Beating big tobacco
Last month the first global treaty on tobacco control was adopted. Hala Sakr reports on the politics of smoke and international efforts being exerted to stamp out tobacco use
On 24 May, 2003, the multinational tobacco industry was dealt a fierce blow when all 192 members of the World Health Organisation (WHO) adopted the Framework Convention on Tobacco Control (FCTC). The treaty was met with unanimous global support after the United States expressed its approval at the last moment. The US claimed it wanted to ensure that the treaty would not encroach on commercial free speech or state or congressional power. American attempts to allow countries to avoid certain provisions with which they disagreed were finally defeated.
The treaty includes a number of actions aiming at curbing tobacco-related deaths and diseases. According to the FCTC, countries should impose restrictions on tobacco advertising, sponsorship and promotion. New labelling on tobacco products, indoor air quality controls and more stringent legislation on tobacco smuggling are also required.
"This is a historic moment in global public health, demonstrating the international will to tackle a threat to health head on," said Gro Harlem Brundtland, director general of WHO, before the 56th World Health Assembly (WHA), the governing body of WHO.
In 1999, the WHA initiated the first comprehensive international response to the use of tobacco and paved the way for multilateral negotiations to formulate regulations hindering the spread of tobacco in the 21st century.
The 2002 World Health Report Reducing Risks, Promoting Healthy Life listed tobacco use among the top 10 health risks. According to Brundtland, combined with HIV/AIDS, tobacco use is the fastest growing cause of death in the world. WHO statistics show that there are 1.2 billion smokers around the world and that tobacco kills five million people every year. This figure could double by 2020 if the FCTC is not implemented. Over 70 per cent of the projected deaths are expected to occur in the developing world, particularly among younger generations, which are fiercely targetted by the tobacco industry to make up for decreasing smoking rates in industrialised countries.
Official statistics suggest that the number of Egyptian smokers increases by six to eight per cent every year as compared with minus one per cent in Western countries.
The internal documents of big tobacco companies were made public in the US in late 1990s. They revealed the ways in which the industry has mobilised resources in order to, as one 1988 Phillip Morris document put it, "fight and halt the deteriorating social and legislative trends against tobacco [and] resist the deterioration in public attitude towards smoking".
In February 2003, Brundtland said that research has shown that "in Canada, England and Wales, Poland and the United States, the middle age mortality gap between the rich and the poor would be reduced by one-half and two-thirds if smoking could be eliminated."
FCTC, the fruit of four years of arduous discussions and deliberations, should be particularly helpful to developing countries in building legal and regulatory protective frameworks to confront multinational tobacco companies. A united global front and universal commitment could help those countries resist the pressures of powerful tobacco lobbies.
However, the treaty must first be ratified by 40 countries before it can be implemented. Brazilian diplomat Luis Felipe Seixas de Corria, who chaired the Intergovernmental Negotiating Body of FCTC, warned of the need "to ensure the agreement we have reached will do what is intended -- save lives and prevent disease."
The controversy over the effectiveness of international treaties, particularly in the absence of any international enforcement mechanisms, has always existed. WHO, however, has expressed optimism that the FCTC could play a significant role in addressing the problem as other international agreements have done in other areas. "Arms control agreements have limited the proliferation of nuclear weapons. The General Agreement on Tariffs and Trade has brought down trade barriers... [and] production and consumption of substances that deplete the ozone layer have declined dramatically as a result of the Montreal Ozone Protocol," Seixas de Corria said.
Fatemah El-Awwa, regional adviser for WHO's Tobacco Free Initiative (TFI) in the Eastern Mediterranean Region (EMRO), told Al-Ahram Weekly that such treaties can have a positive impact by facilitating collaboration between various countries to achieve mutual goals and create a unified global stand against a common aggressor.
Given the huge economic incentives and revenues at stake, and with many states involved in the tobacco industry itself, the extent to which signatories to the treaty will be obliged to change their behaviour remains in question.
"Powerful, well-constructed myths developed and disseminated by tobacco companies over decades about the economics of tobacco remain pervasive. [They] dominate the minds of finance ministers and development agencies in many countries," stated Derek Yach, director of non- communicable diseases and mental health at WHO. "Simplistic notions conjuring up visions of massive unemployment among tobacco growers and empty government coffers as a result of tobacco control have been repeated over and over again in different settings until they are accepted by many as conventional wisdom," he added.
In Egypt, for example, the state owns the Eastern Tobacco Company, established in 1920 and nationalised in 1956. The company monopolises local tobacco production and is the largest cigarette producer in the Middle East. A report released by the Egyptian parliament in 2002 showed that tobacco revenues contributed LE3.1 billion to the state budget.
El-Awwa contends that "although major immediate changes are unlikely, long-term shifts are hoped for... [to reduce] the drastic toll of tobacco on lives and health. At the moment, the moral weight of FCTC is of utmost importance. Signatory countries should at least feel that they have to comply with their commitment."
Despite worldwide adoption, until FCTC comes into force it will be largely ineffective on the ground. "History rarely affords such an opportunity on such a large scale to so many people to contribute collectively to a process that will save lives. If we fail to rise to the challenge, history will look back and wonder why we staked our claim on truth and responsibility in the first place," notes Yach of WHO.
