Author: Laurent Huber, Executive Director, Action on Smoking and Health; former Director, Framework Convention Alliance
It has been 25 years since the WHO FCTC negotiations began and 20 years since its entry into force.
In May 1999, the World Health Assembly adopted Resolution WHA 52.18, giving the green light for the world to begin negotiating a global treaty to address tobacco harms, and about a year later, negotiations began for the WHO Framework Convention on Tobacco Control (FCTC).
On a personal note, this year also marks my 25th year working at ASH and working on the WHO FCTC. ASH’s entry into the FCTC process was thanks to the dedication and visionary leadership of ASH Board members like Ms. Ethel Wells. Ms. Wells believed that tobacco had to be addressed through multilateral negotiations as “the rule of international law must be the basis for the settling of differences between the sovereignties of the world.” Another instrumental, visionary ASH Board Member is Dr. Alfred Munzer. Dr. Munzer, a pulmonologist who was tired of treating tobacco related lung diseases, wanted to promote the use of international law to curb the tobacco epidemic and reach “a day when smoking is no longer a sign of personal success and when tobacco is no longer a measure of national wealth or a legitimate commodity in international trade.” As Dr. Munzer clarified when explaining his dedication to the FCTC, “I decided that whatever I did in my practice, I also wanted to contribute to changing the terrible statistics, the terrible toll that tobacco was taking on our citizens.”
I was welcomed at ASH in September of 2000 with a very broad mandate: do everything you can to support this treaty (the FCTC).
The FCTC and FCA | Early Days
As a civil society organization, ASH took several actions to support the treaty process, most substantially, ASH strengthened the participation of civil society in the treaty by supporting the Framework Convention Alliance, now the Global Alliance for Tobacco Control, an alliance of non-governmental organizations that was a powerful voice and had a tremendous impact on the FCTC negotiations and the entire FCTC process.
During the early days, the FCA worked as a loose coalition until 2003, when it was first officially incorporated in Switzerland. ASH served as the secretariat of the FCA for seventeen years, and I had the honor of serving as its director during that time. It has been such an honor to engage and contribute to so many FCTC related meetings, activities, and processes all over the globe. We’ve had the privilege to work with government officials, UN representatives, foundations, media, and civil society organizations from all regions of the world to combat the tobacco epidemic.
I am extremely proud of everything the FCA achieved with our partners and friends around the WHO FCTC.
The FCA was able to form a coalition of more than 500 public health, human rights, consumer rights, women’s and children’s rights organizations and environmental activists from over 100 countries, rallying to support the development of the strongest, evidence-based, and most effective FCTC.
Working with a coalition of supportive countries, including India, Thailand, Canada, New Zealand, the island nations of the Pacific and Caribbean and the entire continent of Africa, the FCA was able to thwart the desires of tobacco producing governments that sought a weak and non-binding treaty during the FCTC negotiations. In just a few years, from the beginning of the treaty negotiations to its adoption in 2003, the FCA grew tremendously in size and influence and had a very significant impact not only on the final text of the FCTC but also its rapid entry into force and later development of guidelines and protocol.
FCA members participated in all negotiating sessions of the FCTC, working collaboratively with governments, the WHO and other UN entities during the entire FCTC process. FCA provided educational materials, held delegates’ briefings, created a daily newsletter during the negotiations, provided tobacco control expertise, and offered in-country and regional strategic support. The FCA and its members helped shape much of the public climate that provided momentum for international regulation of the tobacco industry and then helped achieve consensus on what measures needed to be taken to reduce tobacco use.
Without the scientific, educational, media and organizing expertise of hundreds of public health, tobacco control, consumers, human rights, and other organizations worldwide, a strong FCTC Convention may not have been achieved.
The FCTC | After Adoption in 2003
The FCA and its members helped increase the speed at which countries joined the FCTC, hence also accelerating its entry into force.
After the FCTC was adopted in 2003 and opened for signature by individual nations, the FCA began an advocacy campaign, including a door-to-door campaign to permanent UN missions in New York City as the signing deadline approached in 2004. This resulted in numerous signatories of the FCTC.
Later, to accelerate the entry into force of the FCTC, the Alliance organized regional capacity building workshops in support of ratification and accession of the treaty in all six WHO regions and provided small grants to support ratification projects. Its activity at the national level was crucial to ensure that nations signed the FCTC and then ratified it within a reasonable period of time and may have contributed to the fact that the FCTC entered into force in an almost record time.
Public Record of FCA’s Contribution
The contribution of civil society networks like the FCA are recognized within the FCTC treaty in itself. Article 4.7 states that the “participation of civil society is essential in achieving the objective of the Convention and its protocols.”
Various political and global health leaders have recognized the contribution of the FCA to the FCTC process. For example:
“I regard the Framework Convention on Tobacco Control as vitally important for global health and, without a doubt, the role of the FCA in motivating, organizing and coordinating the input of civil society into the treaty-making process was crucial to its success.”
