WHO framework convention on tobacco control: Report of the firstmeeting of the working group (fwd)

[Robert Weissman <rob@essential.org>]

WHO framework convention on tobacco control: Report of the first meeting
of the working group

by ; Source: World Health Organization , Thursday, 10/28/99 

WORLD HEALTH ORGANIZATION

WORKING GROUP ON THE WHO (Draft) A/FCTC/WG1/7

FRAMEWORK CONVENTION 28 October 1999

ON TOBACCO CONTROL

25-29 October 1999

Agenda item

1. Opening of the meeting by Dr Gro Harlem Brundtland, Director-General 1.
Dr Brundtland, Director-General of WHO, opened the meeting with an
overview of the impact of tobacco on death and disease. The problem
extended beyond the bounds of public health, and beyond national
frontiers. WHO now led the United Nations Ad Hoc Interagency Task Force on
Tobacco Control.

Dr Brundtland hoped that the current meeting, the first in which WHO
exercised its constitutional mandate to negotiate a legally-binding
treaty, would change the course of public health.

Agenda item

2. Election of officers 2. The following officers were elected: Dr Leppo
(Finland), Chairman; Dr da Costa e Silva (Brazil), Vice-Chairman;

Dr Chan (China), Vice-Chairman; Dr Mochizuki (Japan), English-language
Rapporteur;

Dr Chaouki (Morocco), French-language Rapporteur.

Agenda item 3. Adoption of the agenda and timetable (Document
A/FCTC/WG1/1)

3. The Chairman suggested that items 10 to 13 be taken up on Thursday,
along with item 9. The agenda and timetable were adopted as amended.

Agenda item 4. Method of work of the working group

4. The Chairman noted that, by resolution WHA52.18, the Health Assembly
had established the working group on the WHO framework convention on
tobacco control pursuant to Rule 42 of its Rules of Procedure.

As a subsidiary body of the Health Assembly, the working group was
governed by those Rules of Procedure.

It was to provide not detailed text but a list of proposed draft elements
of the framework convention.

United Nations Ad Hoc Interagency Task Force on Tobacco Control, Report of
the First Session, UNICEF, New York, 1 29-30 September 1999.

2 Agenda item 5. Overview of the WHO framework convention on tobacco
control process

(a) Summary of work to date and resolution WHA52.18

5. Resolution WHA52.18 outlined an integrated process for developing the
framework convention and any related protocols. Dr Bettcher, Tobacco Free
Initiative, reviewed earlier WHO resolutions on the subject which might
guide the working group.

(b) Summary reports from the recent WHO regional committees

6. Dr Bettcher reported on the recent WHO regional committees and provided
information on forthcoming meetings.

(c) Report concerning the first meeting of the Ad Hoc Interagency Task
Force on Tobacco Control

7. Dr Yach, Project Manager, Tobacco Free Initiative, reported on the
first meeting (29-30 September 1999) of the Ad Hoc Interagency Task Force
on Tobacco Control, established through United Nations Economic and Social
Council resolution E/1999/56 of 30 July 1999, and led by WHO. The Task
Force 1 replaced the UNCTAD focal point for tobacco.

8. Focal points from WHO regions and representatives of several countries
reported on intercountry and interministerial activities in support of the
framework convention, which was seen also as a rallying point for national
work on tobacco control. The contribution of nongovernmental organizations
was acknowledged.

Agenda item 6. Technical briefings

(a) Treaties make a difference (Document A/FCTC/WG1/4)

9. Professor Laurence Boisson de Chazournes, Professor of International
Law, University of Geneva, showed how framework conventions allowed action
to be taken in stages, at different speeds in different countries,
consolidating consensus with regular meetings, in a way that permitted
amendments, and facilitated adoption of additional protocols. The
framework convention made for general cooperation, and the details were
set out in protocols. That type of instrument had proved its worth in
disarmament and environmental protection.

(b) Treaty-making process (Document A/FCTC/WG1/5)

10. Professor Paul Szasz, New York University, outlined WHO’s
constitutional authority to adopt international treaties and described the
various stages of the treaty-making process. He outlined the tasks before
the working group in relation to the future timetable for the framework
convention.

