By:

Ravi Kanta Mishra

MPH, 3rd Batch

National Medical College, Birgunj

THE FRAMEWORK CONVENTION ON TOBACCO

CONTROL (FCTC)

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Outline of seminarIntroductionHistorical backgroundParadigm siftObjectives, Guiding Principles and General ObligationMitigation Measures FCTC in NepalCritics and Challenges regarding FCTCDiscussion

Total No of Slide:47Estimated Time Period : 40 Minutes

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Tobacco : Introduction• Tobacco use is the leading cause of

preventable deaths in the world.

• Tobacco has been with humans for thousands of years

• In 1000 B.C., people already started using the leaves of tobacco plant for smoking and chewing

• The use of tobacco was not stopped or discontinued even tobacco is proven to be extremely hazardous to human health

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Some Examples

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Tobacco : SituationGlobally:

4.9 million deaths per year 70 % in developing countries.

-WHONepal:

Current tobacco users are37.1% (M/F=53.3/19.2%)

Prevalence of smoking among women (22.6%) is the highest reported of all SE Asian countries

-WHO/MPOWER, 2008

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FCTC: Introduction

• World’s first global public health treaty

• Adopted by the 56th World Health Assembly on May 21, 2003

• Entered into force in February 2005

• Signed by 168 of the 192 WHO member states and 156 WHO member states have become parties to the convention

• Establishes mechanisms to control the use and the proliferation of tobacco

EWORK CONVENTION ON TOBACCO CONTROL (FCTC)ONTROL (FCTC)

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FCTC: History

• 1995– idea of an international instrument for tobacco (WHA 48)

-feasibility of developing an international instrument on tobacco control.

• 1996– WHA 49 -requesting the Director-General of WHO to initiate

"International framework convention for tobacco control“

• 1999– WHA 52 paved the way for multilateral negotiations on the

WHO FCTC and possible related protocols.

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History Contd…Established-

technical working group and intergovernmental negotiating body

1999first meeting of the WHO FCTC Working Group in Geneva

2000second meeting in Geneva World Health Organization (WHO) conducted public hearings on

the proposed WHO FCTC in Geneva

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History Contd…• 2001– first draft released as a basis for further negotiations at the second

session

– second session: set of three Co-Chairs’ working papers, an inventory of textual proposals merged with the Chair’s original text which became the rolling draft text of the Framework Convention

– third session -Revisions made on draft paper.

– first four session-considered numerous textual alternatives

– fifth session-address six main issues- advertising, promotion and sponsorship; financial resources; illicit trade; liability and compensation; packaging and labelling; trade and health

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History Contd…

• 2003– intense and broad ranging negotiations: Two important issues,

advertising, promotion and sponsorship and financial resources raised

– Negotiating Body agreed to transmit the text to the Fifty sixth World Health Assembly for consideration for adoption in accordance with Article 19 of the Constitution

– 56th WHA adopted the WHO Framework Convention on Tobacco Control

• June 2003 to June 2004– Singing period

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FCTC: SEARCountries signed date ratified date national legislation Bangladesh 16/6/2003 14/6/2004 Enacted

Bhutan 9/12/2003 23/8/2004 Still in draft

DPR Korea 17/6/2003 27/4/2005 Still in draft

India 10/9/2003 5/2/2004 Enacted

Maldives 17/5/2004 20/5/2004 Still in draft

Myanmar 23/10/2003 21/4/2004 Enacted

Nepal 3/12/2003 7/11/2006 Enacted

Sri Lanka 23/9/2003 11/11/2003 Enacted

Thailand 20/6/2003 8/11/2004 Enacted

Timor-Leste 25/5/2004 22/12/2004 Still in draft

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FCTC: Importance

Developed in response to the world’s tobacco epidemic and it reaffirms the right of all people to the highest standard of health

Million deaths annually due to tobacco-related disease, with the balance split roughly between developed and developing countries.

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Importance contd…The tobacco epidemic has spread globally through many

complex factors with cross-border effects, including trade liberalization and direct foreign investment

Other factors such as global marketing, transnational tobacco advertising, promotion and sponsorship, and the international movement of contraband and counterfeit cigarettes have also led to the explosive increase in tobacco use.

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Paradigm ShiftDrug control treaties-Regulatory strategies for addictive

substancesIt will act as a global complement to, not a replacement for

national and local tobacco control actions. FCTC changed that with a shift in perspective. Foreign policy

must now be developed with a view to taking into consideration the impact on health.

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What the treaty requires?Enact and undertake comprehensive bans on tobacco

advertising, promotion and sponsorship

Ban misleading and deceptive terms on cigarette packaging such as “light”, “low-tar” and “mild”;

Implement rotating health warnings on tobacco packaging that covers at least 30 percent (ideally 50 percent or more) of the display areas – this may include pictures or pictograms

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What the treaty contd…

• Protect people from tobacco smoke exposure on public

transport, and indoor work and public places

• Adopt or maintain taxation policies aimed at reducing tobacco

consumption; and

• Combat illicit trade in tobacco products-requires monitoring,

documenting and controlling product movement as well as

including origin and destination information on packaging plus

enacting legislation with appropriate penalties and remedies

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FCTC: Objective

• To protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke.

