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COP7 decisions: an overview

Nov 28th, 2016
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http://www.fctc.org/fca-news/opinion-pieces/183-news/1499-cop7-decisions-an-overview

FCA identified three interlinked implementation-related priorities for COP7 of the Framework Convention on Tobacco Control (FCTC):

  • Follow-up on the 30-percent prevalence reduction target agreed at COP6;
  • Establishment of an implementation review mechanism (IRM: i.e. a system to review Parties’ reports);
  • Action on fundraising for national-level implementation, building on the work of the sustainable measures working group.

At the meeting there was action on all three, though with a somewhat surprising twist with respect to IRM. Rather than immediately establishing an implementation review committee, Parties instead set up a working group to draft a “strategic framework” for the FCTC – which should deal with a range of implementation issues, including a possible IRM. The working group will also review and prioritize Parties’ needs for implementation assistance and will reflect them in the strategic framework.

It is quite common for treaty bodies to draw up strategic plans, and these have proven to be helpful both to keep a tight focus on priority issues and to raise funds.

30-percent target

On the 30-percent target, Parties requested that the Secretariat and WHO hold a technical consultation between COP7 and COP8 to identify necessary actions that the COP could take to ensure that the global voluntary target is achieved. The decision also requests that the Secretariat collect information regarding national targets.

There were other notable debates at COP7. On the Illicit Trade Protocol, unlike during previous COP sessions, there was widespread recognition that people shouldn’t wait until the ITP is in force before thinking about some of the implementation issues that are likely to arise.

On e-cigarettes, Parties spent a considerable amount of time re-hashing the issue, and butted heads for quite a while on the exact wording of a decision. The COP7 decision is quite similar to what was decided at COP6.

Finally, there were a host of other decisions. (COP7 had the longest list of official documents of any COP session to date.) These included:

Art 5.3 Knowledge Hub

  • On Article 5.3, a decision to establish a Knowledge Hub, and to ask the Secretariat to continue promoting measures to address tobacco industry interference among UN agencies.
  • On Article 9/10, additions to the existing guidelines were adopted. These included provisions to regulate design features that increase attractiveness (e.g. slims), and disclosure to governments of the contents of tobacco products.
  • Continuing work on Article 17&18, including a request to WHO to develop guidelines for surveillance, prevention and early diagnosis of occupational harms and risks specific to tobacco cultivation and manufacture.
  • Endorsement of a toolkit on Article 19 developed by an expert group, as well as some follow-up by the Secretariat.
  • On the FCTC impact assessment submitted to COP7, the COP welcomed the findings but did not commit to repeating the exercise immediately, instead encouraging Parties to consider evaluating on a regular basis the impact of the Convention at country level.

Cross-border advertising

  • On cross-border advertising, establishment of a new expert group to provide recommendations on operationalizing the implementation of Article 13 and its Guidelines on cross-border advertising and TAPS in entertainment media.
  • On Waterpipe: a request for a report to COP8 including a situation analysis and an overview of challenges and recommendations for improving the prevention and control of water pipe tobacco use.
  • On Gender: the Secretariat and WHO were requested to prepare a paper for COP8 on opportunities and challenges in implementing gender-specific tobacco control policies.
  • On trade and investment agreements, the COP called on Parties to increase coordination and cooperation between health and trade/investment departments, including in the context of negotiations of trade and investment agreements. It also requested a report for COP8 on a number of topics, including on practices in promoting and safeguarding public health measures under trade and investment agreements.
  • Moving to institutional matters, COP7 decided the following:

‘Voluntary’ no more

  • Parties’ mandatory payments to the FCTC budget will now be called Assessed Contributions (not Voluntary Assessed Contributions). The COP also agreed on a scheme of penalties should a Party fail to provide these payments.
  • The Convention Secretariat should consider holding a financing dialogue to raise extra-budgetary funding for the FCTC budget and to alert funders to the implementation needs of Parties. It was also agreed that when raising funds from stakeholders other than Parties, the Secretariat should follow the practices agreed on in WHO’s Framework for Engagement with Non-State Actors (FENSA).
  • The Secretariat was tasked to undertake a review of accreditation of intergovernmental organizations (IGOs) with the status of observer to the Conference of the Parties, as proposed by the COP7 report. At COP8, results of this review will be discussed and further decisions, such as whether this review should take place on a regular basis or whether observer status may be discontinued for some IGOs, might be taken.