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(c) Public health context (Document A/FCTC/WG1/3)

11. Dr Alan Lopez, Evidence for Health Policy, provided a briefing on the
individual risk to health of smoking and on the implications of the
smoking epidemic for public health. There was abundant evidence that
smoking greatly increased the risk for such diseases as lung cancer and
cardiovascular disease, resulting in high excess mortality. Public health
measures could substantially reduce the burden of disease attributable to
tobacco. Local evidence of the health impact of tobacco use was stressed
as an effective tool to promote national policy.

12. Ms Roberta Walburn, Tobacco Free Initiative, described the process by
which the internal documentation of tobacco companies had been placed in
the public domain as part of the legal action brought by the State of
Minnesota, United States of America, against some tobacco companies (“the
industry”). The suit had focused on the conduct of the industry, and
particularly what it knew, and at what date, about the dangers of smoking.
The more than 35 million pages of documents had shown that the industry
had been aware of the health hazards of smoking and the addictive nature
of nicotine. Evidence had also been found of strategies to neutralize the
efforts of WHO and other organizations.

13. Representatives of Member States stressed the potential value of the
working group’s efforts in improving national control activities.

(d) Economics of tobacco control (Document A/FCTC/WG1/2)

14. Dr Prabhat Jha, Evidence and Information for Policy, highlighted the
salient findings of the World Bank’s recent book on Curbing the Epidemic:
Governments and the Economics of Tobacco Control, which provided a clear
rationale for government intervention. The central message of the study
was that a number of tobacco control interventions - notably higher
taxation - had proved successful and were cost-effective.

Developing countries could save millions of lives, especially among the
poor, if they controlled tobacco use.

At the same time, the impact of reducing or eliminating tobacco
consumption or production would have little impact on employment, and that
impact would be very gradual.

15. Representatives stressed the importance of applying taxation equally
to different tobacco products to discourage users from shifting from one
product to another.

(e) Strengthening national legislation

16. Ms Judy Obitre Gama, Lecturer in International Law, Makerere
University, Kampala, Uganda, showed how various international treaties had
helped to strengthen national legislation, and described the relationship
between international and national law.

17. In the discussion, the value of establishing a national institution or
committee to drive the framework convention process forward, raise
awareness, and prepare for changes in national legislation was further
stressed.

4 Agenda item 7. Technical briefing/discussion: preparation of the
proposed draft elements of the framework convention (Document
A/FCTC/WG1/6)

Section I. Preamble, objectives, principles and definitions

18. Participants made a number of general comments on the framework
convention as a whole and expressed views on the elements in section I,
covering the preamble, objectives and principles of the framework
convention.

19. An inclusive approach that draws upon input from a wide variety of
sectors was essential at national and international levels. At national
level it was vital to maintain close linkages between the administration
and elected bodies of Member States and to maximize involvement of
nongovernmental organizations in the process.

20. The framework convention should contain general provisions, with
protocols spelling out detailed obligations. An incremental approach was
needed that built upon the Health Assembly’s past resolutions as a minimum
starting point, taking into account the particular circumstances of
developing countries.

21. Complementary national and international approaches were needed that
built on WHO’s past resolutions, which reflected a comprehensive approach
to tobacco control.

22. Several countries urged that the provisions of the framework
convention should be worded in a manner that would allow broad acceptance
from as many countries as possible. One country expressed concern about
reference to creation of rights such as “the right to a smoke-free
environment”.

23. Several delegations said that the framework convention should be
flexible to the needs and realities of countries, especially developing
countries.

24. Many countries expressed general support for items contained in
section I of the document.

25. Some delegations suggested that issues related to testing and
measurement standards, package design and labelling, pricing, full
disclosure of tobacco product contents (including additives) should be
considered for inclusion as obligations in the framework convention and
not wait for inclusion in protocols.

Preamble

26. Primary attention should be given to the health effects of tobacco use
and the harmful effects on national economies. The importance of a focus
on youth, women, disadvantaged groups and indigenous people was
highlighted. Positive health images should be developed aimed at youth.
For that to occur, the framework convention should make reference to other
conventions that addressed youth behaviour, such as the Convention on the
Rights of the Child.

27. Other suggested additions to the preamble included referring to the
right to health in the WHO Constitution: “The enjoyment of the highest
attainable standard of health is one of the fundamental rights of every
human being without distinction of race, religion, political belief,
economic or social condition”.

28. Evidence-based interventions at the international level were deemed to
be important.

5 29. The important role of all stakeholders and sectors of society in
tobacco control was stressed.

30. The importance was also stressed of taking account of social, economic
and agricultural impacts of tobacco control, especially in developing
countries, within subregions of certain countries and within regions.

