2
of Africa, South East Asia, and the island nations of the Pacific and Caribbean,
4
was
brought about by persistence, patience and stamina on the part of both sets of actors.
Civil society brought to the alliance its technical expertise in public health, its media
contacts and its political contacts within friendly and not so friendly governments; the
governments of the south brought their votes, their voices and their unwillingness to be
bullied.
Part I: Setting the Stage
TOBACCO MARKETING: THE DISEASE VECTOR
…tobacco is the only legally available
consumer product, which kills when used as
intended. The Oxford Medical Companion,
1994
Cigarettes kill half of all regular users and of those half will die during the productive
years of middle age, 35- 69. Currently the death toll is almost five million per year world
wide, but by 2025, the total will rise to 10 million per year and 70% of those deaths will
be in the developing world. Tobacco exacts an enormous toll in health care costs, lost
productivity, and pain and suffering inflicted upon smokers, passive smokers and their
families.
5
The burden of disease is perhaps more awesome since it will overwhelm the
already overtaxed and inadequate health care systems of low and middle-income
countries. A short list of the ills caused by or implicated by tobacco use would include:
•
lung cancer, cancers of the larynx, oral cavity, esophagus, bladder, pancreas,
uterus, cervix, kidney and stomach;
•
chronic obstructive pulmonary disease, emphysema and chronic bronchitis;
•
heart disease, stroke and the progression of atherosclerosis; and
•
spontaneous abortions, still births, and sudden infant death syndrome after birth.
6
The synergies between diseases and smoking are equally as terrible.
7
•
Smoking most affects those who are ill and whose immune systems are weak
(HIV) and
4
This unlikely alliance also benefited enormously from WHO and World Bank assistance, from
information and materials to moral support and statements on the floor of the negotiations.
5
“Tobacco Free Initiative,” World Health Organization, 2004. http://www.who.int/tobacco/about/en/
6
See generally, USDHHS, PHS, Office of the Surgeon General, The Health Consequences of Smoking, A
Report of the Surgeon General, 2004; Campaign for Tobacco Free Kids, “Health Harms from Smoking and
Other Tobacco Use” www.tobaccofreekids.org.
6 Katharine Esson, “The Millennium Development Goals and the WHO FCTC –An Opportunity for
Global Partnerships,: Presentation at FCTC IGWG, 21 June 2004.
http://www.who.int/tobacco/areas/communications/events/en/mdgs_tobaccocontrol.pdf
, 21 August 2004.
Convention