History-making tobacco treaty now five years:

Uniting globally to fight the smoke

Diseases stemming from tobacco use drain scarce health resources and funds in developing countries. Tobacco control has yet to make its way to the global development agenda:

Manjari Peiris

The WHO Framework Convention on Tobacco Control (FCTC) came into effect, marking an important milestone in public health history on February 26 in 2005. Already 168 of 195 parties have joined the treaty through ratification or accession, and more are set to join. Sri Lanka too ratified the FCTC in 2003 expressing its willingness to join the treaty.

An anti-smoking poster

Many countries have implemented effective evidence based measures to decrease prevalence of tobacco use and save lives through banning tobacco advertising and sponsorship by protecting citizens from tobacco smoke exposure and mandating pictorial warnings on cigarette packs.

The FCTC is a remarkable achievement. It is the first treaty negotiated under the auspices of the WHO, a resounding recognition that international law has a critical role to play in global health.

The treaty catalyzed global action, elevating the importance of tobacco control as a global health and political issue, stimulating policy change at the domestic level and bringing new public and private resources into the field.

The FCTC Conference of the Parties (COP) adopted strong guidelines on four of the convention’s key substantive articles, and work is under way on the development of a number of other guidelines and a protocol.

However, for each success there is an equally difficult challenge because universal FCTC implementation is still far away, particularly with respect to tobacco taxation, control of illicit trade of tobacco products and any measures that require resources, such as public education and cessation.

Richer parties have made no significant effort to ensure tobacco control efforts in low and middle income countries receive appropriate technical and financial assistance. Framework Convention Alliance (FCA) would like to see countries include tobacco control in their development agendas to boost funding in this crucial area.

While tobacco kills more than five million people a year, tobacco control programs are grossly underfunded. As a result, during the next five years FCA will focus on improving FCTC implementation and increasing resources to adequately fund implementation of measures and policies that are compliant with the treaty. Alliance would also like to see more stringent measures in place such as 90 percent graphic warnings on cigarette packages, bans on cigarette package displays and duty free tobacco sales, generic packaging, higher tobacco taxes, more cessation methods and an effective protocol on illicit trade in tobacco products.

FCA director Laurent Huber said over the past five years, the number of deaths caused by tobacco have increased and not decreased. “Tobacco use remains high in low and middle income countries and it is increasing among women and young people,” he said.

“We have five years of good progress on policy but deaths due to tobacco use continue to rise. Governments need to fund their policy promises to stem the tide of tobacco deaths.”

FCA would also like to see tobacco control treated as a development issue because the tobacco epidemic is shifting rapidly from developed to developing countries.

Tobacco addiction is a tremendous burden to poor families because it diverts money from necessities such as food and education into the pockets of the tobacco industry. Subsequent diseases from tobacco use consume already scarce healthcare resources. Despite this, tobacco control has yet to make its way onto the global development agenda and receives no mention in the UN’s Millennium Development Goals. If tobacco control is treated as a global after-thought, development in the world’s poorer countries will be handicapped by rapid rises in tobacco-caused diseases for decades to come. “Our attitude should not be one of doing the bare minimum, but we should utilize the FCTC as a mechanism to escalate tobacco control efforts to save lives,” said Huber.

“The tobacco industry is alive and well, but health is still lagging behind. FCA challenges Parties to put action to intention, to do more, do what is needed and do it faster.”