Further, explicit attention should be given to the dependence of certain
countries on tobacco growing and to the need to highlight strategies to
reduce that impact in the long term.

31. The increased impact of tobacco use in developing countries should be
stressed. Further, the implications of tobacco companies based in
developed countries marketing in developing countries needed attention.
All forms of tobacco use should be included in the framework convention.
Those included smokeless tobacco and water pipes, in addition to
cigarettes and beedis.

32. Consideration should be given to treatment of tobacco dependence and
protection from environmental tobacco smoke.

33. Several delegations stressed that the framework convention should
emphasize demand reduction strategies. Multisectoral approaches, planned
over the long term, were needed to address supply side aspects of tobacco
control. Particular attention should be given to smuggling as a supply
side measure.

34. The role, behaviour and accountability of the tobacco industry should
be stressed.

35. The special circumstances of developing countries and their need for
assistance in implementing the framework convention should be taken into
account.

36. “Inequity” and “scientific evidence” ought to be highlighted in the
preamble.

37. Several delegations stressed that all countries should take immediate
action to strengthen and implement comprehensive, multisectoral tobacco
control strategies.

Objectives

38. A revised text version of the objective was suggested by some
countries and regional economic integration organizations, as follows:

The aim of this Convention and its related protocols is to establish and
agree on international responses to achieve a reduction in tobacco use in
order to reduce the public health, social and economic consequences of
tobacco consumption, and to provide the mechanism for implementing such
responses through the engagement of the Contracting Parties.

39. Another suggested revision of the objective was the following:

The ultimate objective of the Convention and any appended texts is to
engage in integrated tobacco control efforts so as to put an end to
tobacco use in any form and begin this by stemming tobacco consumption and
to find palliative measures in respect of tobacco use and the health
damaging effects with a view to protecting human health.

40. Some countries recommended that time-bound qualitative and
quantitative targets for tobacco use be developed for the framework
convention.

6 Principles

41. A principle of “polluter pays” should be developed as a means of
holding the tobacco industry accountable for the harm it caused.

42. Building national capacity for tobacco control in developing
countries, especially in public health law, should accompany development
of the framework convention.

43. The right of the public to information on the health effects of
tobacco should be noted.

44. The working group heard statements from a number of observers,
including representatives of a number of nongovernmental organizations,
who expressed strong support for the framework convention process. The
representatives of nongovernmental organizations stressed the important
role nongovernmental organizations could play in achieving the strongest
possible outcome, and called for rapid action.

Section II. Obligations

45. There was broad general support for the five subitems used. Many
countries considered that issues listed under obligations provide a useful
starting point for developing obligations under the framework convention.
Under section I several additional possible items for inclusion under
obligations were raised.

Final wording on the subitems might need to be adjusted. Specific areas of
support for inclusion are mentioned below. The need to avoid pre-emption
(having obligations under the framework convention that block stronger
national action) was stressed.

46. Items in paragraphs 29 and 37 needed to be differently organized,
certain items being moved to protocols and others placed under
obligations. Some merging of items under these paragraphs was felt to be
possible.

47. Some countries felt that supply side measures, particularly those
related to tobacco farming and alternative livelihoods, should be limited
under obligations and belonged under protocols. Others suggested that
certain aspects of smuggling could be included as an obligation.

National measures to control tobacco use

48. Many speakers stressed the need for comprehensive tobacco control
measures to be implemented at national level for inclusion in this
section. The importance of countries establishing and adequately funding a
national coordinating mechanism was stressed. Usually these mechanisms
should be led by the health ministry but be inclusive of other relevant
ministries and existing institutions of society. A proportion of the
excise tax could be used as a possible means of funding tobacco control.

49. In addition to national measures, international cooperative support
(including financial assistance) to developing countries was needed to
build capacity in research, policy development and implementation.

50. A ban on sales to children and a ban on duty-free sales were suggested
by some countries for inclusion under obligations.

51. Certain countries felt that countries that exported manufactured
tobacco products had a special responsibility to provide support to
developing countries.

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52. Some countries recommended that a distinction be made between
essential national measures required for all countries (for example,
surveillance, monitoring and programme evaluation) and optional national
measures that could be initially executed at a regional level.

53. Some countries suggested that provision for smoke-free environments
should be included under national measures.

54. It was recommended that regulation of the content of tobacco products
should be included under national measures. The scientific basis for such
regulation will be addressed in a forthcoming meeting in Oslo

(February 2000).

