By Providence Ayanfeoluwa

The World Health Organization’s Framework Convention on Tobacco Control (FCTC) Conference of Parties (COP11) was held last week in Geneva from 17 to 22 November.

COP11 highlighted key debates between those demanding strong, abstinence-based controls and those advocating for harm reduction. The ‘Lives Saved – 100 Million’ report illustrates the massive potential of harm reduction tools to save lives globally. The time for decisive action is now.

Africa stands at the center of this debate. Faced with overwhelmed healthcare systems and persistent smoking epidemics, the continent must move immediately. The ‘Lives Saved – 100 million’ report signals that adopting innovations such as e-cigarettes and nicotine pouches can save millions of lives. Delaying is not an option—urgent action is required to protect Africa’s future.

Traditional controls—bans, taxes, campaigns—are effective but insufficient given Africa’s complexities. Evidence finds e-cigarettes may nearly double quit rates versus conventional aids. Thus, Africa needs frameworks based on local research and flexible, inclusive policymaking.

Many governments aim to lower the health burden from smoking-related diseases. In Africa, the challenge is more complex. There are higher smoking rates and limited support for quitting. Imported regulations often do not fit local realities. James, a 35-year-old father of three in rural Kenya, tries to quit smoking without access to cessation programs or resources. His struggle reflects the support gap for people like him across the continent. It highlights the need for truly local policies.

Lessons from the Good COP 2.0

At Good COP 2.0 in Switzerland, a third-party event in the sidelines of the WHO FCTC’s COP, experts advocated for evidence-led decision-making and greater flexibility in harm reduction, particularly regarding e-cigarettes, supported by studies showing higher quit rates. This approach contrasts with the WHO FCTC’s abstinence focus and signals a shift toward science-based, regionally tailored strategies.

Speakers also emphasized the importance of transparency and scientific integrity as guiding principles for global health policy. Building on other discussions, Tikki Pangestu warned that ‘follow the science’ has too often become little more than a slogan. This phrase can leave dissenters unheard. A public evidence-hearing mechanism could help as a transparency tool and answer this critique. Such a mechanism would give a platform for diverse voices and ensure discussion of both supporting and challenging evidence. Consumer stories, like Kurt Yeo’s switch from smoking to vaping, showed why agency and access matter. Experts noted that harm reduction is not just for health. It is also an economic issue that can reduce disease burdens and taxpayer pressure. Clive Bates and Jeannie Cameron urged policy reform, not roll-back. They called for the update of treaties to embrace innovation, inclusion, and evidence. This momentum sets the foundation for Africa’s next policy moves.

The core message is clear: Africa’s tobacco control must be rooted in local scientific evidence, authentic consumer representation, and innovation tailored for African realities. There is no time to wait. Developing Africa-specific, science-based frameworks is non-negotiable—we need to start building them now to drive real and lasting public health progress.

Emerging Themes from COP11 (2025)

At COP11, youth nicotine addiction emerged as a central concern, with Belgium convening a Ministerial Roundtable that called for stricter rules on new products and flavours. For Africa, this presents a critical dilemma: how to protect young people from addiction while ensuring adults have responsible access to safer alternatives that could save lives. Striking the right balance—limiting youthappealing flavours or marketing, while maintaining regulated adult access to less harmful products—remains essential. Approaches must simultaneously satisfy public health experts, protect youth, and serve adult smokers’ needs. The conference also spotlighted Tobacco’s environmental impact, with proposals to hold producers accountable and ban single-use plastics. Harm reduction can strengthen this agenda by linking environmental and health gains, such as reduced filter waste and lower disease rates, thereby attracting support across multiple ministries.

Delegates further discussed liability under Article 19, exploring recovery tools and sanctions that could help African governments align health, environmental, and harm reduction goals. While some Parties pushed for radical ‘endgame’ measures such as sales bans and reducednicotine products, such approaches pose feasibility challenges in Africa, given the lack of parallel harm reduction options. Experience shows that bans often fuel black markets and enforcement difficulties, whereas safer alternatives like e-cigarettes and nicotine pouches offer a pragmatic pathway to reduce tobacco use. Policymakers must weigh these trade-offs carefully to ensure realistic, effective strategies.

Finally, COP11 highlighted the risks of industry interference, warning that harm reduction can be misused to weaken regulations. African advocates must ensure harm reduction remains science-based and consumer-focused. Resource constraints were also emphasised, with many Parties struggling to implement even basic measures. For Africa, this underscores the urgency for affordable harm reduction strategies that complement prevention and cessation. Civil society voices linked tobacco control to human rights, gender, and environmental justice—an especially vital framing for Africa, where tobacco disproportionately harms vulnerable communities. Grounding harm reduction in equity and justice offers a path to fairer, more sustainable public health progress.

Why Africa Needs Its Own Tobacco Control Playbook

Tobacco control in Africa must match local enforcement realities to avoid unintended black markets, as seen in Kenya’s 2015 display ban. Equally, harm reduction should be adopted by providing safer, regulated substitutes. Building trust requires transparency and the engagement of consumer voices in policymaking, not exclusion. African-led research is vital to inform harm reduction strategies tailored to local settings, while bodies such as the African Union can drive regional cooperation and oversight. These steps together create a balanced, science-based framework responsive to local contexts.

African governments must act decisively: embed science-based, risk-proportionate language into strategies, set measurable goals- such as differential tax structures- and monitor for meaningful declines in smoking. Institutionalize the involvement of consumers, researchers, and harm reduction advocates for genuine policy impact. Allocate resources for African-led research. Strengthen regional governance, boosting enforcement, and demand full transparency now. Build a strong, context-sensitive framework without delay to protect public health and secure Africa’s future.

COP11 revealed one truth: Africa’s tobacco control landscape is changing rapidly. Policymakers, scientists, and civil society leaders must act now—boldly and without hesitation—or risk losing the chance to save millions of lives. This is Africa’s moment to act and lead.