Why Africa needs locally adapted, science-based tobacco frameworks: A call to action after COP11

By Dr Vivian Manyeki

Every year, the world comes together to discuss global climatic issues affecting the environment, while the tobacco industry regulators head to the WHO’s Framework Convention on Tobacco Control (FCTC) Conference of the Parties (COP). This event serves as the primary platform for reviewing global tobacco control policies, setting international standards and guiding member states on effective strategies. This year’s meeting took place on November 17-22.

Decisions made at COP greatly influence national regulations, public health priorities, and the adoption or rejection of innovative approaches such as harm reduction.

For many years, the tobacco industry, which is trying to evolve from cigarettes to innovative nicotine and tobacco products, has called for the FCTC to adopt harm reduction strategies. But this conversation has not been welcoming at the FCTC.

COP11 marks a decisive moment for tobacco control, after countries called for a relaxation of the hard-line stances so far adopted at the behest of Western countries. African countries, in particular, feel that they can no longer be imposed upon to implement strategies that no longer work, ignore evidence, and seek to abolish the innovations.

Tobacco control has long fought cigarettes and the harms of smoking. What industry is unable to understand is why regulators appear tone deaf to new innovative products whose spectrum of harm is so much less. They continue to put the same energy into fighting the far less harmful products, turn their back on the evidence, and cite the accessibility of these products to children as a reason.

Africa stands at the centre of this debate. Faced with overwhelmed health systems and persistent smoking epidemics, the continent cannot afford to ignore the evidence or the pragmatic approaches afforded by these products. E-cigarettes and nicotine pouches can save millions of lives, as highlighted in the Saving 100 Million Lives by 2060 report.

According to research, e-cigarettes may nearly double quit rates versus conventional aids. The report illustrates the massive potential of harm-reduction tools to save lives globally. So, delay is not an option. Urgent action is required to protect Africa’s future.

Many African governments aim to lower the health burden from smoking-related diseases, but are held back by poverty and limited fiscal realities. Think of a 35-year-old father of three in rural Kenya, who wants to quit smoking. Advising him to go for Nicotine Replacement Therapy (NRT), which is expensive, is to be unaware of the harsh realities of rural life. That kind of therapy is only accessible to a certain class that can cover that expense.  Such a smoker needs access to openly available cessation programmes or resources. His struggle reflects the support gap for people like him across the continent. It highlights the need for truly local policies.

Imported regulations will therefore never work in African contexts because most Western-based solutions are designed for largely middle-class nations that can easily afford NRT solutions. 

COP11 highlighted key debates between those demanding strong, abstinence-based controls and those advocating for harm reduction. And the latter is slowly realising that there is a need for broader, more inclusive approaches, and stakeholder collaboration.

At the Regional African Health Summit in March 2026, the continent has a limited window to lead and reshape its future. This will be an opportunity for African leaders to take charge and discuss facts rather than ideals.

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Dr Vivian Manyeki is a medical practitioner and harm reduction advocate