Education, training and public awareness

55. Items listed were generally supported. A particular focus should be
given to ensuring that children and youth are fully informed about the
risks of tobacco use and protected from tobacco industry marketing through
all media. Countries differed with regard to whether advertising
restrictions should be the subject of protocols or obligations. There was
support for positive health images to be portrayed through the globally
communicated worlds of art and entertainment.

General cooperation

56. Further, regional approaches to price harmonization were being pursued
within certain regions and were felt to have wide application.

Cooperation in scientific research

57. There was broad support for this subitem as stated in the document.
Special attention was given to the need for cooperation in developing a
scientific basis for regulating tobacco products.

Exchange of information

58. A mechanism to share positive and negative experiences of policy
implementation, as well as epidemiological information related to health
effects, should be included in the obligations.

Additional comments

59. It was recommended that where possible, agreed texts from other
treaties should be used.

60. Several countries supported the need for technical and financial
support to allow all countries to participate fully in the framework
convention process, from development to implementation.

61. Several countries recommended that the implications of provisions of
the framework convention for WTO agreements required specification.

Section III. Institutions

62. The creation of institutions was described.

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63. Many speakers stressed that their comments were of a provisional
nature, but there were signs of consensus on some basic principles: (1)
the institutional set-up would ultimately be dictated by the functions of
the treaty; (2) in order to cut costs and overlapping, existing structures
should be used where possible, and meetings should be arranged around
existing events, such as the Health Assembly.

64. The specific issues were that a conference of parties was needed. The
secretariat could be provided by WHO. A scientific advisory mechanism
should provide strong multidisciplinary support, but there were differing
views as to how. Speakers agreed that effective implementation was
essential, but whether to set up an implementation committee was a
question that might be left to the conference of parties. Many countries
stressed the need for a financial support mechanism - a matter that others
preferred to defer, although it was seen by many as important in ensuring
the participation of countries that otherwise would not be able to
participate fully. The establishment of a tobacco control fund was
advocated, to help with a parallel process between WHO and nongovernmental
organizations.

Section IV. Implementation mechanisms

65. Discussion of sections IV, V and VI of document A/FCTC/WG1/6 was
introduced by Professor Szasz, New York University.

66. Many countries indicated that national reporting and international
review were essential to the convention. Nevertheless, reporting
requirements should be well designed and cost effective. Several countries
called for transparent reporting procedures and unlimited access to every
State report by any State Party.

67. Several countries advocated a dispute resolution mechanism that
produced binding decisions; others preferred non-binding procedures. One
country favoured the involvement of the International Court of Justice,
whereas another opposed it. One country favoured conciliation procedures,
but another was against compulsory conciliation. Another suggested that
compliance mechanisms should focus on implementation rather than on
dispute resolution procedures. One country noted that the United Nations
Charter provided a possible model for dispute resolution.

68. One country suggested that an implementation mechanism should be
addressed in a protocol, whereas most said it should be included in the
framework convention. One country maintained that tobacco exporting
countries should be held accountable.

Section V. Law-making procedures

69. It was noted that, given consensus, it might be possible to negotiate
protocols concurrently with the framework convention. One country spoke in
favour of deferring discussion of protocols.

70. A regional economic integration organization stated that two protocols
should be adopted concurrently with the framework convention. One country
suggested that desirable aspects of comprehensive tobacco control measures
- such as a model legislation - be listed in a non-binding annex or
addendum to the framework convention.

Section VI. Final clauses 71. A number of countries said it was too soon
to address many issues involved in the final clauses.

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72. Several countries suggested that the framework convention should allow
for reservations. Some stated that the framework convention should allow
for denunciation whereas others said it should not.

73. One country suggested that entry-into-force requirements for the
framework convention and for the protocols need not be identical. Another
stated that the final clauses of the framework convention should not be
required to apply to protocols. One country suggested that the United
Nations act as depository.

74. One country stated that entry-into-force provisions should be modelled
on the Kyoto Protocol to the Climate Change Convention: in addition to a
particular number of State signatories, a significant proportion of
producer countries and consumer countries ought to ratify the framework
convention.

