If the world is going to permit organizations to exist for the purpose of promoting consumer products that used as intended cause death and disease, then it at least ought to establish meaningful restraints on how those organizations can operate.
That is the modest premise underlying an initiative by the World Health Organization (WHO) to create a Framework Convention on Tobacco Control (FCTC).
WHO member countries unanimously agreed in 1999 to launch negotiations on a global tobacco treaty. If adopted, the FCTC will constitute the first treaty negotiated through the WHO. The second round of formal negotiations over the treaty are underway this week in Geneva.
WHO predicts that by 2030, 10 million people will die annually from tobacco-related disease, with 70 percent of those deaths in developing countries. That's a lot of blood on the hands of the Big Tobacco companies that aggressively cultivate new smokers, manipulate their product to keep smokers addicted and work to circumvent public health and taxation systems that would deter smoking.
The Framework Convention could make an enormous contribution to stemming the global tobacco epidemic by fostering international cooperation on issues such as smuggling and the global marketing of tobacco products.
A proposed smuggling protocol should involve a system of tracking cigarette exports, including labels indicating the intended final destination. Cigarette smuggling is at epidemic levels -- an estimated one in three internationally traded cigarettes is smuggled -- and newly emerging evidence from company documents suggests the tobacco industry is facilitating, encouraging or even directing smuggling on a massive scale. Smuggling allows tobacco companies to evade excise taxes, which in most countries make up a considerable portion of the consumer price -- and which deter smoking by keeping prices up.
A marketing protocol should impose a worldwide ban on cigarette advertising and marketing, or at least require countries to adopt prohibitions on tobacco advertising to the extent permitted under their national constitutions.
But even though the tobacco control movement has effectively vilified Big Tobacco in the last several years, the multinational companies remain enormously powerful, and they are pursuing varied strategies to undermine an effective international treaty.
The biggest and slickest of the companies, Philip Morris, claims to have turned over a new leaf. Philip Morris now says it supports a tobacco treaty.
"It is time for regulation," says David Greenberg, Philip Morris International's senior vice president for corporate affairs. "The company is ready to embrace regulation around the world whether by international institutions and/or at the national level."
"We'd like to see a convention have as broad a reach as possible," Greenberg says, "so we know what the rules are."
Philip Morris would support treaty provisions on youth smoking prevention, information to adult smokers, ingredient disclosure, disclosure of the constituents of tobacco smoke, marketing standards and smuggling. The company also supports government regulation of the tobacco product itself, so that cigarettes can be "made as safe as they can be," Greenberg says.
A "cooperative" Philip Morris may be at least as dangerous as an obstructionist one, if it is able to influence the negotiating process and shift the treaty away from aggressive measures. For example, Philip Morris supports restrictions on broadcast advertising of tobacco products, bans on the use of cartoons in cigarette ads and prohibitions on the placement of advertisement in locations with a "particular appeal to minors" -- measures that many activists believe to be of little value, because they can be easily circumvented and leave so many marketing opportunities open to the tobacco pushers. Philip Morris says it strongly opposes a total marketing ban, which has proven public health benefits.
Where once the major risk in the FCTC process seemed to be that no treaty would emerge, activists are increasingly concerned that the main danger is that the treaty that emerges may not be worth much.
"This is the week when we will find out if governments are simply making gestures or if they have the guts to take on the tobacco industry and really deal with the world's biggest public health epidemic," says Clive Bates, of ASH UK. "The danger is that too many governments and the WHO just want a treaty and any treaty will do."
But any treaty will not do. A strong treaty could meaningfully assist the heroic efforts of the understaffed tobacco control activists in developing countries and the former Eastern bloc who are trying to stem the preventable death toll from tobacco-related disease.
"The overturning in the courts of the EU ban on tobacco advertising last year has stopped Czech tobacco control legislation from coming to fruition, and the tobacco industry is doing very strong and systematic lobbying of our politicians," explains Eva Kralikova of the Czech Medical Association. "This is why we need a strong FCTC -- as a defense against back-sliding in the West and to help us get tough national tobacco control policies implemented as soon as possible."
By contrast, a weak treaty will enable the tobacco predators to continue unimpeded in their determined efforts to spread death and disease, with horrific consequences in the countries least well equipped to protect the public health from Big Tobacco's organized onslaught.