– Dr. Gro Harlem Brundtland, Director-General, World Health Organization,1998-2003 and former Prime Minister of Norway
“I had the privilege to work closely with the FCA through the development of the FCTC and to witness firsthand the expertise they bring to the process of negotiating and adopting complex policy. The importance of having non-government and government agencies work together cannot be underestimated, and FCA understands very well how to influence governments to create the best possible policies.”
– Dr. Tábare Vázquez, President of Oriental Republic of Uruguay, 2005 to 2010
“The FCA has made a phenomenal contribution to the success of the WHO FCTC … the effect has been particularly evident in the low and middle income countries. FCA has been both a pilot and a beacon for addressing non-communicable disease efforts as we move into the 21st century.”
– Dr. Judith Mackay, 2007 Time Magazine 100 Most Influential People Award Winner, 2008 OBE Award from Queen Elizabeth, and 2009 British Medical Journal Lifetime Achievement Award
Even one of the members of the U.S. delegation to the FCTC Negotiations, Gregory Jacob, who did not agree with many of the FCA positions, recognized the effectiveness of the FCA in a Chicago Journal of International Law article where he wrote:
“The NGOs in Geneva were well organized and outspoken. In fact, Action on Smoking and Health (‘ASH’), Campaign for Tobacco Free Kids, and an assortment of other NGOs banded together to form an umbrella organization called the ‘Framework Convention Alliance.’ The Alliance sponsored seminars for the delegates, lobbied them in the hallways, and put out an ‘Alliance Bulletin’ every morning designed to sway delegates’ positions on various proposed treaty provisions. Much of the information distributed by the NGOs was valuable and accurate.” He went on to say, “the NGOs thus exerted tremendous influence over the course of the negotiations” and “the NGOs worked the halls masterfully and, for all intents and purposes, filled the roles of deeply entrenched Washington insiders.”
The FCA’s Impact
As I reflect on the early stages of the FCTC negotiations, I remain impressed by the way we were able to coalesce and work so effectively as civil society under the FCA during the FCTC negotiations, especially given that much of this coordination work was done with modest resources.
The FCA displayed an amazing ability to bring together people from all over the world and successfully influence the FCTC. The membership constructively debated positions and then reached consensus on which tobacco control measures to include in the treaty. Then, most importantly, members put individual and institutional egos aside to speak with one voice during the treaty negotiations.
The way in which the FCA was able to effectively organize around the FCTC process has become a model for civil society engagement in international treaty processes and has been written about in numerous academic articles and writings on effective coalitions. For example, the 2005 report Advocacy for Impact: Lessons from Six Successful Campaigns commissioned by the Global Interdependence Initiative, a Program of the Aspen Institute has an entire section on the FCTC in which they describe the “strong supportive role” of the NGOs by describing the FCA as “a vibrant network of more than 200 NGOs in 100 countries that are in continuous consultation and debate via a closed web link. Each member organization lobbies for the treaty and works on tobacco control in its own country, using strategies and tactics that are most effective in that situation.”
The FCA’s Values
The values of the FCA were also admirable, as all members had a voice.
As the Advocacy for Impact report stated, “although the Alliance is funded by the West, the group has a decisively democratic and egalitarian feel where all strategies and tactics, and even funding decisions, are fiercely debated.” This was a key priority for ASH.
As the Advocacy for Impact report concluded when describing the FCA, “the global power of this loosely bound group derives from its ability to come together as a highly organized and unified force, as it did during the six rounds of international treaty negotiations. During these meetings, advocates from around the world met daily to coordinate their messages, events, and press releases for maximum impact. They used a wide range of advocacy tactics to influence the delegates to these meetings, including: providing solid research-based educational materials; publishing a daily newsletter of conference proceedings; organizing lunch meetings and performances; and orchestrating sensational, attention-getting displays like unveiling a ‘tobacco death clock.’”
ASH is proud to have been able to facilitate the participation of members of civil society and at times government representatives with tobacco control expertise from low-income countries to the FCTC negotiations. Their contributions were critical to the outcomes of the treaty.
Where It All Began
Things have changed tremendously since negotiations began in earnest in 2000.
At that time, tobacco was advertised everywhere, no country had comprehensive smoke free policies, not a single country had pictorial health warnings and plain packaging was barely a consideration.
A few instances come to mind demonstrating our initial landscape. For example, there was a debate during a side meeting at INB2 in early 2001 with delegates from the European region. One of ASH’s priorities was to include a protection from tobacco smoke in the treaty, so I asked the European delegates if they would support the inclusion of an article to protect citizens from exposure to tobacco smoke in the FCTC. I can still remember the response from a governmental delegate from Ireland who stated vehemently that this was not feasible because he claimed it could go against a presumed “right of smokers to smoke.” Ironically, Ireland became the first country to implement a comprehensive ban on smoking in public places. Even among civil society members, many thought the concept of smoke free bars and restaurants was going too far. But thanks to the FCTC this has changed, as the FCTC helped the world reach consensus about what needed to be done to achieve its Objective, “to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke.”
