WHO Framework Convention on Tobacco Control

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is a treaty adopted by the 56th World Health Assembly held in Geneva, Switzerland on 21 May 2003. It became the first World Health Organization treaty adopted under article 19 of the WHO constitution. The treaty came into force on 27 February 2005. It had been signed by 168 countries and is legally binding in 182 ratifying countries.

The FCTC, one of the most quickly ratified treaties in United Nations history, is a supranational agreement that seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by enacting a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. To this end, the treaty's provisions include rules that govern the production, sale, distribution, advertisement, and taxation of tobacco. FCTC standards are, however, minimum requirements, and signatories are encouraged to be even more stringent in regulating tobacco than the treaty requires them to be. Worldwide tobacco control set a precedent for EU Commission participation and negotiation in multilateral treaties, and further defined the powers and capabilities of the EU as a supranational entity.

The perceived success of the FCTC has fueled calls for many other global health treaties, although a recent review of 90 quantitative impact evaluations of international treaties broadly raises questions about their real-world impact. Four criteria have been put forward to guide the development of follow-on global health treaties.

Background

The WHO has long been active in preventing the myriad health issues that result from tobacco consumption. As the leading cause of preventable death globally, tobacco has seen an upsurge in both its consumption and its fatality rate worldwide with the increasing interconnectedness of the global economy. Thus, while tobacco related-diseases differ from the communicable diseases that have traditionally been the concern of the WHO, the effects of globalization have made tobacco increasingly relevant for such intergovernmental authorities.

Under the auspices of tobacco activist and UCLA professor Ruth Roemer, the WHO urged individual countries throughout the 1980s and 1990s to adopt national laws that have been shown to reduce tobacco use. The FCTC, however, marked the first time that the WHO went so far as to enact its international legal powers to address the problem. In fact, Roemer herself was among the original group of academics and tobacco activists who supported the idea of a framework-convention protocol approach (the rest of the group included Allyn Taylor, Derek Yach, and Judith Mackay).

The idea for a multilateral treaty regarding tobacco control gained traction in 1994 at the Ninth World Conference on Tobacco or Health in Paris, France, when Roemer and Taylor presented their strategy for international legal action. Roemer and Allyn, along with Judith Mackay, were successful, and their proposal was adopted as one of the conference's first resolutions.

Negotiation, drafting, and economic implications

It took three years for negotiators to come to an agreement on the terms of the FCTC. After being adopted by the World Health Assembly, the policy-making arm of the WHO, it officially went into effect in February 2005. According to Elinor Wilson, the past vice-president of World Heart Federation, "the FCTC is an excellent example of government/non-governmental collaboration through the Framework Convention Alliance resulting in global public health gains". Such collaboration between NGOs and the WHO forever changed the way that the WHO treats nongovernmental organizations, and in 2002 the WHO constitution was amended to reflect this shift in relations. In particular, the FCTC favors sustainable development options over tobacco farming. To achieve this, Party governments and tobacco control advocates are encouraged to invest in better infrastructure, especially transportation, to ease farmers' access to new and foreign markets when making the transition, while simultaneously improving farmers' access to credit that may be necessary in converting their existing facilities.

Requirements

The Convention defines tobacco control as comprising demand, supply, and harm reduction (Article 1d). Significant provisions of the treaty require that parties implement the following measures:

{| class="wikitable"

! Topic

! Measure

! Articles

| Lobbying

| Call for a limitation in the interactions between lawmakers and the tobacco industry.

| Article 5.3

| Demand reduction

| Tax and other measures to reduce tobacco demand.

| Article 6 & 7

| Passive smoking

| Obligation to protect all people from exposure to tobacco smoke in indoor workplaces, public transport and indoor public places.

| Article 8

| Regulation

| The contents and emissions of tobacco products are to be regulated and ingredients are to be disclosed.

| Article 10

| Packaging and labeling

| Large health warning (at least 30% of the packet cover, 50% or more recommended), plain packaging is recommended; deceptive labels ("mild", "light", etc.) are prohibited.

| Article 9 & 11

| Awareness

| Public awareness for the consequences of smoking.

| Article 12

| Tobacco advertising

| Comprehensive ban, unless the national constitution forbids it.

| Article 13

| Addiction

| Addiction and cessation programs.

| Article 14

| Smuggling

| Action is required to eliminate illicit trade of tobacco products.

| Article 15

| Minors

| Restricted sales to minors.

| Article 16

| Research

| Tobacco-related research and information sharing among the parties.

| Articles 20, 21, & 22

World Map Status

Non-parties

The United States is a non-party to the Framework Convention on Tobacco Control. and Australia.

