Tobacco Free Initiative (TFI)

Third Meeting of the Human Rights and Tobacco Control Network (HRTCN)

Singapore, 19 March 2012

Speech by Dr Douglas Bettcher, Director, WHO Tobacco Free Initiative

Honorable Guests, Distinguished speakers, Ladies and Gentlemen

Thank you for inviting the World Health Organization to speak at this 3rd meeting of the Human Rights and Tobacco Control Network. As you know, WHO recognizes the importance and benefits of a human rights based approach to public health, and is proud to be a part of this Network's effort to bridge the gaps between human rights and tobacco control.

Three years ago, in Mumbai, I had the honor and pleasure to also give the opening speech of the 2nd meeting of the Network. During my speech, I came back to the history of human rights and its treaties, I talked about the General Comment adopted by the UN Committee on Economic, Social and Cultural Rights in 2000, which set out its interpretation of the right to health. As you may recall, it stated that the right to health is an inclusive right. It is not just about access to health care services but also the underlying determinants of health. These are much broader and include relevant elements for tobacco control, such as the rights to information and to education. Further, the Committee set out that health care and underlying determinants must be available, accessible, acceptable and of good quality, paying particular attention to the most vulnerable and marginalized groups in society.

During my speech, I also recalled that the WHO Framework Convention on Tobacco Control enshrined human rights throughout WHO's first global health treaty. The Framework Convention recognizes the fundamental responsibility of governments to protect the right to health. Indeed, the preamble of the Framework Convention highlights human rights, and its article 8 on the protection from exposure to tobacco smoke, firmly positions fundamental human rights in the context of second-hand smoke.

Finally, I addressed one of the major and still ongoing and widespread human rights violations. The constant widespread use of child labour in tobacco farming and leaf production. This contravenes the principles enshrined in the ILO's Minimum Age Convention No. 138 and the Worst Forms of Child Labour Convention No. 182. Since my speech three years ago, many of the same challenges remain. Yet there are also new challenges and also new opportunities

A new opportunity is this. People are more than ever aware of their rights. Indeed, 2011 has been a year like no other where millions of people decided that time had come to claim their rights. Human rights are now high again on the agenda of the international community because of people, ordinary people. All around the world, people are demanding their social and economic rights, the right to equality, dignity, justice, participation, and an adequate standard of living: the rights enshrined in the Universal Declaration. People are expecting transparency and accountability from their governments. They want to know how decisions are made, how money is spent, whose interests are protected, who is given voice and so forth. This applies to tobacco. People are expecting their governments to exercise leadership and stewardship in creating the conditions in which they can enjoy good health. They are expecting their governments to prioritize the health of their people over short-term economic interests generated by trade and foreign investment. This brings me to one of the new challenges which we are facing. As you know, Australia and other countries such as Uruguay are seeing their legislation on packaging and labeling legally challenged by the tobacco industry.

How can the governments of Australia and Uruguay live up to their right to health obligations when faced with such challenges? Under the right to health, governments are required to pass legislation and other regulatory measures to protect health. Indeed, Article 44 of Uruguay's constitution requires the State to "legislate on all questions connected with public health".

WHO reaffirms before you today, its unconditional support to Australia, Uruguay, and to all other countries that may face such legal challenges by the tobacco industry in its path to interfere with tobacco control.

In several countries already, human rights arguments have been used in legislative discourse and have moved the agenda forward on tobacco control. The protection of the right to health, to life, and of consumer's rights have been invoked in policy and legislative debates. Correspondingly, the tobacco industry has increased their efforts to thwart tobacco control initiatives by lobbying and litigation. The threats posed by the tobacco industry are not just threats against tobacco control. Rather, we should come to the realization and re-frame our arguments to propose that the threats posed by the tobacco industry are also threats against human rights and the right to health. When viewed in this light, there are a number of pressing tobacco industry issues that we have to tackle front and center.

This brings me back to the more positive side of recent events. With the increased recognition of the importance of human rights, there is a greater use of UN human rights mechanisms to advance public health goals. The example of the Committee on the Elimination of Discrimination against Women (CEDAW) is a good example. It has recently paid attention to tobacco in the context of its harmful impact on the health of women. For example, in its recommendations to Argentina in July 2010, it expressed concern about tobacco use among women and urged the national authorities to work on public policies aimed at reducing tobacco consumption and the harmful consequences of this addiction. Let me quote from the CEDAW Committee: "The Committee is concerned about the widespread use of tobacco among women in Argentina and the serious health impact of tobacco on women. The Committee is particularly concerned that women are often targets in tobacco advertising campaigns, which encourage and increase the usage of tobacco among women, resulting in tobacco related diseases and deaths." "The Committee urges the State party to ratify and implement the World Health Organization Framework Convention on Tobacco Control and put in place legislation aimed at banning smoking in public spaces and restricting tobacco advertising."