Agenda item

8. Technical briefing/discussion: possible protocols (Document
A/FCTC/WG1/3)

(a) Subjects of possible protocols

(b) Relation of possible protocols to the framework convention 75. It was
pointed out that protocols could be adopted either at the same time as the
framework convention or at a later stage. New protocols could be
negotiated as new knowledge arose. The question of which subjects were
included in the framework convention itself and which were the subject of
protocols was a matter for the decision of Member States. Attention was
drawn to the series of topics set out in the background document, which
focused on key areas for tobacco control from the public health viewpoint.

Procedural issues

76. Many countries considered that it was too early in the framework
convention process to discuss procedural or substantive aspects of
potential protocols in detail. A number of countries and a regional
economic integration organization stated that such discussions should be
deferred to the intergovernmental negotiating body.

77. A number of countries suggested that it might be possible to adopt
concurrent protocols, depending upon political will. However, some
countries noted that there was a potential difficulty in negotiating
protocols at the same time as the framework convention until the content
of the framework convention was more clearly defined.

78. Some countries stated that parties to the framework convention should
not be required to become parties to any protocol, i.e. adherence to
protocols should be optional. One country suggested that the protocols
should be open to all countries, and not just to parties to the framework
convention.

79. Several countries stressed that financial and technical assistance
would be necessary to assist developing countries to negotiate and
implement protocols. A country and a regional economic integration
organization emphasized that protocols should not restrict countries from
taking stronger measures than those required in the framework convention
or protocols.

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Substantive issues General comments 80. A number of countries stressed
that protocols should focus on items on which there was political
consensus. One delegation stated that protocols should be addressed during
the negotiation phase according to the following criteria: (1) impact; (2)
feasibility; and (3) need for international action. Countries from
different regions expressed support for this formulation.

81. Several countries considered that the relationship between the
framework convention and WTO treaties, as well as other multilateral
agreements, needed further consideration.

Themes 82. Many countries expressed the view that it was premature at the
present stage in the process to define and limit the subject matter of
protocols and that the question should be left open. The potential
subjects should not be limited to those enumerated in document
A/FCTC/WG1/3.

83. Among specific topics mentioned for possible inclusion in protocols
were:

C tobacco price and tax policies;

C environmental tobacco smoke;

C protecting children and adolescents;

C smuggling of tobacco products;

C sale of duty-free tobacco products;

C advertising, promotion and sponsorship;

C testing and reporting of tobacco product ingredients;

C tobacco industry regulation;

C information exchange;

C health education and research;

C agricultural policies;

C product regulation;

C evidence-based prevention and treatment programmes.

84. A number of countries emphasized the importance of adopting protocols
on tax and price policies. On the other hand, one country stated that
increased taxes at high levels would encourage smuggling, while another
suggested that they were unfeasible or would have inflationary effects.
One country suggested that all tobacco products and associated
paraphernalia should be addressed in a protocol addressing pricing. Other

11 countries pointed out that taxes were already a very high percentage of
tobacco prices in their countries. One country expressed concern that
there was insufficient research to justify tax increases and that such
increases would be a burden on the poor. However, several countries
emphasized that the recent World Bank report provided significant evidence
to allay concerns about the desirability of tax policies for all
countries. One country considered that tax and price policies should be
addressed at the regional level.

85. A number of countries expressed support for a possible protocol on
advertising, sponsorship and promotion but disagreed on the potential
content. Some emphasized that the evidence base fully supported the
importance of complete bans on advertising. Several countries stated that
an advertising protocol should address both direct and indirect
advertising. Other countries suggested that a more flexible approach to
advertising and promotion should be included in a protocol. One country
noted that constitutional requirements might prohibit a complete ban.

86. Several countries suggested the inclusion of counter-advertising in an
advertising protocol, but noted that financial assistance would be needed
to implement a protocol in this area. Another country suggested that a
possible consensus on the subject might include a ban on all advertising
and promotion aimed at children.

87. A number of countries emphasized the global nature of smuggling and
the need for a protocol on this topic. Some countries emphasized the
importance of contraband cigarettes in their markets. It was reported
that, in one country alone, over 80% of branded cigarettes were smuggled.
Another country observed that small packets of cigarettes were being
smuggled into its territory, and that those activities were being
supported by tobacco companies themselves.

88. Countries also stressed the importance of a protocol on packaging and
labelling of tobacco products.

It was noted that the size of warning labels was directly related to the
effectiveness of those measures. In response to a question, it was noted
that some countries were advocating warning labels covering 60% of the
large surface areas of cigarette packets.

