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Kai Ryssdal: Hillary Clinton starts a trip to Africa today. Seven countries in 11 days. One of the seven is South Africa. The Secretary of State will talk about the AIDS crisis there. She's expected to promise American support for wide range of other health initiatives, too. The South African government is trying to cut back on smoking-related diseases. Tobacco companies are cultivating millions of new smokers in Africa as the West cracks down on the habit. But activists in South Africa, who had some success against international businesses during Apartheid, are fighting back. Gretchen Wilson reports.
GRETCHEN WILSON: At a construction site south of Johannesburg, Sibusiso Mtshali takes a lunch break. As he comes off the site, the first thing he does is light a cigarette.
SIBUSISO MTSHALI: It's like if you are thirsty you want to drink some water.
Mtshali knows the risks.
MTSHALI: Smoking is not right. We kill ourself. But if you want to relax, light your cigarette.
The World Health Organization says there are now a billion smokers around the world. More than 80 percent of them live in low-and-middle-income countries like South Africa. Francois van der Merwe heads the Tobacco Institute of Southern Africa, a lobbying group for the industry.
FRANCOIS VAN DER MERWE: Emerging markets, developing countries in the world, are growing markets for tobacco products.
Many African governments are trying to pass reforms aimed at reducing tobacco use. Yussuf Saloojee heads South Africa's National Council Against Smoking. He says the tobacco companies have tried to stymie those reforms.
YUSSUF SALOOJEE: They've acted in South Africa the way they act all around the world, which is both bribing and bullying governments and trying to get them not to act.
He says the tobacco industry tries to cozy up to public officials with free cars or vacations. And threatens the government with expensive lawsuits.
But South Africa has largely resisted those tactics, making it an example for the developing world. When apartheid ended in 1994, the new government enacted a series of tobacco control laws.
South Africa's roads used to be plastered with cigarette billboards. Not any more. Nor any other tobacco advertising. Smoking's banned in many public places. Brand new legislation ups the fines for selling cigarettes to minors. Back in 1994, about 33 percent of adults here smoked. Now that's down to 22 percent.
SALOOJEE: So not only has South Africa taken strong legislative action, but the actions have proven to work.
Farmers have grown tobacco in South Africa for centuries. And the tobacco industry here generates a billion dollars in excise taxes every year, about 1 percent of government spending. Industry officials say tough legislation means governments lose that money as sales are driven into an unregulated black market. Again, Francois van der Merwe of the Tobacco Institute.
VAN DER MERWE: Nobody can deny the massive economic impact of the tobacco industry in the world, in terms of taxes, in terms of jobs, in terms of being good corporate citizens.
But anti-tobacco activists say that even in the region's poorest countries -- like Malawi and Zambia -- those lost taxes and jobs are nothing, compared to what smoking-related diseases cost the public health systems.
Kathy Mulvey is international policy director for Corporate Accountability International, a nonprofit group that fights for tougher tobacco laws around the world.
KATHY MULVEY: These are the countries that can least afford the burden of an entirely preventable epidemic. So it's a ticking time bomb of health and economic disaster.
She says even the countries with the strongest political find it hard to go up against the vast resources of the big tobacco companies.
MULVEY: You know, what we're talking about are giant transnational corporations whose annual revenues eclipse the economies of many of these individual countries.
In South Africa, a company called British American Tobacco is the largest manufacturer and distributor of cigarettes. But it's now expanding its reach to friendlier shores. The global giant recently announced it would buy the fourth-largest cigarette maker in Indonesia.
In Johannesburg, I'm Gretchen Wilson for Marketplace.