, that people learn that they have rights to live and work in a healthy environment. We want to create a snowball affect,” says Wara. “Once this process begins, I don’t think it will stop.”

“I want what all tobacco control advocates hope for: comprehensive tobacco control interventions countrywide,” she says. “however, I think the only insurance that any intervention will be sustainable is if there is community awareness and support.”

It seems that ICTER is getting that much-needed support. Recently, Wara overheard a conversation between two people discussing how their life, and the lives of family members, had changed for the better since their workplace went smoke free.

Sounds like a success story.

The WHO’s Framework Convention on Tobacco Control
 
The FCTC entered into force on February 25, 2005.
 
To date, 168 countries have signed the treaty, and more than 150 have become Parties
 
Canada became a Party to the FCTC on November 26, 2004.
 
Countries that have ratified the FCTC have vowed to
  • eliminate illicit trade in tobacco products
  • ban tobacco sales to and by minors
  • promote alternative livelihoods for tobacco farmers
  • restrict or ban tobacco advertising, promotion, and sponsorship
  • protect non-smokers from tobacco smoke in public places, including workplaces, public transport, and indoor public places
  • require health warning labels on tobacco product packages
  • include tobacco cessation services in national health programs.
For more information: www.who.int/tobacco/framework/en/