89. A number of countries expressed support for protocols that addressed
environmental tobacco smoke and the protection of children and
adolescents.

90. Several countries supported the regulation of tobacco products,
including full disclosure of ingredients and additives, in a protocol. It
was suggested that the regulation of new tobacco products should include a
provision requiring manufacturers to prove the safety of new tobacco
products before they were licensed for sale to consumers.

91. A number of countries emphasized the importance of transparency and
information sharing. One country considered that issues regarding
information sharing should be addressed in the framework convention
itself, and that a separate protocol was not needed. Another country
stated that the suggested protocol should be renamed “Information sharing,
education and awareness”. Another country proposed the creation of a new
protocol on education and training.

92. A number of countries addressed the question of a protocol on
agriculture. One country noted that subsidies for tobacco growing could be
eliminated immediately in developed countries, but needed to be phased out
gradually in developing countries. Another country suggested that such a
protocol would need to provide for gradual implementation.

93. A country emphasized the importance of regulating the tobacco industry
through protocols. It was suggested that the industry should be prohibited
from marketing products in developing countries in a manner

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different from its practices in industrialized countries. Another country
supported that suggestion. One country proposed the inclusion of the
regulation of tobacco retailers through licensing.

94. Dr Leppo resumed the chair. He gave the floor to Dr Chan,
Vice-Chairman, to recapitulate discussion of item 8, subjects of possible
protocols and their relation to the framework convention, a subject on
which 30 delegates had spoken.

Agenda item 9. Administrative arrangements: discussion of the work plan
and timetable for developing the proposed draft elements of the framework
convention

(Document A/FCTC/WG1/5)

Agenda item 10. Role of the secretariat

Agenda item 11. Participation in the framework convention process: the use
of electronic communication

Agenda item 12. Working group budget

Agenda item 13. Next meeting of the working group 95. The Chairman turned
to agenda items 9 to 13, administrative matters. The secretariat presented
the items: distribution of tasks, the role the secretariat could play
until the next Health Assembly, and any additional documentation the
working group might require. Several Member States had requested
background on the technical briefings on health and economic effects,
which the secretariat could provide. As regards electronic communication,
the secretariat would strive to provide documentation in the six official
languages on the Internet in good time, and in readily accessible
electronic format.



96. Since the working group was a subsidiary body of the Health Assembly,
in accordance with resolution WHA50.1 travel expenses for least developed
countries would be reimbursed. A Director-General’s trust fund was being
set up under the WHO Voluntary Fund to enable other developing countries
to take part in meetings. It was hoped that Member States would contribute
generously to it. The suggested date for a second meeting was between
Monday, 6 March, and Friday, 17 March 2000, midway between the 105th
session of the Executive Board and the Fifty-third World Health Assembly.

97. The Chairman said that if the working group was satisfied that that
information covered items 11 and 12 of the agenda (“Participation in the
framework convention process: the use of electronic communication”, and
“Working group budget”), the meeting would move on to consider items 9, 10
and 13 together.

98. To questions on the working group budget, the secretariat replied that
US$ 125 000 had been budgeted to enable least developed countries to
participate in the process, and a total of US$ 1 000 000 for the entire
negotiation process in 2000-2001 including meetings. Additional funding
was available or being sought for scientific and technical meetings in New
Delhi and in Norway and for work in countries, where legislative and
economic interventions should be developed in tandem with the framework
convention process.

99. Numerous countries commented on the high quality of the background
documentation prepared by the secretariat. The working group, after a
comprehensive exchange of views during which the Legal Counsel explained
that the Executive Board could express views but not rule on the matter,
decided to hold a second meeting, between the 105th session of the
Executive Board and the Fifty-third World Health Assembly, taking care
that the meeting not coincide with the Muslim Feast of Sacrifice.

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100. Many countries commented on the considerable progress achieved by the
working group and questioned the purpose of a second meeting. The
predominant view was that a second meeting of the working group would
ensure fuller participation of States, and of the relevant sectors within
States. In order to ensure continuity of work, one delegation recommended
that Member States designate the same delegates for the second meeting.
The second meeting should neither repeat the work of the first meeting nor
encroach on the negotiation process. It should consider further
elaboration of the proposed draft elements of the framework convention and
protocols, indicating where general agreement was reached, and prepare a
text, including possible options for consideration, for the Health
Assembly and subsequent negotiation.

Documentation would be prepared by the secretariat in close collaboration
with the bureau.