Initially published on Dakar Actu
A STRONG COMMITMENT AGAINST ARTIFICIAL DEPIGMENTATION
President Paul Kagame's courageous decision to tackle voluntary cosmetic depigmentation head on is to be commended in more ways than one.
For more than four decades, several authorized voices have informed and alerted not only the population but also the state authorities about the dangers of the cosmetic use of depigmenting products , but it is clear that all the warnings have remained unheard.
Fortunately, the charismatic Rwandan president declared on November 25 that his administration was determined to remove skin whitening from the cosmetic habits of Rwandans.
Confirming his words, his Minister of Health, Dr. Diane Gashumba, said that a law governing the use of these chemicals has already entered into force and that some regulatory bodies such as the Food and Drug Authority and the Rwanda Standards Board, will be mobilized.
AN INTERNATIONAL CONDEMNATION
Before, the Rwandan FDA, the American FDA (Food and Drug Administration), had been seized on November 01, 2017, by American dermatologists of the Georgetown University of Washington who reported to the FDA a case of misuse of dermocorticoids in a patient of African-American origin.
In addition, they reported that these drugs came from specialized stores for African products where they were sold over the counter.
It should be remembered that in the United States, Food and Drug Administration (FDA) regulations require that potent dermocorticoids be available only by prescription because of potential adverse effects.
This letter to the FDA was widely reported in the press. This shows a desire for balance in the treatment of information concerning the prevention of health risks regardless of ethnic group.
Hélas, Malgré L’Impact Sur La Santé Publique
The warnings have gone unheeded for several decades on this continent which pays a heavy price for the medical complications of voluntary depigmentation.
Indeed, for several years, health professionals have been protesting against the fact that dermocorticoids are used as cosmetics when they used to be drugs and the fact that hydroquinone is used as an ingredient in the manufacture of cosmetic products.
No concrete measures have been taken by the authorities either to regulate the advertising of depigmenting products or to prohibit the sale of these drugs diverted from their use. For its part, the European Union has banned the use of hydroquinone in the manufacture of cosmetic products since 2001.
However, many depigmenting products are manufactured in Europe before being exported to Africa...
The fight against street drugs should include dermo corticoids used for cosmetic purposes.
D’Autres Pays Avant Le Rwanda
Certainly other countries such as South Africa, Gambia, Burkina Faso, Ivory Coast, Kenya and Ghana have tried to tackle this phenomenon with mixed results.
In the Gambia, after the announcement effect, the practice has continued unabated, in Côte d'Ivoire only products containing hydroquinone are prohibited, while in Burkina Faso, even if the advertising of depigmenting products is prohibited, the frequency of the phenomenon does not seem to have decreased.
In South Africa, Kenya and Ghana the results seem to be more encouraging.
Mais Toujours Pas Le Sénégal
In Senegal, the health consequences are now well known by the population thanks, in part, to a continuous awareness raising for many years. The A.I.I.D.A association has been playing its part for almost 17 years.
Sociologists, journalists, members of the civil society, in short all the bangs of the society have always been indignant about the lack of reaction from the state authorities.
However, in Senegal, in 2018, scientific studies have confirmed not only the extent of the phenomenon (more than 60% in Kaffrine, more than 50% in Parcelles Assainies), but also the association with skin cancers and the high economic cost.
Despite all this, Senegal remains the great absentee in the fight against depigmentation in Africa. The State and local authorities would benefit from following the lead of other countries in taking concerted action to tackle this fashionable phenomenon that has become a public health priority.
Otherwise, history will remember that Senegal, an independent country since 1960, where one of the first faculties of medicine in Africa was built, which had one of the most efficient health systems in Africa, a hygiene and public health policy cited as an example in the world, preferred to increase taxes on depigmenting products instead of prohibiting them.
History will remember that the State of Senegal has mortgaged the future of its children, has preferred the profits from the manufacture, sale, and advertising of toxic products to the health of its population.
Finally, history will remember the obvious contradiction in Senegal's health policy which, on the one hand, makes the fight against non-communicable diseases, including cancer, a priority and, on the other hand, favors the occurrence of skin cancers by allowing the sale of toxic products for the skin.
Le succès passe par des actions concertées à l’échelle africaine
As signatories of the UN Charter for the achievement of the MDGs, sub-Saharan African countries must actively engage in the fight against VCT and its health consequences in order to meet the 2030 deadline. Indeed, the continuation of this practice constitutes an obstacle to the achievement of goals 1, 3, 5, 10 and 14 set out by the United Nations.
Almost all of these goals have a health component or will contribute to improving global health. However, the good health of the population depends on the prevention of pathologies linked to behaviors such as pathologies associated with VCD.
The banning of depigmenting products and their withdrawal from the cosmetics market is imperative. However, the involvement of women to ensure their support and ownership of the planned actions (cosmetovigilance, sector regulations, particularly in the advertising sector) will be a guarantee of success.
President Kagame for all the actions taken since his accession to the head of the AU is certainly the one who most embodies this leadership.
Mais Attention Cette Bataille Ne Sera pas Facile
The battle will be tough but deserves to be won and the Rwandan president, president of the AU and therefore of the Africans, will be able to use his charisma to invite his African peers to come to the end of this scourge, a real plague, and cholera of the XXI century.
On their way, the harsh economic reality with job losses, lobbying of some cosmetic industries threatened to put the key under the mat. The drop in customs revenue but also the addiction of some women to depigmenting products ...
As an example, let's recall the case of France in 2015 where, despite the fact that the National Academy of Medicine advocated a total ban on tanning booths for aesthetic purposes, the union of tanning professionals was strongly mobilized.
It was not until 2018 that the National Agency for Health Security (Anses) asks "public authorities to take any measure to stop the exposure of the population to artificial UV" in front of the risk of cancer "proven".
But there are other encouraging examples in the fight against pathologies related to behavior. For example, Brazil and Australia succeeded in banning the use of tanning booths for aesthetic purposes in 2009 and 2014 respectively.
Remember that these are incriminated in the occurrence of melanoma, which is the most deadly skin cancer. The WHO has even classified UV rays from tanning booths as carcinogenic since 2009 because they increase the risk of melanoma, the most aggressive form of skin cancer, by 75%.
In the interest of fairness, the WHO should also look at the DPs whose long-term use is associated with squamous cell carcinoma in subjects of phototype VI, i.e. black subjects.
Let us hope that the World Organization will soon address this issue, and not only for cosmetic purposes.
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