First of all, I would like to thank the government of Turkmenistan for extending an invitation to attend the International Health Forum in Ashgabat. It’s a privilege for the Secretariat of the WHO FCTC to celebrate with you the achievements of the European region in the ever-challenging area of health.
This region has much to celebrate. From the Health 2020 agenda to the Ashgabat Declaration, strong collaboration has been forged in Europe to tackle major public health issues. And no agreement could be more exemplary in setting the agenda for national and international cooperation than the WHO FCTC.
The treaty is designed to foster tobacco demand and supply reduction measures. Sectors as diverse as international affairs, education, agriculture, trade, customs and finance have to be encouraged to work hand-in-hand with the health sector to curb the tobacco epidemic. Health warnings, smoke-free areas, advertising bans, alternative livelihoods for those reliant on the tobacco business and measures to eliminate the illicit trade are some of the core provisions mandated by the treaty. Many have been implemented by countries in the region.
The treaty also allows us to address one of the most serious perpetrators of non-communicable disease – the tobacco industry. Provisions to address the rights of governments to protect public health from undue interference by the tobacco industry and the focus on liability also pave the way for countries to approach other risk factors such as alcohol, processed foods and soft drinks.
These are certainly a major challenge, as most of you will know from experience of the pernicious and energetic lobbying by the tobacco industry, and its consequences for your work. They are everywhere and use every strategy to engage groups across society while falsely claiming to defend freedom of speech, intellectual property and trade rights, and emphasising the economic and social importance of the tobacco value chain for farmers’ livelihoods, especially in developing countries.
Parties rightly identify interference by the tobacco industry as the major threat to the implementation of the WHO FCTC in the most recent reporting cycle and that means we must be vigilant. Take the recent example of lobbying by the American Chamber of Commerce, a large private US-based group, which reportedly sought to dilute advances in tobacco-control regulation on the territories of several FCTC Parties, actions that have a seriously detrimental effect on public health. Tobacco industry interference is also visible in efforts to hijack efforts to implement the Protocol to Eliminate Illicit Trade in Tobacco Products. One flagrant example is the work conducted by the International Trade and Investment Center (ITIC), which promotes industry solutions for illicit trade in tobacco products and for the industry-controlled tracking and tracing systems known as Codentify. The Protocol, the first negotiated under the WHO FCTC, has only 9 Parties and needs 40 Parties to enter into force. I urge every Party in this region to ratify, accede, approve or legally confirm the Protocol so that we can hold the first Meeting of the Parties in November next year in India.
The implementation of this legally binding international treaty has plummeted in the rankings of core public health strategies and frameworks discussed in recent years. The treaty requires an extensive inter-sectoral partnership, aiming at “Health in all Policies.” It also promotes international cooperation, a core value of global treaties that endorse the principles of multilateralism.
The importance of the WHO FCTC is increasing. The 180 Parties to the treaty have proposed that it should be a key element of the zero draft of the post-2015 Sustainable Development Goals (SDGs). There is also a commitment that by 2030 there should be a one-third reduction in premature mortality from non-communicable diseases, which include tobacco-related illness.
Nonetheless, funds to finance implementation of the treaty provisions need greater international consideration. And the good news is that last week’s Addis Ababa Finance for development (FfD) Conference has adopted an historic agreement, whereby tobacco taxes are promoted as a source of funds for sustainable development. As a result, Parties to the WHO FCTC have one more reason to add implementation of the treaty to their development agenda.
Increasing tobacco taxes is anyway a virtuous process, as public health improves over time as a result of higher tobacco prices and tax revenues, while the economic consequences of tobacco use lessen. Health services benefit as the burden of tobacco-related disease declines, while economic output rises as citizens live healthier lives.
I have recently published an op-ed on the Head of the Convention Secretariat pages of our website. There, I relate the story of Mario and Maria, two ordinary (though fictional) smokers in the developing world. Perhaps I can share their story with you.
It’s 2030 and the doctor who sees Mario rapidly diagnoses terminal lung cancer. He’s depressed by the outcome, but there’s nothing he can do for the father-of-four, a factory worker. The doctor tells him to go home and get some rest, though in reality, he’s sent away to die. Much the same happens to Maria, a single mother of two children who’s also the sole provider for her parents. She has emphysema.
By 2030, both Mario and Maria have been smoking for three decades, like millions of others in their homeland. With grim inevitability, the tobacco epidemic has arrived with a vengeance and the healthcare system just can’t cope. Hospital wards are full to overflowing with people suffering from tobacco-related diseases including cancer, heart disease, emphysema and stroke. The country can’t afford enough treatments, or even palliative care.
It’s a very different story in the developed world of 2030, where tobacco consumption has been falling for decades and where expensive new drugs and treatments are showing success. As a result, wealthier countries see tobacco consumption and illness as yesterday’s problem, requiring little attention. But, it is wholly wrong to see the tobacco threat as a thing of the past.
Right now, in 2015, forecasts of the coming epidemic are stark, even frightening. About 100 million deaths were caused by smoking in the 20th century, more than in the two world wars combined. At current rates, the number of deaths from tobacco will rise to 1 billion in this century. While tobacco consumption is falling in the developed world, it is rising in poorer countries. It goes without saying that governments have to act now.
Fully implementing the WHO FCTC and its Guidelines and Policy recommendations and becoming a Party to the Protocol to Eliminate Illicit Trade in Tobacco Products are critical requirements for global public health. Furthermore, ensuring that development agencies and governments include tobacco control in development aid programmes, will I believe, not only re-energise the worldwide tobacco control movement but also save many tens of thousands of lives. Action now will help all the Marios and Marias, throughout the world, who might otherwise face a bleak diagnosis in a doctor’s office in the years ahead.