One hundred sixty nations, many of them in the developing world, have vowed to stand up to the tobacco industry and its efforts to water down antitobacco laws.
Bolstered by a 2005 global treaty, sponsored by the World Health Organization – the Framework Convention for Tobacco Control – more than 100 nations have created new laws to ban public smoking, ban tobacco advertising, particularly those targeting youths, and ban partnerships between tobacco companies and government. This weekend, at a meeting in Durban, South Africa, countries took that treaty a step further by agreeing that tobacco lobbyists must be prevented from interfering with healthcare policy.
"This was a big step," says Kathy Mulvey, international policy director for Corporate Accountability International, based in Boston. "The anchor principle of this meeting was that there is a fundamental conflict between tobacco industry interests and public health interests. These guidelines will help advocates and public officials begin to slam the door on tobacco industry tactics, and focus on implementing the treaty's lifesaving measures."
Times have been hard for the tobacco industry in the developed world, as smoking diminishes in Europe and North America – evidence that education on tobacco's harms are starting to pay off. But as the tobacco industry shifts its attentions farther south to Africa, Latin America, and Asia – betting that weaker governments or corrupt officials will smooth the path for their product to be sold – it has met surprising resistance from individual nations and citizens groups who refuse to allow their countries to be dumping grounds for what has been called the world's largest preventable epidemic.
Tobacco consumption across Africa has increased 4.3 percent per year, according to the World Health Organization. Nearly 5.5 million people die every year because of tobacco products, WHO says, and more than 70 percent of these deaths occur in developing countries. Citizens groups argue that developing nations have to protect themselves with strong legislation, since their poorly funded hospitals and clinics cannot handle the wide range of health problems linked to tobacco use.
"Yes, governments do go to international conferences and make promises, but then when they come home, reality bites and they forget their obligations," says Dr. Yussuf Saloojee, executive director of the South-African-based National Council Against Smoking. "What we need to have are clear guidelines that rule out interaction between the tobacco industry and government."
A law is only effective if it is enforced, of course, and antitobacco activists admit there are plenty of examples across Africa of excellent laws being ignored because poorly paid government officials don't enforce them. Yet activists say that both the FCTC treaty, and now the new guidelines will give moral force for making sure that these news laws are actually implemented.
By agreeing to enforce the antitobacco treaty to the fullest measure, signatories of the treaty have agreed that they can now force tobacco manufacturers to put graphic photographs of cancer on their packages, instead of written health warnings – a significant step in Africa where up to 50 percent of the population cannot read. In addition, countries have decided to ban government officials from investing in tobacco companies, and to green-light new laws that ban tobacco advertising and enforce smoke-free legislation.
"These are not provisions that cost money," says Ms. Mulvey. "This is about having rules and clear guidelines on how to deal with industry, because the tobacco industry has a range of strategies for interfering in matters of public health policy."
Even seemingly benign programs, such as the tobacco industry's charitable contributions to AIDS prevention programs or its "youth smoking prevention" programs can be a back door for actually promoting smoking, says Mulvey. Advertisements intended to discourage smoking by young teens, for instance, often use the same scenes used by tobacco advertisers to glamorize smoking.
While the tobacco industry can easily outspend the average antismoking activist group, delegates in Durban pointed out success stories where African countries stood up to Big Tobacco and won.
"Small countries can do a lot if we all come together," says Lanre Onigbogi, director of the Africa Tobacco Control Regional Initiative (www.atcri.org). "They may have unlimited resources, but we have unlimited enthusiasm."