You may recall earlier this year when the U.S. lost a legal appeal over its ban on candy flavorings for cigarettes, flavorings clearly meant to attract children to start smoking. The plaintiff in that case was the nation of Indonesia, which exports a lot of clove-flavored “bidis” to the U.S. The court was an international trade tribunal formed by the World Trade Organization. Under WTO rules, a country may drag another country to court over any laws that it feels violate trade rules. The decisions are binding, and the trade tribunals’ final decisions cannot be overruled, even by the U.S. Supreme Court.

ISDS creates a similar right to sue over any law that impacts trade, except that it allows any corporation to sue a country in an international trade tribunal. In the example above, the Indonesian tobacco industry would not have needed to convince the government to sue on its behalf. It could do so on its own. And the suits need not be against federal laws. They could go after state and local tobacco laws and regulations as well.

The reason this is particularly problematic for tobacco is that the tobacco industry has publicly stated that its strategy is to sue even when they don’t have a good case, just to impose an economic punishment on governments who try to reduce smoking. Trade cases cost millions of dollars each, win or lose. The federal government may be able to afford a vigorous defense, but states, counties and cities already facing historic deficits are a different story. Industry’s goal is to “chill” governments from passing tobacco control laws in the first place, just to avoid costly court cases.

For a real life example of what ISDS can mean in the face of a cynical, rich industry, read about Australia’s experience>

Harold Elliot Varmus, the winner of the 1989 Nobel Prize in Medi-cine, said a person’s genetic predisposition for cancer was small compared to the enormous cancer risk from smoking or tobacco consumption.

“Genetic research is a means to develop [cancer] therapy. In some cancers, such as colon cancer, breast cancer, thyroid cancer, renal cancer and several others, the genetic risks are less strong, compared to lifestyle behavior,” Varmus told The Jakarta Post here on Monday

Many kinds of cancer, especially lung cancer, were absolutely linked to smoking, he added. “The effort to diminish tobacco use, if it can be done, is very important to control cancer in Indonesia.”

Varmus, the director of US National Cancer Institute (NCI), made his comments after a lecture on the genetic basis of cancer at the University of Indonesia’s (UI) medical school.

During the lecture, which was sponsored by the US embassy, USAID Indonesia launched its Partnerships for Enhanced Engagement in Research (PEER)-Health Indonesia progam, a US$770,000 initiative to enhance public health research in Indonesia.

Ratna Sitompul, the dean of UI’s medical school, said that non-infectious diseases, including cancer, had become more common in Indonesia, while at the same time the nation was struggling against infectious illnesses.

“We need to conduct a lot of research to uncover why a particular cancer is affecting patients. Some of the viruses we are now dealing with can cause cancer. By learning about the differences between the biodiversity of the two countries, we may get some answers on how best to fight cancer,” Ratna said.

According to the central government’s 2010 Basic Health Research Report (Riskesdas), 63 percent of adult men in Indonesia smoked. A large number of children, some under 5, also smoked, the report said.

Although the smoking rate for Indonesian women was low compared to other parts of the world, it has been growing rapidly.

The report also said that 4.3 of every 1,000 Indonesian people were afflicted by cancer.

“There’s a very high incidence of tobacco smoking in the country,” Varmus said.

According to Varmus, even in the US, which had dramatically reduced its number of smokers, 20 percent of the population continued to smoke, ignoring evidence that smoking led to cancer, respiratory diseases and cardiovascular illnesses.

“I know there is an opposition to tobacco control, but I believe we need to take bold preventive steps on tobacco use,” Varmus said.

Tobacco consumption is one of three major factors to assess a person’s risk for cancer, along with the presence of Human Papilloma Virus (HPV), which is the leading cause of cervical cancer, one of most prevalent forms of cancer afflicting Indonesian women.

Varmus said there were now many ways to try to combat cervical cancer, such as, among other things, early detection of the disease using pap smears in addition to vaccination.

A HPV inoculation program initiated by the local chapter of the Indonesian Obstetricians and Gynecologists (POGI) in Denpasar, Bali, a year ago, met with a cool reception, which was attributed to the Rp 3.6 million price tag for the 3-shot vaccination program.

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By Elly Burhaini Faizal, The Jakarta Post

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