New Observers

  • The observer status of non-governmental organizations (NGOs) was extended for most of the current observers. In addition, the following three NGOs were granted an observer status: American Cancer Society, Inter-American Heart Foundation, Vision mondiale de la santé / World Vision Health. A number of organizations were denied observer status per the recommendation of the Bureau.
  • The Secretariat was encouraged to apply for observer status to a number of UN bodies and other relevant entities, including UNDP, World Bank, ILO, FAO, and WTO. The Secretariat’s participation at governing body meetings of these organizations could raise the profile of the treaty and its provisions, including the Article 5.3 principles.
  • Synergies between the WHO and FCTC governing bodies – the Conference of the Parties (COP) and the World Health Assembly (WHA) – were strengthened by agreeing that reports on decisions from COP will be presented to WHA and vice versa.

WHO and FCTC agreement

  • The Bureau was requested to oversee and guide the preparation of the draft hosting terms between the Convention Secretariat and WHO. Once finalized, the hosting agreement should clarify the exact WHO contributions to support the work of the Convention Secretariat.
  • A dedicated methodology to review performance of the Head of the Secretariat was agreed upon. The review of performance for the current Head is set to take place in 2017, as her mandate expires in mid-2018.
  • The COP took no decision on transparency of Party delegations (i.e. whether Party delegates should make a declaration on any links with the tobacco industry, and what possible follow-up steps should take place). This point will be reviewed again at COP8.

Finally, on the issue of the FCTC budget, it was decided that the budget for 2018-2019 covered by Parties’ mandatory payments will be lowered by nearly US$300,000 compared to the budget for the current biennium. As a result, virtually all activities included in the workplan for 2018-2019 will need to be funded by extra-budgetary contributions.

Please note that the above summary is not an exhaustive list of all the decisions taken at COP7, and there may be surprises in the final version of the decisions when they are published (in part because many decisions were not finalized till very late in the session.)

– See more at: http://www.fctc.org/fca-news/opinion-pieces/183-news/1499-cop7-decisions-an-overview#sthash.giEvrPnq.dpuf

Experts urge WHO to back tobacco harm-reduction strategies at CoP7

Nov 7th, 2016
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The seventh Conference of the Parties (CoP7) of the WHO’s Framework Convention on Tobacco Control (FCTC) — the world’s first public health treaty — kicked off here Monday with a coalition of experts seeking a focus on policy for new nicotine products like e-cigarettes.

http://www.newkerala.com/news/2016/fullnews-139597.html

The FCTC entered into force in 2005 and establishes requirements and recommendations for reducing demand-supply of tobacco products to reduce preventable diseases and premature death caused by tobacco use. As many as 180 countries are now parties to the convention.

Slated to run till November 12, CoP7 is expected to play a crucial role in shaping global policy in the field of tobacco harm reduction.

Ahead of the conference, a coalition of top tobacco harm-reduction experts warned that “one in two life-long smokers will die prematurely from a smoking-related disease”.

The coalition, established to provide balanced, evidence-based information on harm reduction, observed that “if current smoking patterns and trends continue, a billion people might die from smoking-related diseases in the 21st century”.

“Despite the availability of smoking-cessation medications, many smokers do not want to try them. Of those who use them, the majority either fail or relapse within a year,” the coalition pointed out in a Mission Statement.

It explains how “public health experts have recommended that smokers be encouraged… to switch completely to less harmful substitutes”.

The World Health Organization (WHO) has identified harm-reduction strategies as a core principle of tobacco control, and recently stated: “If the great majority of tobacco smokers who are unable or unwilling to quit would switch… to using an alternative source of nicotine with lower health risks… this would represent a significant contemporary public health benefit.”

According to the Mission Statement, there are new technologies that comply with this principle. One such is the “electronic cigarette” — or, as WHO calls it, Electronic Nicotine Delivery Systems, ENDS — which delivers nicotine without burning tobacco. The vapor from e-cigarettes and personal vaporisers contains very low levels of potentially-harmful chemicals”.