In 2008, the FCTC advised to introduce plain tobacco packaging, which in 2012 subsequently was adopted in Australia.

Criticism

Recent attempts to evaluate the implementation and efficacy of FCTC showed that actual state compliance with the framework is quite low, and that its implementation infrastructure is ridden with errors. For instance, when Hoffman et al. compared WHO's FCTC implementation database with national implementation reports they found that 32% of country responses were misreported in the database; 3% were obvious errors, 24% were missing despite being reported by countries, and 5% were misinterpreted by the WHO staff. In some cases, the FCTC has been actively undermined. These findings highlighted the need for a stronger WHO infrastructure to track and record state compliance with policies.

Reporters and the public were forcibly removed from the October 2014 convention in Moscow (COP6). The Washington Times reported that the FCTC delegates were discussing a global tobacco tax in secret.

Future direction – FCTC 2030 Project

In 2017, the Convention Secretariat started a new project, FCTC 2030, to help parties to strengthen treaty implementation by aligning it with the United Nations 2030 Agenda for Sustainable Development and its Sustainable Development Goals (SDGs).

This reflects the importance of tobacco control in promoting development, including specific reference to WHO FCTC implementation in target 3.a. Given the impact of tobacco on development, the implementation of the convention will play an important role in achieving the Sustainable Development Goals.

The FCTC 2030 project aims to support Parties to the WHO FCTC that are eligible to receive official development assistance (ODA) to achieve the SDGs by advancing implementation of the convention. The project will run from April 2017 until March 2021.

Through the FCTC 2030 project, technical support will be provided to national governments of these countries to:

implement the requirements of Article 5 of the WHO FCTC, to improve tobacco control governance and protect tobacco control policies from the vested and commercial interests of the tobacco industry;
strengthen tobacco tax;
implement WHO FCTC time-bound measures for:
comprehensive ban on tobacco advertising, promotion and sponsorship;
effective health warnings on tobacco packaging; and
smokefree work and public places;
implement other Articles of the WHO FCTC according to national priorities; and
promote overall implementation of the WHO FCTC as part of the 2030 Agenda for Sustainable Development and to support Parties to incorporate the implementation of the WHO FCTC into their national health and development agendas.

Through the FCTC 2030 project, the Convention Secretariat will promote WHO FCTC implementation as part of the Sustainable Development Goal (SDG) agenda and provide general support and materials for low- and middle-income countries (LMICs) in the areas set out above. This will include workshops, toolkits, online training on tobacco control, south-south and triangular cooperation, and other forms of assistance to national governments to accelerate treaty implementation.

The Convention Secretariat will also be able to provide intensive support up to 15 selected countries that are Parties to the WHO FCTC, are eligible to receive ODA and have demonstrated the motivation and commitment to advance treaty implementation. This will include the provision of direct, demand-driven expert advice, technical assistance and peer support to build domestic capacity to improve tobacco control in line with available resources.

Protocol

In 2012, a supplementary Protocol to Eliminate Illicit Trade in Tobacco Products to the convention was concluded in Seoul, South Korea. The Protocol will enter into force after it has been ratified by 40 states that have ratified the convention. In July 2017, there are 28 signatures and the Protocol is reuniting more countries every year.

References

Bibliography

External links

Official website
Institute for Global Tobacco Control
GLOBALink Tobacco Control, The International Tobacco Control Community (archived 2012)
GlobaLink (tobacco control), part of ncdlinks.org (registration required)