Death And Reasons


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  • Topic is treaties and civil society-   I am a lawyer who spent most of my career as a litigator and government regulator- I am a real latecomer to foreign relations- that is my husband’s area- he teaches international relations. But after I retired from the government I was offered the opportunity to help create an international NGO coalition in support of the nascent Framework Convention on Tobacco Control. Having spent almost 30 years in the US governmental bureaucracy- I figured how much more difficult could it be. Well- I had a four-year education awaiting me. Issues were diverse- not just learning how a treaty was negotiated- what were the issues- is a multilateral treaty the best mechanism for health- Treaty may be first- health but it startd with many economic issues- industry wantd to be a part as they usually are, but seen as disease vector, needed client governments- US, Germany and Japan. North south, is it a developed world life style issue or corporate greed.
  • Death And Reasons

    1. 1. The Growing Global Tobacco Epidemic and the International Response Ross Hammond Campaign for Tobacco-Free Kids University of Washington 2 May 2007
    2. 2. 1. Tobacco & Globalization 2. Tobacco & Poverty 3. The Global Toll 4. The International Response
    3. 3. 1. Tobacco & Globalization <ul><li>Free Trade & Financial Liberalization have greatly increased profit opportunities for Big Tobacco </li></ul><ul><li>Global Communications/Marketing has helped them take advantage of these opportunities </li></ul><ul><li>Coordinated Lobbying has ensured (so far) that their profits are protected </li></ul>
    4. 4. “ Tobacco exports should be expanded aggressively, because Americans are smoking less.” -- U.S. Vice-President Dan Quayle, 1990
    5. 5. Global Expansion Fuelled By: <ul><li>opening up of formerly closed economies (FSU, E. Europe, China) </li></ul><ul><li>pressure to liberalize investment laws and privatize state-owned industries </li></ul><ul><li>pressure to embrace “free trade” (as defined by the West) & expansion of free trade areas in Asia & L. America </li></ul>
    6. 6. Complete Transformation of the Global Tobacco Industry in the Last 25 years <ul><li>Privatization of state-owned tobacco monopolies </li></ul><ul><li>Joint-venture agreements </li></ul><ul><li>Consolidation/mergers </li></ul><ul><li>Between 1991-2001, over 140 mergers and acquisitions </li></ul>
    7. 7. Global Expansion <ul><li>In 2002, Philip Morris, BAT and Japan Tobacco operated in over 50 countries each and had combined tobacco sales of over $121 billion, a sum greater than the combined GDPs of: </li></ul><ul><ul><li>Albania, Bahrain, Belize, Bolivia, Botswana, Cambodia, Cameroon, Estonia, Georgia, Ghana, Honduras, Jamaica, Jordan, Macedonia, Malawi, Malta, Moldova, Mongolia, Namibia, Nepal, Paraguay, Senegal, Tajikistan, Togo, Uganda, Zambia and Zimbabwe </li></ul></ul>
    8. 8. Philip Morris Tobacco Revenue & Select Country GDPs (2000) Source: Philip Morris, World Bank Philip Morris US$ billions Czech Rep Kenya Senegal Sri Lanka Costa Rica Hungary
    9. 9. <ul><li>“ We are still in the foothills when it comes to exploring the full opportunities of many of our new markets.” </li></ul><ul><ul><li>-- Geoffrey Bible, Philip Morris CEO, 1996 </li></ul></ul>
    10. 10. US Government Has Promoted Tobacco Overseas <ul><li>1980s: Threat of trade sanctions to pry open Japan, Thailand, S. Korea & Thailand. In S. Korea led to 10% increase in prevalence. </li></ul><ul><li>1999: US-China treaty for PNTR included provision requiring China to slash tariffs on imported cigarettes </li></ul><ul><li>2001: Pressure on S. Korea not to raise tobacco tariffs </li></ul>
    11. 11. <ul><li>“ Philip Morris strongly supports NAFTA and also supports the Uruguay Round process….We are well positioned to take advantage of the new opportunities that the removal of trade barriers will offer us. I see both the NAFTA and the Uruguay Round as real “winners” as far as Philip Morris is concerned.” </li></ul><ul><li>-- Internal Philip Morris document, 1994 </li></ul>
    12. 12. Global Communications & Marketing
    13. 13. Traffic Lights in Bucharest, Romania
    14. 15. “ This is a market with tremendous potential. The rate of population growth is 2.2. percent each year, and 40 percent of the population is under 18.” -- Philip Morris Turkey, 1997