We should identify strategic entry points on how to further engage the UN human rights mechanisms in leveraging attention to the harmful effect of tobacco on health. Indeed, the UN Committee on Economic, Social and Cultural Rights in its General Comment which I mentioned earlier stated that the failure to discourage production, marketing and consumption of tobacco can constitute a violation of the obligation to protect the right to health. The Committee has issued recommendations that State parties take measures to ban the promotion of tobacco products and enact legislation to ensure that all enclosed public environments are completely free of tobacco. Finally, we need to ensure that children are protected, reminding States that they have the obligation to take special measures to ensure that children are protected against non-communicable diseases (NCDs) by regulating or prohibiting information on and marketing of substances such as alcohol and tobacco, particularly when it targets children and adolescents. Here we have powerful instruments to draw from such as the UN Convention on the Rights of the Child which is nearly universally ratified.

Tobacco use is recognized as one of the main shared modifiable risk factors for noncommunicable diseases and this is why its reduction is one of the 6 objectives of WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. Tobacco causes great socioeconomic harm within all countries, particularly developing nations.

The developmental challenge posed by the global epidemic growth of non-communicable diseases was affirmed at the United Nations High-Level Meeting on the Millennium Development Goals in 2010. The decision by the United Nations General Assembly to convene a High-Level Meeting on NCDs on September 2011 presented a unique opportunity for the international community to take action against the epidemic, save millions of lives and enhance development initiatives. The UN Secretary-General stated that the summit was our chance to broker an international commitment that puts non-communicable diseases high on the development agenda, where they belong. The UN General Assembly, comprised of heads of state and many ministers, adopted by consensus the resolution titled "Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases" , wherein Member States unanimously committed to advancing the implementation of multisectoral, cost-effective, population-wide interventions in order to reduce the impact of NCD risk factors. Given the global support expressed in September 2011, the time is ripe for effective translation of this political declaration into international cooperation and action in protecting the regulatory autonomy of countries from the tobacco industry.

As of today, although human rights are relevant to advance tobacco control, the human rights' based approach to tobacco control has not been explored and used enough. However, the right to health can provide significant support to tobacco control policies (for instance the State must respect the rights to health by refraining from spreading the tobacco epidemic).

Governments also have an obligation to protect people's right to health from the threat of tobacco. This obligation requires governments to regulate private parties if their activities infringe on human rights. Clear examples of measures oriented at realizing this obligation are:

  • smoking bans in public places, which protect individuals' health from involuntary exposure to second-hand smoke; and
  • bans on advertising and promotion of tobacco products, as I said previously, which protect current or potential tobacco consumers from publicity that will likely increase the spread of the epidemic.

An example of the application of the linkage between human rights and tobacco control policies was recently given by the constitutional tribunal of Peru that even stated that the Framework Convention is a human rights treaty. Regardless of whether the Framework Convention is considered a human rights treaty, it has important implications for human rights discourse. By ratifying the Framework Convention, nations acknowledge that the tobacco epidemic is a major threat to public health and that implementation of the Framework Convention is the standard to protect the public's health. Nations are therefore legally bound to protect health and must comply with their Right to Health obligations. This requires nations to develop laws and policies at the domestic level that meet these minimum international standards.

Human Rights and Tobacco Control are synergistic and mutually reinforcing. They have both evolved separately and have been elevated singly at global levels, in parallel, and it is now time to unite and create strong linkages between these two agendas, and HRTCN is the forum for this critical foundational work.

Let me conclude by saying that a human rights based approach transforms the paradigm for development. It shifts our approach from responding to needs to realizing rights. The reality is that tobacco is an addictive killer, full stop. It threatens the health and well-being of those exposed to it. Governments must act boldly to control tobacco, not only as part of their obligation to safeguard fundamental rights to health of their citizens but also because of the staggering costs to society that are a consequence of tobacco use and exposure to second-hand smoke.

As Dr Chan stated at the opening of last November's Special Executive Board on WHO reform, in reflecting upon the role of WHO, “The world needs a global health guardian, a custodian of values, a protector and defender of health, including the Right to Health”.

On behalf of WHO, I am happy to open this 3rd meeting of the Human Rights and Tobacco Control Network, I welcome you and I wish us a very productive meeting. Thank you.