According to the experts, Public Health England recently concluded vaping is at least 95 per cent safer than smoking and acknowledged that e-cigarettes can be an effective aid to quitting smoking. The experts said they support “government policies that seek to remove barriers to the availability of better, safer, non-combustible nicotine delivery products, with appropriate quality standards and regulations”. They added that disproportionate restrictions — regulation of e-cigarettes as medical products, restrictions similar to tobacco cigarettes, advertising bans — will make such products expensive and create misconceptions that they are as harmful as smoking. The coalition called such measures “counter-productive”.

The Tobacco Harm Reduction Expert Group includes Konstantinos E. Farsalinos of the Onassis Cardiac Surgery Center in Athens; Prof. Riccardo Polosa of the Institute for Internal and Emergency Medicine, University of Catania; Christopher Russell of the Centre for Substance Use Research, Glasgow; Amir Ullah Khan, member of the Telangana government’s Commission of Inquiry on Socioeconomic Conditions; Julian Morris, Vice President of Research at Reason Foundation; and Prof. Rajesh N. Sharan of the Department of Biochemistry, North-Eastern Hill University.

With mixed progress, nations review war vs. tobacco industry

Nov 7th, 2016
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http://elkodaily.com/business/with-mixed-progress-nations-review-war-vs-tobacco-industry/article_be11c60f-d418-562d-83ab-d5dcf0a5c0c1.html

In Nepal, health warnings cover 90 percent of cigarette packs, while Australia requires those packets be wrapped in drab, plain paper. Indonesia’s new ban on outdoor advertising brought down tobacco billboards depicting smiling, smoking youths. And India wants scary photos of rotting lungs and mouth tumors covering packets sold in the country.

Still, national drives to discourage smoking and cut back tobacco sales haven’t done enough, campaigners say. Smoking-related deaths are still rising worldwide, with 80 percent of them expected to occur in developing country populations by 2030.

“Most people in the United States think tobacco is over and done with, but it’s still the largest preventable cause of disease on the planet” killing 6 million people a year — or one person every six seconds, said John Stewart, deputy campaigns director at the Boston-based lobbying group Corporate Accountability International.

Starting Monday, representatives from at least 178 countries are meeting for five days in the Indian capital to discuss how they can further the fight against smoking and push back against tobacco company lobbyists.

Since they set down stiff regulations and guidelines in a landmark 2003 treaty called the Framework Convention on Tobacco Control — the first and only global treaty dealing with public health — most of the 180 signatories have ratified it and passed laws restricting tobacco advertising or sales.

Still, many governments remain entangled with powerful tobacco companies, while industry lobbyists continue attempts to stymie efforts to implement anti-smoking laws through bribery, misinformation and even suing national governments for lost profits, campaigners say.

“The tobacco industry is definitely feeling the heat,” Stewart said. “They’ve got their back against the wall.”

Indian courts are currently grappling with 62 lawsuits filed by tobacco companies or cigarette makers challenging laws requiring that 85 percent of all cigarette packets be covered with photos of medical horrors.

In Japan, a 10-percent hike in taxes on cigarettes has led to a 30-percent decline in smoking. But the country still has some of the lowest tax rates on cigarettes among industrialized nations, while its finance ministry owns 33 percent in Japan Tobacco.

The anti-tobacco campaign has had some success. It is widely accepted, at least among national leaders, that smoking causes cancer, cardiovascular and respiratory disease, along with a host of other harmful health impacts.

That awareness still has not trickled down to national populations, though. And campaigners say tobacco interests have shifted their focus to poorer, less educated populations in the developing world.

India — among the first to ratify the anti-tobacco treaty in 2004 — is still considered one of the biggest battlegrounds in the fight against the tobacco industry, public health specialists say.

Despite harsh laws passed more than a decade ago banning smoking in public and sales to children, smoking is still common across the country. A government survey in 2010 showed nearly 35 percent of adults were either smoking or chewing tobacco.

Meanwhile, more than 1 million Indians die each year from tobacco-related diseases that cost the country some $16 billion annually, according to the World Health Organization.

“The revenues that the government earns from tobacco taxes are far less than the billions that are spent on health care,” said Bhavna Mukhopadhyay of the Voluntary Health Association of India, a public health organization.

“Public health and the health of the tobacco industry cannot go hand in hand,” she said, noting that campaigners are now pushing for countries to make tobacco companies and their shareholders civilly and criminally liable for the harm done by tobacco.