    15. 17. Thailand
    16. 18. “ Give me an amerika” Czech slang for a good cigarette
    17. 19. Global Lobbying Effort <ul><li>In every region of the world: </li></ul><ul><li> </li></ul>
    18. 20. “ Tobacco use is unlike other threats to global health. Infectious diseases do not employ multinational public relations firms. There are no front groups to promote the spread of cholera. Mosquitoes have no lobbyists .” -- WHO Zeltner Report, 2000
    19. 21. <ul><li>“ We must try to stop the development towards a Third World commitment against tobacco. We must try to get all or at least a substantial part of Third World countries committed to our cause….We must try to mitigate the impact to WHO by pushing them into a more objective and neutral position.” </li></ul><ul><li>-- BAT internal document, 1979 </li></ul>
    20. 22. 2. Tobacco & Poverty
    21. 23. How Tobacco Impoverishes Individuals <ul><li>Money spent on tobacco cannot be spent on food, health care or education. </li></ul><ul><li>I n Bangladesh, over 10.5 million malnourished people could have an adequate diet if money spent on tobacco was instead spent on food. </li></ul>
    22. 24. Child Labor <ul><li>Use of child labor in tobacco growing and manufacturing widespread. </li></ul><ul><li>These children miss out on educational opportunities that could help lift them out of poverty. </li></ul>
    23. 25. How Tobacco Impoverishes Families <ul><li>Smokers are at much higher risk of falling ill and dying prematurely. If the main breadwinner becomes ill from tobacco, the family loses that person’s income AND has to bear the additional health care costs. </li></ul>
    24. 26. Tobacco Farming Can Lead to Indebtedness & Ill Health <ul><li>Extremely labor-intensive </li></ul><ul><li>Requires expensive inputs (fertilizers, pesticides, etc.) </li></ul><ul><li>Pesticide and nicotine poisoning common. </li></ul>
    25. 27. Tobacco Growing: Who Profits? <ul><li>Limited # of purchasers for tobacco. Farmers dependent on the companies to grade tobacco (and thus set price). </li></ul><ul><li>A tobacco farmer in Brazil would need to work for 6 years to earn what BAT's Director earns in a single day. It would take him 2,140 years to earn the Director’s annual salary. </li></ul>
    26. 28. How Tobacco Impoverishes Countries <ul><li>Environmental Damage </li></ul><ul><li>Increased Health Care Costs </li></ul><ul><li>Lost productivity due to illness and premature death </li></ul><ul><li>Foreign exchange losses </li></ul>
    27. 29. Environmental Damage <ul><li>Wood used to cure tobacco in many countries. Each year an est. 494,000 acres of forest is cut down (equiv. to ¾ the size of Olympic Natl. Park) </li></ul><ul><li>Tobacco leeches nutrients from the soil, requiring more fertilizer use. Runoff from fields pollutes watersheds vital for drinking water. </li></ul>
    28. 30. Environmental Damage Has Economic Costs <ul><li>All of this environmental damage has an economic cost, though not currently captured in official statistics. </li></ul>
    29. 31. Increased Health Care Costs <ul><li>In high income countries, annual tobacco-attributable health care costs est. at between 6% and 15% of total health care costs (very few estimates for low income countries). </li></ul><ul><li>In China, direct and indirect tobacco-attributable health care costs est. at $6.5 billion per year in mid-’90s. </li></ul>
    30. 32. Lost Productivity <ul><li>If current trends persist, about 500 million people alive today will eventually be killed by tobacco, half of them in productive middle age, each losing 20 to 25 years of life. </li></ul>
    31. 33. Foreign Exchange Losses <ul><li>Most countries import more tobacco leaf, tobacco products and tobacco-related machinery than they export. </li></ul><ul><li>Most tobacco profits repatriated to the home countries of the multinationals. </li></ul>
    32. 34. Tobacco’s Economic Importance Exaggerated <ul><li>Despite industry claims, few countries benefit from tobacco. Only 5 derive more than 5% of export earnings from tobacco </li></ul><ul><li>Tobacco represents small % of the labor force. In Brazil (world’s largest tobacco exporter), tobacco accounts for less than 2% of the ag. labor force. </li></ul>
    33. 35. 3. The Global Toll
    34. 36. Global Causes of Death * WHO World Health Report 2002
    35. 37. The Coming Epidemic
