People have died from tobacco-related diseases since the opening of the first FCTC working group on 28 October 1999.
By Dr Peter Piot1, Dr K Srinath Reddy2 and Shoba John3
*A decade since its adoption, a fair number of Parties have begun to take measures to implement the WHO Framework Convention on Tobacco Control (FCTC).
The 2014 Global Progress Report, however, reveals the overall implementation rate of the Convention to be only 54 percent. Clearly, implementation of the world’s first public health treaty is yet to gain momentum.
Other key global health initiatives have gone through a similar phase when they needed to mobilise substantial resources and high-level political commitment to boost action on the ground.
To support discussion on these topics at COP6, we examined the strategies that galvanised political and resource commitments to tackle public health concerns, such as AIDS, malaria, tuberculosis (TB) and maternal and child health, and identified the lessons learnt.
8 strategies identified
The research identified eight strategies that worked to garner political will and resources for health concerns in the last two decades.
We applied these lessons learnt to the case of the FCTC and propose the following recommendations:
- Demonstrate cost of action and inaction
Showcasing pragmatic, low-cost interventions to address global health problems has worked to mobilise action. The tobacco control movement should similarly demonstrate country and global assessment of costs of action versus inaction and returns on investment at both levels.
- Develop a long-term strategy for implementation and implementation assistance
Global and country strategies that included targets and timelines guided decisions on resource allocation, be it national or international. The COP should seize leadership in fulfilling the non communicable disease (NCD) targets related to tobacco control and identify what needs to happen to meet this target.
- Focus on the emerging epidemic
More work needs to take place on the ground in both low and middle-income countries, where tobacco prevalence is already high and is rapidly expanding, as well as in countries where the prevalence is still low but the tobacco industry is heavily promoting its products.
- Agree on messaging and communication
Messaging around human suffering, equity, social justice and economic consequences was instrumental in prompting action on maternal mortality, HIV infection, malaria and TB. Similar strategies should be used to draw the world’s attention to the global tobacco epidemic.
- Actively seek synergies
Tobacco control reflects the essence of sustainable development. It has among its interventions a sustainable means of funding, tobacco taxation, which matches the sustainable models of financing of the future development agenda. Such a unique feature should be actively promoted beyond health fora.
- Promote multi-sectoral engagement
Partnerships that actively engaged non-health sectors and multiple stakeholders were critical in raising the profile of other major health concerns. Best practices to actively engage different parts of the government in tobacco control need to be identified and replicated.
- Spearhead commitments through leadership
Advocacy by high-profile global leaders lent credibility and voice to many of the health concerns. In some cases, the champions were UN special envoys, in others they were world leaders or celebrities. The tobacco control movement should identify its country and global champions
- Support civil society activism
Civil society has played a number of roles in capturing global attention across the various health challenges. An active civil society movement for tobacco control exists and governments, even the COP, should actively seek coordination with it.
The experiences of the researched public health concerns demonstrate that it is critical and feasible to garner political and resource support for global health issues. In the case of the tobacco epidemic, our findings suggest that efforts need to begin by identifying the barriers to implementation of the FCTC, developing a political and programmatic strategy, and communicating a sense of urgency for action.
Identifying champions and strategies to engage sectors beyond health should follow these steps.
*This article was first published in the FCA Bulletin at COP6.
1. Director, London School of Hygiene & Tropical Medicine
2. President, Public Health Foundation of India
3. Development professional, researcher & policy analyst
Read also: How to accelerate FCTC implementation
Read more from the Bulletin on our COP6 resources page