Part of the trouble in India is “the Indian consumer is spoilt for choice,” she said, with cigarettes sold alongside chewing tobacco and cheap, hand-rolled smokes known as bidis.

The easy availability and wide choice means many smokers get hooked at a young age. Some are initiated early through the common, cultural practice of chewing something called gutka, which combines tobacco with spices, lime and betel nut and is widely sold as a mouth freshener.

Putting pictorial warnings on cigarette packets is an attempt to educate people about the risks.

“The idea was that even an illiterate person, or a child, would understand the message about the health risks from smoking,” said Monika Arora of the Public Health Foundation of India, who runs an anti-smoking campaign aimed at young Indians.

Need to take multi-sectoral action to tackle tobacco challenge: J P Nadda

Nov 7th, 2016
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The Union Health Minister said there are nearly 275 million current users in the country and close to one million lives are lost every year due to tobacco use.

http://indianexpress.com/article/india/india-news-india/need-to-take-multi-sectoral-action-to-tackle-tobacco-challenge-j-p-nadda-3741862/

Health Minister J P Nadda on Monday termed the challenge of tobacco control as “formidable” and said there is need to take multi-sectoral action and integrated approaches to health goals, especially as the country is facing the dual burden of infectious and non-communicable diseases. He was speaking during the inauguration of the Seventh Session of the Conference of Parties (COP7) to World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) which India is hosting for the first time.

Sri Lankan President Maithripala Sirisena gave a special address during the inaugural session of the conference.

Nadda said there are nearly 275 million current users in the country and close to one million lives are lost every year due to tobacco use, either directly or indirectly.

He said the economic cost to India or the healthcare cost to treat tobacco-related diseases is a whopping USD 22 billion and the target of achieving relative reduction of tobacco use by 30 per cent is no longer a choice but a necessity.

“The challenges faced by India in the realm of tobacco control are formidable, both in their number and in their complexity. However, despite our vast complexity, substantial investments for implementation of WHO FCTC are slowly improving the situation,” he said at the conference where more than 1500 delegates from all over the world are taking part.

He said India has to go a long way in preventing millions of avoidable deaths resulting from the habit of tobacco use and there are many challenges like new products which are emerging and the existing products are profilerating locally and internationally to newer areas.

“The prevalence of tobacco use is still unacceptably high. Morbidity and mortality due to its use is also very high. There is a huge economic burden on people and governments due to adverse health consequences of tobacco use. Certain parts of the world, including India, have a myriad of tobacco products.

“We cannot do this alone. Along with national will and resources, we also need the strength of international collaboration to mitigate the rising burden of health, social and economic costs of tobacco,” Nadda said.

He said this is a landmark year for tobacco control activities as the country has successfully implemented, from April, large pictorial health warnings occupying 85 per cent of the principal display area of tobacco packs and on all forms of tobacco.

Terming WHO FCTC as India’s strongest tool to curb the emerging non-communicable diseases, Nadda said India cannot tackle these diseases only by making more hospitals, cancer institutes and producing more doctors and allied health professionals.

“Today, India and other developing countries in the south east Asian, African and Latin American regions face the dual burden of infectious diseases like malaria and TB, and emergent conditions like zika and dengue, along with non-communicable diseases like cancer, cardiovascular diseases, diabetes etc.

“All countries are gearing up and making efforts to strengthen their health systems to tackle these challenges. For this to happen, we need multi-sectoral action along with integrated approaches to health programmes and health goals,” he said.

“We need to prevent the risk factors, tobacco being the biggest of them, since today’s risk factors are tomorrow’s diseases,” he said.

He said India is committed to strengthening non- communicable disease programmes and interventions and implementation of the WHO FCTC as an integral part of the post 2015 sustainable development goals.

“Tobacco use is detrimental to all aspects of life and grips users in the most productive years. We must reverse this tide. We must, for this purpose, target our young children, catch them young, and indoctrinate their minds against the harms of tobacco use,” he said.

CoP7: A Tobacco Harm Reduction Expert Group to advise delegations

Nov 7th, 2016
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A coalition of leading tobacco harm reduction experts from science, economics and policy areas of tobacco harm reduction, has been formed to provide a balanced and evidence-based information on harm reduction at CoP7, the seventh Conference of the Parties (CoP7) that is being held this week in New Delhi, India.

