It is a great pleasure to be here in New York among fellow members of the United Nations community.
This meeting always feels a little like a family reunion, and like a family we have much catching-up to do. We should allow some time to acknowledge our successes, while recognising just how much more we need to do in the coming year.
It is 11 years since the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect and there have been some notable achievements. Smoking in high-income countries is falling, plain packaging and display bans are widely adopted, and tobacco advertising is in retreat.
But - and it’s a big but - consumption is rising, largely because the populations of low- and middle-income countries are being lured into addiction by the tobacco industry. In time, this will result in a public health catastrophe, as rising rates of non-communicable diseases like cancer and respiratory illness overwhelm the health systems of countries unable to afford effective treatment. We know this will happen.
Unless we can find more effective ways to work together to stem the threats caused by tobacco consumption. And that, as you know, is why we’re all here.
We have done some good work in the past, especially the initiatives of the UN Ad Hoc Interagency Task Force on Tobacco Control, which began in 1999 and whose work has been invaluable in guiding UNIATF on NCDs.
We will spend today looking at several aspects of the WHO FCTC, the modern world’s first public health treaty, and its first Protocol, which aims to eliminate the illicit trade in tobacco products.
The WHO FCTC coordinates scientifically based international action against tobacco, which is the only common risk factor in the four main NCDs. Tobacco is responsible for one-in-six NCD deaths.
The tide has turned against tobacco consumption in the last 11 years, with near-universal acceptance among policymakers that it damages those who are addicted to it, as well as the healthcare systems that pick up the bill for their treatments.
But we have to accept that implementation is patchy. Some countries are way ahead of others, some have taken action in just a few areas. Some, I’m sorry to say, have barely begun.
The Convention needs to be implemented. In full. We will only make significant progress when our 180 Parties move to comprehensive enactment of all the main provisions. At that point, we will have a fighting chance of meeting the NCD Global Action plan’s Target 5 – a 30% relative reduction in prevalence of current tobacco use among people aged 15 and above by 2025.
WHO FCTC implementation happens at the country level and so, as with so many other aspects of the tobacco control campaign, it needs to be remembered and acknowledged in national planning. Only when it’s included in plain sight can we expect governments to take action, and remind them to do so.
For this we need the assistance of UN country teams, the people on the ground.
There are two other major issues to consider. Firstly, we are working to ensure that signatories to the illicit-trade Protocol become Parties. The Protocol is an international treaty and offers significant new powers to tackle illegally traded tobacco, which is responsible for about a tenth of all consumption.
When we’re talking to governments, it is worthwhile emphasising that the Protocol will work best in low- and middle-income countries (where illicit tobacco can amount to 50% of consumption). The illicit trade costs governments at least US $ 30 billion a year in lost tax revenues and it lures citizens with low-incomes into addiction. It also fosters organised crime and is an easy source of revenue for terrorist groups.
Eradication of this pernicious trade should be an easy case to make within government and the aid community. Health ministry officials will see the benefits of treating fewer victims with tobacco-related illnesses, the finance ministry will appreciate that it bolsters tax revenue and law-enforcement agencies will understand the damage that it will do to criminal groups.
We have 13 Parties to the Protocol so far, and we need another 27 as soon as possible. So it’s worth remembering the Protocol when you’re talking to governments and seeing if there are ways to include it in discussions with ministers and officials.
As I mentioned when discussing the illicit-trade Protocol, interagency co-operation is of central importance. A small secretariat, like the FCTC Secretariat, just can’t be everywhere at once. It’s the agencies on the ground which multiply our effectiveness.
Happily, this work is already underway and we will discuss some recent positive examples to see if we can learn lessons from how they worked. Naturally, the ties are strong with WHO, and we had worked hard to further strengthening our cooperation in various technical areas with WHO headquarters and the regions. In recent months, we have worked with UNDP on needs-assessment missions that has also involved UN resident coordinators and country teams; we have worked with UNCTAD on material about the tobacco chain and intellectual property and tobacco packaging; we have joined hands with the ILO on alternative livelihoods for tobacco farmers and we hope to launch a programme soon in cooperation with the FAO. Our work with the World Customs Organization stretches back several years and likewise we have a solid relationship with the World Bank, which currently focuses on the costs of implementation and non-implementation of the WHO FCTC.
In our session today, my colleagues will offer more detailed examples. We will discuss work carried out with the World Bank in Africa; the positive role of UN Country Teams and to the growing role of south-south and triangular co-operation, where Parties can support one another with relevant experience of tobacco control approaches.
Then – you will be relieved to hear – we will have lunch, before afternoon sessions on knowledge management (especially the issue of data sharing), gender and reproductive issues, as well as issues affecting tobacco farmers. We will conclude with an examination of the UNITAF 2016-17 work plan, looking in particular at how we can keep communicating between our meetings.
We are going to be examining a wide range of issues today, but the unifying theme is effectiveness – what works, why does it work and how do we make it better?
We know, for example, that raising excise duties on tobacco is extremely effective. It increases government revenues and it cuts consumption. Our World Bank friends tell us that regardless of the scale of the tax rise, it never cuts revenue.
But when we speak to finance ministry officials at country level, that message may not have got through. They may have heard the tobacco industry’s often-repeated lie that tax rises mean less money for government.
If we can work with finance ministries, we can help build their administrative capacity, and counteract bogus tobacco-industry arguments through the robust use of tax-system analysis and country specific research.
Likewise, the case for plain packaging is well-grounded. This campaign is something of an innovation and just a few countries have acted as trailblazers.
Australia, the first to introduce the measure, has seen a significant fall in smoking rates and – most importantly – studies since 2012 show that young people between 12 and 17 say they find plain packets much less enticing.
There is another important issue that I want to mention today – the interference in our work by the tobacco industry.
We have been aware of this problem for a while, and it really needs to end. For those interested in how this works, the BBC recently aired a documentary on the issue. It is a depressing story.
So I want to press ahead with a common policy framework for UN agencies, allowing us all to take the same approach. There are many aspects to this problem, but perhaps the most glaring are the payments made by the tobacco industry to delegates at treaty meetings, and the involvement of government-owned tobacco companies at COP and subsidiary body meetings. Neither is acceptable and both need to stop.
There is one other issue. At the end of most family meetings, everyone promises to stay in touch. Happily, I can play my part by letting you know about the forthcoming meeting of the seventh session of the Conference of the Parties, which will be held in Noida, India, from 7 to 12 November and the first session of the Meeting of the Parties from 14 to 16 November 2016, should the Protocol enter into force.
It has been a central aim of the COP to encourage greater co-operation among UN agencies, development banks and UNIATF, among others. Interagency cooperation will be among the issues we will address. Some of you, of course, are already observers to the COP and we look forward to seeing you there and continuing the debate.
But let me take the opportunity to invite those organisations and agencies that are present today, but not yet observers to the COP, to apply for observer status. We would be very pleased to see you there and I think you will find the discussions useful in advancing the tobacco and NCD agendas.
Thank you for listening, for the contribution you make and for your efforts to advance this great cause.