Negotiations are being launched for a new Convention on Tobacco Convention to be finalised by 2003 under the World Health Organisation. Since smoking is the main cause of preventable death (estimated victims: 10 million by 2030), this international agreement will be a good step forward. Some health groups however are calling for it to have "real teeth" by also tackling the key issue of the international trade of tobacco products.

by Martin Khor

The fight against smoking is moving to a new stage this week when the World Health Organisation launches negotiations for an international framework convention on tobacco control.

The World Health Assembly, now meeting in Geneva, is expected to pass a resolution establishing a negotiating body and a working group under the WHO to produce a convention by the year 2003.

If it comes into being, the Framework Convention on Tobacco Control (FCTC) would be the first legally-binding global agreement to curb tobacco. And it would also be the first time the WHO is initiating an international convention on a health problem. In This it has lagged behind the UN Environment Programme which has sponsored many environmental agreements.

Whilst the proposed convention is being widely lauded as a significant step forward, some NGOs and analysts have pointed out its scope (as spelled out in WHO documents) appears to be limited. In particular, it does not sufficiently deal with curbing the international trade in tobacco.

Smoking is one of the most important causes of preventable deaths in the world. Its dangers are well known and governments pay at least lip service to curbing it. Ironically, however, the overall rate of smoking is escalating and so too is the numbers of deaths.

In 1998, at least 3.5 million people died from tobacco use. If the pandemic is not controlled, the figure is expected to rise to 10 million by 2030 and of this 7 million deaths will be in developing countries.

According to the WHO, the FCTC would be based on the principles that tobacco causes inequities, must be considered a harmful commodity, the public has a right to know about its dangers and all sectors of society must contribute to combating the tobacco epidemic.

Under the Convention, countries will take coordinated actions to meet its aims, including protecting the young from tobacco exposure and use; preventing and treating tobacco dependence; promoting smoke-free environments; promoting healthy tobacco-free economies; strengthening women's role; enhancing the capacity of countries in tobacco control and exchanging information; and protecting vulnerable communities.

Protocols would also be set up under the Convention to address issues such as prices, smuggling, tax-free tobacco products, advertising and sponsorships, Internet advertising and trade, testing methods, package design and labeling, information sharing and agriculture diversification.

The process of developing the FCTC is expected to help mobilise support for tobacco control, raise awareness among various Ministries and the public, strengthen national laws and action, and mobilise NGOs.

Whilst the aims of the Convention are laudable and its launching has been supported by many groups campaigning against smoking, some health activists see its scope as being too limited as it fails to deal with the pressures being piled on developing countries to open their markets to the giant tobacco companies of the industrial countries.

Unless the Convention becomes an effective countervailing force to unilateral trade actions (particularly by the United States administration) and to the World Trade Organisation (which is used by industrial countries to get developing countries to tear down barriers to their tobacco firms to sell to and produce in the developing world), it would be unable to curb the rising trend of smoking in the South.

And that would be both ironic and tragic: since the tobacco companies lose their revenues and markets in the West as a result of many court cases against them and increasingly stringent governmental controls, they are now focusing on increasing their sales in Third World markets.

The Consumers' Association of Penang, one of the leading Third World campaigners against smoking, played an active role in NGO events in Geneva last week, calling for stronger action against the tobacco trade to be included in the FCTC in order to give it "teeth."

CAP's research officer Mary Assunta represented Third World health groups at several NGO workshops on the tobacco convention that preceded the World Health Assembly.

In a speech at the NGO Forum on Health, Assunta said the decrease in tobacco consumption in the US and Western Europe had resulted in tobacco transnationals turning to the developing world to make up for their loss of markets.

"Whilst per capita consumption of tobacco fell 10 percent between 1970 and 1990 in developed countries, it increased 64 percent in developing countries," said Assunta. "Per capita consumption has more than doubled in Haiti, Indonesia, Nepal, Senegal and Syria, whilst it has tripled in Camroon and China.

"The bulk of the carnage in the future will occur in developing countries, with 7 million deaths a year in the 2020s."

Assunta said the FCTC is a good step forward but must go further if it is to have teeth and the most crucial point it must address is the trade aspect of tobacco.

In the West, national laws are being tightened, court cases are mounting, compensation for Medicare is being paid out by tobacco companies, and the anti-tobacco lobby is gaining ground.

"Unfortunately this has resulted in cigarettes being pushed from developed countries into developing countries," she said. "Tobacco control actions in the North are unfortunately resulting in killing more people in the South. This is why the Convention must address the international trade aspect of tobacco."

In 1964 the US Surgeon General issued the first report declaring cigarettes a major cause of disease and daeth. Despite this knowledge, said Assunta, the US government was instrumental in forcing open markets in Asia in the 1980s which were then closed to its tobacco transnationals. Japan, Korea, Taiwan and Thailand were then having their own tobacco companies with lax promotion.

"But the US used its Super 301 trade law (enabling the use of unialteral trade actions against trading partners) and prised open these markets, its tobacco companies captured the young with glitzy advertisements and sales gimmicks," said Assunta.

"The results were devastating. After the arrival of Malboro Man and other American cigarettes, smoking among the young rose significantly: from 19.5 to 32.2 percent in Taiwan, by 16 percent in Japan, and by 24 percent among Thai teenagers."

Assunta proposed that the following measures be included in the Convention:

** Ban the export of tobacco from developed to developing countries. Such a ban (from OECD to non-OECD countries) already exists for hazardous wastes in the Basel Convention under the UN Environment Programme. It should be extended to tobacco since it is the only consumer product that kills when used as intended by the manufacturer. Besides merely classifying nicotine an addictive drug, its trade should be banned to make tobacco control effective in the South.

** Export only with prior informed consent. If an export ban is not yet possible, at least the Convention should specify that no country should be allowed to export tobacco unless there is "prior informed consent" in writing from the importing counties. Developing countries should have the right not to import tobacco if they so choose. Exporting countries must also furnish to the importing countries all knowldege and information about the product.

** Liability and compensation by manufacturers for adverse effects. The Convention should include the principle that tobacco companies be liable for disease and death from their products in all their global markets. The compensation paid by the tobacco industry to the state and federal governments and to individual victims in the US should be an example of a similar type of liability and compensation system in the Convention. So far the US companies have remained silent about compensation outside the US.

** Phasing our tobacco cultivation. The Convention should also promote the shift away from tobacco cultivation and production, and not only deal with control of marketing.

Whether or not the above proposals will be seriously considered by governments in the Convention when it is launched remains to be seen. Speaking at the World Health Assembly, the US Secretary of Health Dr Donna Shalala addressed the tobacco issue, stating "we must find ways to protect our children from the dangers of the new tobacco epidemic" and pledged to work with WHO on the Tobacco Convention.

As the Convention negotiations get going, public health groups will be watching whether public health concerns of the developing world can be made to take precedence over the trade pressures and concerns of the developed countries.

Martin Khor is the Director of Third World Network.


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