The fifth anniversary of the entry into force of the Framework Convention on Tobacco Control (FCTC) was celebrated on 27 February 2010. Gathering the States, organizations and people who played a key role developing the treaty, the World Health Organization (WHO) FCTC Secretariat organized an event to celebrate this milestone in public health. 

First public health treaty protects millions

The FCTC is the first treaty negotiated under the auspices of the WHO. With 168 States Parties, it is one of the most widely accepted treaties in the history of the United Nations. The FCTC has catalyzed the implementation of strong and effective tobacco control in many countries of the world, and these measures now protect millions of people from the devastating impact of tobacco use and exposure.

Tobacco industry’s biggest enemy

The tobacco industry once identified the WHO as its single biggest enemy. In her opening comments celebrating the FCTC anniversary, WHO Director General Margaret Chan admitted pride in this distinction: “The tobacco industry is ruthless, devious, rich, and powerful. As we all know, neither WHO nor public health is rich, but with the Framework Convention in place, we are indeed powerful.” 

Preventive power of international collaboration

Dr Chan paid tribute to the model of international collaboration for public health that has been created by the FCTC. Pointing to reductions in heart disease, stroke and other diseases linked to tobacco use in affluent countries, she identified the treaty as a “win-win opportunity” for governments and the international community. Recalling how it helped calm exaggerated fears that blocked negotiations, Dr Chan highlighted   how scientific evidence had been key to achieving this public health triumph. “In the end, the right of the public to breathe tobacco-free air, and the right of our children to be protected from addiction to a mortal product carried the greatest weight”.

Tobacco control: a development issue

But while tobacco use has declined among the wealthy, it continues to increase in many low-income settings, especially among women and youth. “Developing countries are the new frontier for the marketing of tobacco products”, Dr Chan revealed “and developing countries cannot cope with the added costs and demands that will inevitably follow increases in tobacco use”. Speaking on behalf of the Framework Convention Alliance (FCA), the network of over 350 organizations working on the development, ratification, and implementation of the international treaty, Dr Mary Assunta (FCA Chair) described tobacco’s heavy impact on poverty and asked why it had been left off of the global development agenda: “If tobacco control is treated as a global afterthought, development in the world’s poorer countries will be handicapped for years to come”. She reminded the audience that richer parties have done little to offer technical or financial assistance for tobacco control in low- and middle-income countries, and while acknowledging the huge difference that recent philanthropic contributions have made to tobacco control, warned that governments cannot depend on these to sustain tobacco control. 

Planning for the future

In spite of our solid progress in tobacco control over the past five years, deaths caused by tobacco continue to increase. To meet the challenges of the next five years, Dr Assunta urged the audience to be attentive to tobacco industry strategy, which is to:

• Ensure access to cheaper tobacco leaves, mainly from low-income countries
• Sell more tobacco products, especially in emerging markets in low- and middle-income countries
• Circumvent regulations with innovations in marketing and products, ensuring that users remain addicted and new ones are hooked
• Consolidate global dominance through mergers and acquisitions

She called on health advocates to take stock of FCTC progress, particularly with respect to taxation, which simultaneously reduces tobacco use and uptake and generates funding for other measures. Additionally, the FCA urges more stringent measures such as 90% graphic warnings on cigarette packages, generic packaging, eliminating duty free tobacco sales, developing more cessation methods, and establishing an effective protocol on illicit trade in tobacco.

Call for action

For the FCTC’s fifth anniversary the World Heart Federation joined other international partners in tobacco control to issue a joint statement. Celebrating the success of the treaty and identifying needs for action, the statement called for more robust monitoring of treaty compliance, better funding for tobacco control, and more engagement of civil society in ensuring FCTC implementation. Professor Srinath Reddy, a cardiologist and respected World Heart Federation board member, who represented India in the FCTC negotiations, concluded: “Tobacco use and exposure cause so much cardiovascular damage that no one committed to better heart health can be indifferent. We have a voice, one which is heard with respect by the wider community, and we need to advocate for tobacco control with commitment and passion”.

Further reading

Joint statement issued by World Heart Federation with partners in tobacco control >

Margaret Chan’s opening comments >

FCTC Secretariat at WHO >

Framework Convention Alliance article on the anniversary >