Cancer survivor pitches for sin tax

MANILA, Philippines - This week Emer Rojas will square up for another round with the industry that took his voice, but failed to silence him.

The 54-year-old father of four from Quezon City has become the face of support for the so-called sin tax and an unlikely thorn in the side of Big Tobacco.

Rojas was a two-pack-a-day smoker until he had his vocal chords and much of his neck muscles removed after being diagnosed with advanced throat cancer.

Three weeks ago he addressed the Senate - with the help of an electronic vibrating machine that replaces his lost vocal chords - in support of the sin tax law.

“They (the senators) didn’t expect that a victim would show up. Because they know that most of the victims in the Philippines just die immediately,” Rojas says, smiling at the memory.

But now, with smoking-related illnesses killing an estimated 10 Filipinos every hour, Rojas fears his message has been ignored.

Early this week the Senate Committee on Ways and Means is due to present its report on Senate Bill 3249.

If passed unaltered, it would increase the cost of a pack of a leading cigarette brand from P30 to about P55 up to 2017 - still cheap compared to other regional countries, but enough of a rise to potentially save 200,000 lives annually.

But Rojas and other health advocates now fear the Ways and Means report will support watered-down tax increases.

The local tobacco industry has argued the proposed increases need to be tempered to protect the livelihood of the country’s tobacco farmers and their families.

If the bill is diluted, the cancer-support group the New Vois Association of the Philippines, of which Rojas is founder and president, will take to the streets in protest.

He says the group gains about five members a month - but loses three in that time.

“We will remember them (the senators) during election time if they will listen to the people, rather than the interests of a few wealthy industry players.”

An unlikely campaigner

Ten years ago, soon after his 44th birthday and 27 years of heavy smoking, Rojas suddenly lost his voice.

“For a while I thought it was just a simple hoarseness... but it lasted more than a week. So I consulted the doctor, and underwent tests.”

One revealed a tumor on his vocal chords. The cancer was advanced and had spread around his neck - but crucially not to his brain or lungs.

Doctors told the electrical engineering graduate and information technology business owner he would need an operation to remove his vocal chords and about 44 percent of his neck muscles.

“I was really devastated, because all people - especially if you’re a businessman - I used my voice a lot. So if I lose my voice, everything will be changed.”

Rojas was his family’s breadwinner, with his eldest daughter at 17 about to enter college.

“I thought, ‘What will happen to these kids if I die? We don’t have enough savings for them to go on with their lives and finish their studies,’” he says.

“So I tried to slug it out with cancer. And probably that’s one thing that made me survive - because of the will to fight cancer. And of course, a lot of prayers also.”

Relatives in the United States saved money and sent him an electrolarynx machine at a cost of about $700 - something he says is far out of reach for most Filipinos.

With therapy he slowly re-learned how to talk, but hid his condition from society and rarely left his home.

Four years after his operation, his relative, a college professor, urged him to talk to his students about the dangers of smoking.

“The first time after sharing my experience, I saw them throw their cigarettes in the waste bin. The janitor was very happy - he got a lot of cigarettes,” Rojas laughs.

“From then on I realized I had a powerful voice, despite the absence of my voice.”

 A killer of the poor

Rojas’ ordeal - he describes himself as a “walking graphic health warning” - and determined intelligence has seen him become a leading anti-tobacco advocate, both in the Philippines and abroad.

He has been chosen by the American Cancer Society as a global cancer ambassador, and addressed the United Nations on the subject last year.

Rojas says his tireless work is thanks to God for a second lease on life - although he acknowledges pesos played a part, too.

“In the Philippines we don’t have any social insurance. And the government cannot afford to have its people taken care in the hospital,” he says.

An inability to pay for doctors’ visits and widespread shame of sickness means by the time Filipinos seek treatment their cancer is often advanced.

Rojas says the two-tiered health system meant a cancer diagnosis for the poor likely meant death.

“More often than not, people who get cancer just wait for their time, inside their rooms.

“If you go to the government hospitals right now, you will see charity patients, or social welfare patients, lined-up along the corridors.”

Rojas cites the example of one member of New Vois, who was diagnosed with a neck tumor, but by the time he received a free MRI scan the cancer had spread and was inoperable.

In 2010 the government estimated it collected about P24 billion in excise tax on cigarettes and alcohol - an amount greatly outweighed by the amount spent to treat illnesses connected to the drugs.

“It is important the sin tax bill is not watered down. Because if it isn’t watered down, P60 billion will be generated (annually),” Rojas says. “And from that P60 billion, P50 billion will go to the universal health care, to provide health services to the poorest of the poor.”

Industry fights back

The National Tobacco Administration (NTA) has argued that Senate Bill 3249 threatens the livelihood of two million Filipino workers.

It says it supports the government’s efforts to protect health, but wants reasonable tax hikes to lessen the impact on the country’s tobacco farmers.

Tax hikes would hurt the cheaper brands - which contain Filipino tobacco - most, the NTA claims.

But Rojas says such arguments are misleading.

The current sin tax would allocate 15 percent of revenues collected from tobacco products to programs to promote economically viable alternatives to tobacco farming.

Rojas says that would amount to P4.5 billion in the first year of implementation alone.

“It’s not the livelihood of the farmers that they are fighting for. It is the manufacturers,” he says.

With countries such as Australia heavily taxing cigarettes and introducing measures such as plain packaging, Rojas says developing countries are a new front in the global anti-smoking war.

About 18 million Filipinos are smokers – about a fifth of the population.

“At the moment here you can buy one cigarette for P1. Well, one candy costs a peso and 50 centavos,” Rojas says. “People are dying. People get sick, and people die prematurely. They should not be dying at this age.”