[Intl-tobacco] Economist: The tobacco war goes global (fwd)

[Robert Weissman]

The tobacco war goes global
The World Health Organisation is trying to organise an international campai=
gn=20
against the demon weed
Source: The Economist, Friday, 10/13/00

SMOKING has long been a battleground between those who wish to pursue one
of life=92s licit pleasures and those who wish to stamp out one of public
health=92s major scourges. This month, a new front opens in the tobacco war=
s
as the World Health Organisation (WHO), in Geneva, gathers those on either
side to begin negotiating an international treaty on tobacco
regulation=97the Framework Convention on Tobacco Control. For the
anti-smoking advocates, the convention offers an unprecedented opportunity
to get adults around the world to give up, to prevent youths from
starting, to clear the air for non-smokers and to make cigarettes safer
for those who persist in puffing. For the opposing pro-freedom lobby, it
is damning evidence that the WHO is meddling in matters of social and
economic policy far beyond its traditional medical remit, and marks a
misguided attempt at supranational regulation of a problem far better
tackled by countries on their own.

The WHO=92s head, Gro Harlem Brundtland, has singled out tobacco as one of
the greatest public-health problems of the new century. There are over 1
billion smokers worldwide, four-fifths of them in developing countries and
a third in China alone. Tobacco-related illnesses such as lung cancer and
heart disease kill 4m people a year, as many as AIDS and tuberculosis
combined. By 2020, the toll of premature deaths will rise to 8.4m a year,
with more than two-thirds of the victims in poor countries. The WHO
reckons that this global ill is spread by means which cross borders=97such
as television and Internet advertising (legal) and smuggling (less
legal)=97and which therefore require international standards and a concerte=
d
international effort to combat.

In recent years the rich world has made progress in reducing smoking by
using a variety of instruments, among them price increases on cigarettes
through taxation, and restrictions on tobacco-company advertising and
sponsorship. The WHO would like to see the same measures put in place in
poor countries which are still in the early phases of the =93tobacco
epidemic=94, as the organisation calls it. Derek Yach, head of the WHO=92s
communicable-disease programme, says it is hard for many poor countries to
fight against the efforts of the tobacco companies that are now making
headway in Asia, Africa and Latin America. He hopes that an international
convention will give these countries moral, as well as technical, support
in their fight against =93big tobacco=94.

This is the first time that the WHO has flexed its constitutional muscles
and tried to pull together an international treaty on public health. Its
mandate to do so comes from a meeting of the World Health Assembly last
year. At that meeting health ministers representing 191 member states gave
it the green light to assemble working groups to come up with possible
measures, or =93draft elements=94, that might go into a framework conventio=
n.

Next week sees the start of wider-ranging formal discussions on the
convention.  National representatives come together in an
=93inter-governmental negotiating body=94 to start working out the
administrative details of how to proceed with such a massive undertaking,
and perhaps begin some serious wrangling over which draft elements should
find their way into the core framework convention and which should be
included in related protocols. The negotiating body has until May 2003 to
deliver the goods to the World Health Assembly. If that body approves the
convention and protocols, these will head back to national legislatures
for ratification; if enough sign on the dotted line, then they will become
international law.

Pipe dreams

At the moment, a long list of draft elements lies on the table. It
includes proposals to harmonise taxes on tobacco products at some
internationally determined minimum rate, of which a certain percentage
would have to be spent on national tobacco-control programmes. (At the
moment, more than two-thirds of the price of a packet of cigarettes in
rich countries goes to the government in tax, compared with less than half
in poor countries.) Tax-free sales might be banned. Governments would be
obliged to tackle smuggling through such measures as better monitoring of
what is for sale and better information exchange with their neighbours.
Ways might have to be found to ease tobacco-growing countries out of their
main crop and into something else worth their while.

Tobacco sales to children might be prohibited, and non-smokers protected
from exposure through smoking bans in schools, restaurants, buses and
other public places. International standards might be put in place
specifying which toxic ingredients and nasty additives would have to
appear on cigarette packets, along with what sort of health warnings.
Manufacturers could be obliged to omit terms such as =93light=94 or =93mild=
=94
from their packets. Tobacco advertising, promotion and sponsorship could
be outlawed, especially when directed at children. Countries might have to
ensure that their legal systems provide recourse for those who wish to sue
tobacco companies for injury, and come to some international agreement on
laws for liability and compensation.

