The WHO FCTC at 10: progress has been mixed
By Derek Yach
Executive Director, Vitality Institute; former Executive Director, WHO NCDs*
The FCTC is an ambitious approach to tackling the world’s most preventable health problem. It was built on solid evidence of what worked best and supported strongly by the IMF, the World Bank, UNICEF, leading pharmaceutical companies and international health NGOs.
Progress has been mixed and the early passion and cohesion of the coalition has dissipated.
It was relatively easy to get laws on the books – but is proving tough to translate these into effective actions without financial resources, expanded leadership and a sharper ability to adapt the FCTC provisions to the reality of diverse countries.
Long-term support missing
Funding for the FCTC, and the NGOs who thankfully keep it on track, has dwindled. WHO’s financial cut-backs have slowed and impeded needed country, treaty and high-profile media work. Efforts to attract significant long-term support from development agencies has withered and face competition in the post-MDG era.
The earliest work of the FCTC involved demonizing the tobacco industry and cutting off contact with them. That was a successful and simple strategy at the time. But now we face new realities. Major multinationals are edging towards greater investments in innovative harm reduction products; and state monopolies led from China, Indonesia and India are poised to soon be the dominant manufacturers by volume of traditional tobacco products.
Implementation of the FCTC will be tougher as state monopolies’ power grows – as it is in the very countries where prevalence remains extremely high or increasing.
A shift required
Multinationals seek predictability and respectability. The FCTC gave them the first and harm reduction may give them the second. There is no example of a legal consumer goods sector being regulated out of existence. There are many examples though of how entire industrial sectors can shift from being damaging to the environment or health to being less damaging through the use of innovative technologies, smart regulations, consumer pressure and constant media voice.
Sustained reduction in tobacco use requires that we learn from other sectors and engage the world of “Environmental, Social and Governance” investing, business experts, innovators and forward thinking public health experts in charting a new way forward.
NGOs switched on the “tobacco death clock” as the FCTC negotiations started. Today it relentlessly ticks away faster than before recording more deaths in developing countries and among women each month.
If we are to make substantial progress over the second decade of the treaty we need to rekindle passion, develop new ideas and stronger coalitions and have the courage to challenge established dogma. All with a sharp focus on preventing millions of deaths.
* This is one of a series of articles written by health experts to mark the 10 anniversary of the WHO Framework Convention on Tobacco Control (FCTC), which is 27 Feb. 2015.The views in this article are those of the author alone and not necessarily endorsed by FCA.
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