    36. 38. <ul><li>Currently: </li></ul><ul><li>4.9 million people die per year </li></ul><ul><li>13,400 people per day </li></ul><ul><li>560 people every hour </li></ul><ul><li>By 2030: </li></ul><ul><li>10 million people a year will die from tobacco use </li></ul><ul><li>70% of those deaths will occur in developing countries </li></ul>Global Deaths
    37. 39. 4. The International Response <ul><li>FCTC </li></ul><ul><li>Civil Society </li></ul><ul><li>Donor Community </li></ul>
    38. 40. Framework Convention on Tobacco Control (FCTC) <ul><li>1 st international public health treaty </li></ul><ul><li>Objective: to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke ... </li></ul>
    39. 41. FCTC <ul><li>Preamble </li></ul><ul><li>38 Articles </li></ul><ul><li>168 Countries Have Signed </li></ul><ul><li>146 Have Ratified (not the U.S.) </li></ul><ul><li>Find the full text at </li></ul>
    40. 42. FCTC: Key Provisions `
    41. 43. Enact comprehensive bans on tobacco advertising, promotion & sponsorship within 5 years of ratification (some exceptions) Pakistan Japan Thailand
    42. 44. Place rotating health warnings on packs that cover 30% or more of the package and can include pictures or pictograms
    43. 45. Ban the use of misleading and deceptive terms such as &quot;light&quot; and &quot;mild&quot;
    44. 46. Protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places
    45. 47. Other Key Provisions <ul><li>Encourage tobacco tax increases </li></ul><ul><li>Establish & finance ntl. coordinating body </li></ul><ul><li>Include cessation services in ntl. health progs </li></ul><ul><li>Prohibit free distribution of tobacco </li></ul><ul><li>Promote NGO participation </li></ul><ul><li>Prohibit sales to minors </li></ul><ul><li>No reservations allowed </li></ul>
    46. 48. Framework Convention Alliance (FCA) <ul><li>Diverse alliance of over 250 NGOS from more than 90 countries working to support FCTC ratification and implementation </li></ul><ul><li>WWW.FCTC.ORG </li></ul>
    47. 49. “ The participation of civil society is essential in achieving the objective of the Convention and its protocols.”
    49. 51. Issued Daily Report Card
    50. 52. Challenges for Civil Society <ul><li>Keep momentum going and maintain sense of urgency </li></ul><ul><li>Hold governments accountable for FCTC commitments </li></ul><ul><li>Work on guidelines and protocols to FCTC </li></ul>
    52. 54. CLOCK IS TICKING <ul><li>February 27, 2008- 40 original ratifying countries must have health warnings on packages </li></ul><ul><li>February 27, 2010- 40 original ratifying countries must have ad ban in place </li></ul>
    54. 56. Global Voices for A Smokefree World Campaign <ul><li>Reach out to governments to secure support for strong Article 8 guidelines. </li></ul><ul><li>Meet with Health Ministers in target countries. </li></ul><ul><li>Conduct a media campaign around smokefree air and the Article 8 guidelines. </li></ul><ul><li> </li></ul>
    55. 57. Donor Community <ul><li>Bloomberg </li></ul><ul><li>Open Society Institute (Soros) </li></ul><ul><li>NIH </li></ul><ul><li>American Cancer Society </li></ul><ul><li>IDRC/Research for Intn’l Tobacco Control </li></ul><ul><li>Cancer Research Campaign </li></ul><ul><li>Bilaterals (Sweden IDA, Canada IDA, etc.) </li></ul><ul><li>Others? (Gates Foundation) </li></ul>
    56. 58. Bloomberg Grantees <ul><li>Campaign for Tobacco Free Kids </li></ul><ul><li>CDC Foundation </li></ul><ul><li>Framework Convention Alliance </li></ul><ul><li>Johns Hopkins School of Public Health </li></ul><ul><li>World Health Organization </li></ul><ul><li>World Lung Foundation/IUATLD </li></ul>
    57. 59. Focus on fifteen c ountries with the greatest number of tobacco users <ul><li>China </li></ul><ul><li>India </li></ul><ul><li>Indonesia </li></ul><ul><li>Russia </li></ul><ul><li>Bangladesh </li></ul>Brazil Mexico Turkey Pakistan Egypt Ukraine Philippines Thailand Vietnam Poland
    58. 60. Campaign for Tobacco Free Kids’ Role in Bloomberg Initiative <ul><li>To support advocacy efforts in the following ways: </li></ul><ul><li>Strategic Planning/Campaign Support </li></ul><ul><li>Research </li></ul><ul><li>Media/Communications </li></ul><ul><li>International Legal Consortium </li></ul><ul><li>Advocacy Grant Fund </li></ul>
    59. 61. MORE INFORMATION: Yach, Wipfli, Hammond & Glantz, “Globalization and Tobacco” in Ichiro Kawachi & Sarah Wamala eds., Globalization and Health , London: Oxford University Press (2006).