What will end up in the final agreement is anybody=92s guess. Even the
wording of the convention=92s main objective=97=93achieving a reduction in
tobacco use=94 versus =93putting an end to tobacco use in any form=94=97is =
up for
grabs. Many national delegations which enthusiastically support a
convention, such as Britain and Thailand, and non-governmental
organisations such as Action on Smoking and Health, are hoping for a
document that is worded strongly enough to galvanise governments into
action, but not so detailed that countries refuse to ratify it because of
squabbles over technicalities.

Snuffed out?

Yet many of the draft elements seem neither feasible nor desirable.
Blanket prohibition of advertising contravenes some national or
supranational regulations on freedom of commercial expression or free
trade, as a recent European Court of Justice ruling overturning the
European Union=92s directive prohibiting tobacco advertising has shown.
Different places also have different ideas about how far smoking should be
tolerated. Bans on smoking in restaurants or bars are less likely to be
accepted in China, say, than they are in California. And the genuinely
cross-border aspects of the issue are actually quite narrow: in the end,
it comes down to smuggling. All this suggests that the idea of a
wide-ranging international convention is itself misconceived.

It remains to be seen whether such objections will be given a proper
airing on October 12th and 13th in public hearings involving hundreds of
groups, from the Adorers of the Blood of Christ, a women=92s missionary
movement, to Philip Morris, regarded by many as the Satan of tobacco.
Smokers, the billion or so people who like a cigarette, seem oddly
under-represented. However, other voices often forgotten in the wrangling
over tobacco in the rich world=97farmers=92 associations from major
tobacco-growing countries such as Malawi or cottage-industry producers of
traditional tobacco products from India=97have been allocated a few minutes
and a few pages on the convention=92s website to express their views.

This is not enough for the major cigarette companies, such as British
American Tobacco, which complain that the WHO has done its best to exclude
them from the preparatory stages of the convention. Unlike
non-governmental organisations, which have official observer status at the
negotiations, the only way the industry gets a look-in is through
representatives who have managed to slip on to national delegations. Chris
Proctor, head of regulatory and scientific affairs at British American
Tobacco, reckons that the tobacco industry has valuable experience to
bring to the table in helping the WHO tackle, say, youth smoking.

The WHO, however, is unapologetic about cold-shouldering the
tobacco-industry devils. Dr Yach reckons there are some areas where
dialogue is possible with tobacco companies, among them the regulation of
technical issues such as tobacco product claims, and new developments in
lowering tar and nicotine levels. But asking them for help on, say, taxes
or advertising is unlikely.  =93Would you ask the fox to run a protection
programme for the chickens?=94 he asks.

Such froideur has no doubt been deepened by recent events. In August, the
WHO published the results of an investigation into the tobacco industry=92s
dirty-tricks campaign against the organisation. Some of the firms=92 method=
s
went beyond normal advocacy (discrediting the WHO in the press and
plotting to set the body and other UN organisations against each other)
and extended to covert surveillance of WHO meetings, subversion of its
staff, and attempts to distort the findings of scientific studies showing
tobacco=92s ill-effects. Dr Brundtland likens the role of the tobacco
industry in creating health problems to that of the mosquito in causing
malaria: both are blood-sucking, disease-spreading parasites.

Despite the provocation, that kind of language can hardly be conducive to
rational debate. But critics of the convention charge that the WHO is not
concerned with such debate. Rather, it is latching on to tobacco to foist
a western agenda on to developing countries, and to advance a campaign of
political self-aggrandisement. It is, they point out, spending its scarce
resources on tobacco, which kills in later life people who have chosen to
smoke, rather than concentrating on the infectious diseases that kill
innocents in the developing world in their youth. They warn of =93mission
creep=94, and say that once the WHO has corralled member states into
regulating tobacco, then alcohol and fatty foods will be next.

The WHO denies these charges but has itself noted: =93The success or failur=
e
of this approach provides a test case for the more active involvement of
the public-health community in international law-making.=94 Would more
active involvement of that kind be such a good thing?