The WHO has an opportunity now to improve radically the life expectancy of today􀀀s smokers by applying the principle of harm reduction that is already one of the core principles of WHO’s tobacco control strategy.

— Tobacco Harm Reduction Expert Group – CoP7, New Delhi, India

The worldwide success of e-cigarettes and the lobbying of tobacco giants in favor of new tobacco products have chilled down the enthusiasm of some government with regard to ENDS, helped in that by alarming messages from the media. This situation is leading to many restrictions, disproportionate sometimes, in many countries that prevent millions of people from accessing a safer alternative to combusted tobacco.

CoP7 will play a crucial role in shaping global policy in the field of tobacco harm reduction, especially for ENDS that remain under-evaluated in their harm-reduction role compared to combusted tobacco products.

Governments from 180 countries attending the conference will be asked to consider the appropriate policy for new nicotine products.

E–cigarettes, of course, are at a center position of the debates but other combustion-free novel tobacco products heat-not-burn cigarettes.

A coalition of experts has been formed, according to press release, in order to provide a guidance to the governments seeking to offer a legal perspective to e-cigarettes in their countries.

Along with Dr Konstantinos Farsalinos and Prof Riccardo Polosa, one can find Dr Christopher Russell, a British behavioural psychologist, Dr Amir Ullah Khan, an Indian economist, Julian Morris (Reason Foundation) the co-author, with Dr Amir Ullah Khan, of The Vapour Revolution: How Bottom Up Innovation is Saving Lives, and Prof Rajesh N. Sharan, an Indian biochemist and molecular biologist who recently co-authored a study on “Electronic Nicotine Delivery System (ENDS) as a substitute to conventional cigarette: an evidence-based audit” in India.

The coalition recalls that “One in two life-long smokers will die prematurely from a smoking related disease”, leading to a billion deaths from smoking-related diseases in the 21st century.

WHO’s FCTC identified harm reduction strategies as a core principle of tobacco control and has recently stated that: “If the great majority of tobacco smokers who are unable or unwilling to quit would switch without delay to using an alternative source of nicotine with lower health risks, and eventually stop using it, this would represent a significant contemporary public health benefit.” A benefit that has also been pointed out by Public Health England when the agency emitted a report that finds the e-cigarette 95% safer than combusted tobacco.

The principle of a continuum of risk in tobacco products with on one side combustible cigarettes and on the other smokeless and new tobacco products, is the view that the coalition of experts will share with delegates to avoid counter-productive measures that provide a protective environment for tobacco cigarette sales while enhancing public health.

Every tobacco death is an avoidable tragedy. The epidemic must stop here.

Nov 6th, 2016
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As India prepares to host a key global anti-tobacco conference, the world must seize the chance to end a scourge that claims 6m lives a year

Tobacco use, the leading cause of death from non-communicable diseases such as heart and lung disorders and cancer, claims about 6m lives a year. On Monday, countries will gather in Delhi, India, for the seventh conference of the parties to the World Health Organisation framework convention on tobacco control, a treaty that has sparked global action to stem the epidemic.

The treaty is already one of the most widely embraced in UN history. One of my proudest accomplishments at the helm of the World Health Organisation has been rallying global efforts to drive down tobacco use. I’m pleased to say that, following the adoption of the agreement, governments around the world have taken decisive steps not only to reduce tobacco use, but also to stand up to the multinational tobacco companies standing in the way of global progress.

The tide of tobacco use is beginning to turn.

After decades of Big Tobacco targeting lowand middle-income countries and years of steadily increasing sales, tobacco sales show signs of dropping. Countries are passing stronger laws to reduce demand for tobacco products not envisioned even a few years ago, and tobacco companies are losing the legal challenges they mount against these measures. From Uruguay to Australia, countries large and small have stood up to the tobacco industry by implementing plain packaging and large pictorial health warning labels.

Where tobacco companies have tried to threaten and bully nations, governments have responded with firm measures to protect public health.

However, amid these clear signs of progress, the tobacco industry has made it absolutely clear that it has no intention of abandoning a business model that depends on enticing millions of new users – especially young people – to its deadly products.

