Author: Prof. Dr. Judith Mackay, Director, Asian Consultancy on Tobacco Control, Hong Kong
The birth of the FCTC
I clearly remember the 26 October 1993 when Professor Ruth Roemer from the University of California Los Angeles invited me to breakfast during the APHA conference in San Francisco, and discussed the novel idea of a WHO Convention on tobacco.
She suggested I do two things. The first was to convey the idea of a Convention to WHO in Geneva and to UNCTAD (UN Conference on Trade and Development), the then UN focal point for tobacco.
I immediately passed on the concept but the idea of a convention that utilized international law to further public health was new. The most common initial reactions ranged from neutral to negative: it was too difficult, would not get the support of Member States, would run into strong opposition from the tobacco industry, and would take at least ten years. My reply was that I lived in China, where ten years is regarded as a short time.
The second task was that I would introduce a resolution to the 9th World Conference on Tobacco or Health in Paris in October 1994. It read:
“This conference resolves that National Governments, Ministers of Health, and the World Health Organization should immediately initiate action to prepare and achieve an International Convention on Tobacco Control to be adopted by the United Nations”
The NGO community immediately embraced the FCTC. Like a toddler taking its first steps, the FCTC was off to a hesitant start.
The 27th April 1998 was probably the most important single day in the FCTC history. Dr. Gro Harlem Brundtland had just been appointed Director General of WHO, and was looking for priority cabinet projects. She invited groups of specialists to make representation on their own topic.
Richard Peto, Neil Collishaw and I were invited to make a presentation on tobacco. It was immediately adopted by Dr. Brundtland as a cabinet project.
Neil focused on a simple graph showing tobacco deaths rising steadily, yet funding for tobacco control decreasing. Richard talked about the magnitude of current and future tobacco-attributable disease and death. I showed pictures of appalling tobacco industry promotion. Dr. Brundtland was moved and horrified by the three presentations.
Our submission was adopted and, on taking office, she immediately formed the Tobacco-free Initiative. The FCTC followed on from this and the rest is history.
“In this one bowl, there is rice from a thousand households.”
The saying of Zen poet Ryokan (1758–1831) well describes the contribution of so many to the subsequent success of the FCTC: WHO, other UN agencies, Member States, nongovernmental organizations (NGOs), academia, the media, and even the tobacco industry – their obstructive tactics left no doubt that the world needed the FCTC, especially low and middle-income countries.
The FCTC indicated that the tide of tobacco control action is international, unstoppable and a necessary public health measure, accepted as good for the wealth and health of nations. Others will write about effects over the last 20 years; suffice to say It has been a sea-changer in global tobacco control.