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FCTC: Guiding Principles• Every person should be informed of the health

consequences, addictive nature and mortal threat posed by tobacco consumption and exposure to tobacco smoke

• Strong political commitment is necessary to develop and support comprehensive multi-sectoral measures and coordinated responses

• The participation of civil society is essential in achieving the objective of the Convention and its protocols

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Guiding Principles Contd…• International cooperation is necessary to establish and

implement effective tobacco control program

• Comprehensive multi-sectoral measures and responses are essential to reduce consumption of all tobacco products -prevent premature disability and mortality

• Issues relating to liability, as determined by each Party within its jurisdiction are an important part of comprehensive tobacco control

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Guiding Principles Contd…The importance of technical and financial assistance to aid the

economic transition of tobacco growers and workers whose livelihoods are seriously affected as a consequence of tobacco control programs should be recognized and addressed in the context of nationally developed strategies

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FCTC: General obligations

Each Party shall develop, implement, periodically update and review comprehensive multi-sectoral national tobacco control strategies, plans and programs.

Establish or reinforce and finance a national coordinating mechanism or focal points for tobacco control; and adopt and implement effective legislative, executive, administrative and/or other measures

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General obl igations Contd…The Parties shall cooperate, as appropriate, with

competent international and regional intergovernmental organizations and other bodies to achieve the objectives of the Convention and the protocols

The Parties shall cooperate to raise financial resources for effective implementation of the Convention through bilateral and multilateral funding mechanisms.

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General obl igations Contd…

Parties shall act to protect the developed policies from commercial and other vested interests of the tobacco industry in accordance with national law.

The Parties shall cooperate in the formulation of proposed measures, procedures and guidelines for the implementation of the Convention and the protocols to which they are Parties.

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Mitigation Measures: Demand Reduction (Art icles 6-14)

• Price and tax measures and

• Non-price measures– Protection from exposure to tobacco smoke;– Regulation of the contents of tobacco products;– Regulation of tobacco product disclosures;– Packaging and labeling of tobacco products;– Education, communication, training and public awareness;– Tobacco advertising, promotion and sponsorship; and,– Demand reduction measures concerning tobacco dependence

and cessation.

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Mitigation Measures: Supply Reduction (Articles 15-17)

Control Illicit trade in tobacco products;Control sales to and by minors; and,Provision of support for economically viable alternative

activities.

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Others Measures(Articles 18-38)

Protection of the environment and the health of personsLiabilityResearch, surveillance and exchange of informationReporting and exchange of informationCooperation in the scientific, technical, and legal fields and

provision of related expertiseConference of the Parties

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Others Measures(Articles 18-38)

Relations between the Conference of the Parties and intergovernmental organizations

Financial resourcesSettlement of disputesAmendments to this ConventionAdoption and amendment of annexes to this ConventionSecretariat

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Others Measures(Articles 18-38)

• Reservations• Withdrawal• Right to vote• Protocols• Signature• Ratification, acceptance, approval, formal confirmation or

accession• Entry into force• Depositary• Authentic texts

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WHO strategy: MPOWER(WHO report on global tobacco epidemic 2008)

MPOWER provides for six most effective and important tobacco control policies:

Monitoring tobacco use and prevention policies; Protecting people from tobacco smoke; Offering help to quit tobacco use Warning about the dangers of tobacco Enforcing bans on tobacco advertising, promotion and

sponsorshipRaising taxes on tobacco for effective tobacco control

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FCTC: Crit ics

Some people have doubt about the FCTC being the framework and being not detailed enough; some others have doubt about the Convention being too specific (just like regulations).

Control of the supply from the source should be an even more effective and long-term method to reduce the hazardous productThe treaty does not say much about the control of the supply from the

source

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Critics Contd…Some big countries or countries with large population

are not on the list. Russia and Indonesia are the prominent ones

However, the contents of the strategies, plans and programs are largely subject to the decisions of Parties. Sometimes, the Convention defers too much to the domestic constitutional rules in the formulation of international norms

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FCTC in Nepal• Dec 2003 – Nepal signed on the paper

• Nov 2006– FCTC ratified in Nepal

• August 2006 – Introduced human right-based approach to tobacco control in Nepal

to establish, advocate and disseminate tobacco control as a human right exclusively

• August 2008– “Smokers’ Room” built and operate at the departure hall of Tribhuvan

International Airport

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FCTC in Nepal Contd…• November 2008– Removed on duty free on tobacco and alcohol sales

• December 2008

–GoN announced to ban smoking in public places

• March 2009

– Juducial commitment on their pivotal role to guarantee for TC: Right to Life and Right to Clean Environment

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FCTC in Nepal Contd…• Political commitment: –Urge Deputy Speaker to add and spell out

clearly that tobacco smoking should be banned in public places and all indoor places

• Tobacco control law enacted on 2068/01/29 from parliament.• Tobacco control Regulation was published on

2069/01/25

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Challenges of TC in Nepal

Violation of the salient features of FCTC by the tobacco industry

Continued political and economic influence of the tobacco industry to undermine, delay and water down public health measures

Eg. Surya Nepal has struck a 5 years deal of Rs 20 million with Cricket Association of Nepal (CAN) on January 10, 2007.( FCTC bans sponsorship of sports by tobacco industries)

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Challenges contd…Lack of comprehensive national anti-tobacco legislation

which should have been in place immediately after ratification of FCTC

Weak political will, commitment and consensus among political parties on tobacco control

Lack of communication on effective anti-tobacco messages and information

Negligence from Public toward tobacco use

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BibliographyWHO Framework Convention on Tobacco Control, World

Health Organization Geneva, Switzerland,2003Establishing Global Governance in the Implementation of FCTC:

some reflections on the current two-pillar and one-roof framework

Human Right-based TobaccoControl: Right to Life in Nepal, Non-Smokers’ Rights Association of Nepal

Anti Tobacoo Act and Regulations, 2068

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Discussion????

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