The Game-Changer: The FCTC
The FCTC was a game-changer in global health as it provided a clear path for countries on what to do to reduce tobacco prevalence like these key Articles that include demand and supply measures:
• Article 6 – encouraging price and tax measures to reduce the demand for tobacco.
• Article 8 – addressing the adoption and implementation of effective measures to provide protection from exposure to tobacco smoke.
• Article 9 – requiring the regulation of the contents and emissions of tobacco products.
• Article 10 – requesting manufacturers and importers disclose to government authorities and the public what constituents and emissions are in tobacco products.
• Article 11 – requiring the adoption and implementation of effective measures to prohibit misleading tobacco packaging and labelling; requiring that packages carry large health warnings and messages describing the harmful effects of tobacco use with warnings covering 50% or more, but not less than 30%, of principal display areas and in main national language(s); and containing prescribed information on the tobacco products’ constituents and emissions.
• Article 12 – education, communication, training and awareness campaigns to raise public awareness of tobacco control issues through all available communication tools.
• Article 13 – requiring a comprehensive ban on all tobacco advertising, promotion and sponsorship.
• Article 14 – addressing support for reducing tobacco dependence and cessation, including counselling, psychological support, nicotine replacement, and education programs.
• Article 15 – addressing the elimination of all forms of illicit trade in tobacco products.
• Article 16 – prohibiting the sale of tobacco products to or by minors.
• Article 17 – addressing the need for support for economically viable alternative activities.
• Article 18 – addressing serious risks posed by tobacco growing to human health and to the environment.
• Article 19 – providing countries with an opportunity to collaborate and use the law to hold the tobacco industry legally liable for its abuses.
• and Article 5.3 of the FCTC which calls on countries to protect health policies from commercial and other vested interests of the tobacco industry,“ which is a model for other UN treaties dealing with consumer products with harmful externalities, setting the standard on how to protect the aims of the treaty from vested commercial interests.
The FCTC Today
Today, the FCTC has been joined by 182 countries and the European Union. Numerous countries have implemented some of its life saving measures.
We even begin to see countries contemplating Article 2.1 of the FCTC which recognizes that the FCTC articles are the floor and not the ceiling by stating that, “in order to better protect human health, Parties are encouraged to implement measures beyond those required by this Convention and its protocols, and nothing in these instruments shall prevent a Party from imposing stricter requirements that are consistent with their provisions and are in accordance with international law”.
In addition, we were already very fortunate to have the FCTC included as a Target in the UN Sustainable Development Goals, and it is also encouraging to see, in the mid-2020s, the FCTC is working in synergy with other UN Bodies around environmental, human rights, and development objectives.
However, despite these successes and some progress at country level, the latest FCTC implementation report concluded that while results, “show some positive developments, there is a need for Parties to devote more attention to the comprehensive implementation of the treaty,” and the report further states that, “in recent years, as shown in previous global progress reports, the overall progress as measured by average implementation rates of the substantive articles of the Convention was relatively slow.”
As a result, countries are not maximizing the potential the FCTC offers.
Looking Forward
I’ve had the privilege of participating in the FCTC negotiations and witnessing its adoption, entry into force, and implementation. As I reflect over these past 25 years, I remain so impressed by what we have been able to collectively achieve as a global health and human rights movement with the FCTC.
Today, thanks to our collective work, we have an evidence-based treaty joined by more than 180 countries that gives clear direction to the world on what to do to address the most dangerous consumer product on the market: commercial tobacco.
Despite the fact that the FCTC involved UN multilateral negotiations addressing consumer products with big financial interests at stake, the countries negotiating the treaty uniquely recognized the importance of prioritizing health and protecting the treaty from the vested interests of the industry they were trying to regulate. UN Members States did so when they affirmed in the Preamble of the FCTC that they are “determined to give priority to their right to protect public health” and when they recognized in Article 5.3 that “in setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry.”
While the negative role of the tobacco industry was recognized, the FCTC is also unique in recognizing the critical role of non-governmental organizations like ASH by including article 4.7 which states that “the participation of civil society is essential in achieving the objective of the Convention and its protocols.”
This has been a long journey, with many victories, but also major difficulties and huge efforts to overcome challenges. While we can rejoice in some victories for health, much more remains to be done given that the tobacco epidemic is still claiming millions of lives every year and unnecessarily damaging our environment.
It is true that the tobacco industry is the main obstacle to the implementation of the lifesaving measures of the treaty, and it is also true that resources to implement and enforce the FCTC at country level are scarce, often due to a lack of whole of government engagement in the FCTC.
Yes, the tobacco industry is powerful, but countries are more powerful.
It is critical that we, as civil society, remain united and demand that governments work together to accelerate the comprehensive implementation of the FCTC and achieve its objective to “protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke”.
Our governments can do this. No one should die because of tobacco, and the FCTC is a best practice tool to achieve not only health, but also environmental, human rights and developmental objectives through a tobacco free world vision.
ASH remains committed to fully supporting the FCTC and its implementation around the world and achieving our joint vision of “a world free from the harm caused by tobacco”.
Let’s do this, together.