The impetus of the global movement to reduce tobacco use should not be lost. More than ever, decisive action is needed. Now is the time for countries to build on the momentum established and protect their citizens. By raising tax on tobacco products, requiring graphic warning labels, conducting hard hitting mass media campaigns and banning tobacco industry advertising and marketing, countries can improve the health of their citizens, reduce healthcare costs and prevent the tobacco industry from addicting another generation of children.

Illicit trade in tobacco threatens the progress governments make in tobacco control by making cheap and unregulated products available. I am pleased to note that governments are increasingly taking action and becoming parties to the new international treaty to eliminate illicit trade in tobacco products.

We need to work together, as allies in global health, to fight to protect people from the dangers of tobacco. I recently appointed Michael Bloomberg as WHO global ambassador for noncommunicable diseases because of his track record in tobacco control, which includes more than 10 years of support for low- and middleincome countries. Advocates like him, and many others who champion tobacco control, stand with the WHO to support governments in this fight.

I am also heartened by progress on standardised or “plain” packaging – a measure introduced by the treaty and pioneered in Australia, where smoking rates have now fallen to record lows. The early evidence from Australia shows that plain packaging, as part of a comprehensive approach to tobacco control, is diminishing the appeal of tobacco products, increasing the effectiveness of health warnings and reducing the ability of the pack to mislead. France and the UK have begun implementing plain packaging laws, and New Zealand and Hungary have recently passed legislation. Many other countries are close behind.

We have made great strides, but we have so much more to do. Tobacco use remains one of the most vexing challenges we face in the global health arena.

I urge global leaders convening in India to see this moment as an opportunity to bend the course of public health history and commit to returning home with a renewed dedication to fully implement the WHO framework convention. To make the event effective, it is vital that governments recognise the inherent conflict between public health and the interests of the tobacco industry. Representatives from the latter should be completely excluded from government delegations.

Every death from tobacco is an avoidable tragedy. It is our task to reverse the tide, effecting an irreversible decline in the number of such deaths.

We need history to show us that the turning point in the tobacco epidemic is now. We know what to do and we know how to do it. We now need to ensure that every country moves forward and no one is left behind. Future generations depend on us.

COP7:’Take meaningful steps to check global tobacco epidemic’

Nov 4th, 2016
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http://www.business-standard.com/article/pti-stories/cop7-take-meaningful-steps-to-check-global-tobacco-epidemic-116110401597_1.html

Ahead of a global meet on tobacco in India, a civil society network today said that one billion people, which is nearly the population of India, will die from tobacco use this century while urging countries taking part in the meet to take meaningful steps to alter this forecast.

India is all set to host the Seventh Session of the Conference of Parties (COP7) to World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) during November 7-12, at Greater Noida, which will be inaugurated by Union Health Minister J P Nadda.

“After 10 years, FCTC Parties have developed a detailed consensus on the measures needed to address the global tobacco epidemic. Starting next week, Parties must shift their focus to ensuring that the treaty is as effective as possible on the ground,” said Framework Convention Alliance (FCA) Executive Director Francis Thompson.

It said that another agenda which should be prioritised is the report of a working group on mobilising more resources for tobacco control.

Despite the FCTC’s life-saving measures being widely recognised as effective and low-cost, in general few resources are dedicated to them.

“FCA urges COP7 to review parties’ current implementation needs and develop a list of priorities, agree on a mechanism to routinely review parties’ needs, and mandate the FCTC Secretariat, working with relevant stakeholders, to communicate implementation needs to potential donors strategically and systematically,” FCA said.

“One billion people – nearly the population of India – will die from tobacco use this century unless current trends change. Parties to the FCTC COP meeting in New Delhi next week can take meaningful steps to alter that forecast,” it said.

It said that at COP6 in 2012, FCTC Parties adopted a global target to reduce tobacco use by 30 per cent by 2025 and highlighting Parties’ progress towards that target would help potential donors to focus on the effectiveness of the treaty’s measures.

“The COP, as the specialised body that deals with the FCTC, must make the case for much more energetic implementation, with the necessary political will, technical assistance and resources to make this global target a reality,” said Thompson.

Other issues on the COP7 agenda that FCA will be focussing include, tobacco industry liability for the devastation caused by its products, FCTC’s illicit trade protocol, the treatment of tobacco in trade agreements, and tobacco and sustainable development.