Click here to download Consortium Statement below
TOBACCO CONTROL AND TRADE AGREEMENTS:
FOR POLICY CHANGE IN THE 21st CENTURY
This statement reflects views and recommendations that emerged from a
consortium meeting convened by the Center for Policy Analysis on Trade and Health (CPATH) and the
Center for Tobacco Control Research and Education (CTCRE) at the University of California-San Francisco on February 19, 2013, in San Francisco. Participants identified strategies to advance tobacco control in
and the U.S., and to strengthen public health and medical voices to inform trade policy.
Public health and medical organizations in the U.S. and internationally are increasingly engaged in
addressing the nexus between tobacco control
and global trade. Trade
rules and trade agreements, including present efforts to negotiate the
Trans Pacific Partnership (TPP), present challenges
to tobacco control, at local, state, and national levels. Tobacco companies
have recently accelerated their use of trade rules to attempt to delay and reverse
tobacco control measures in the U.S., Australia, Uruguay, Norway, and Ireland. In negotiating
the TPP, a new agreement
for the 21st century, the United
States is presented with the opportunity to be a leader to safeguard public health and reduce the enormous burden of disease related
to tobacco use.
The following proposals articulate concerns, goals, and key strategies to achieve them, that were discussed during the consortium meeting. Many have
been consistently advanced by the medical, health care, and public health communities.
Tobacco is unique, the only legal consumer product that kills when used as intended. Causing six million deaths a year, tobacco use is the leading preventable cause of death
worldwide, and a major contributor
to the global pandemic of non-communicable diseases.
tobacco use must be a central element
of policies to reduce preventable childhood morbidity and mortality, a key goal of the present U.S. Administration.
Trade agreements and trade rules offer
the tobacco industry powerful tools to undermine
and supersede local, state, and national measures to
implement and enforce tobacco control measures.
The closed process of negotiating and adopting trade agreements uniquely privileges commercial interests, without the benefit
of democratic public dialogue and debate, and review of evidence. Public health principles and perspectives are shut
Current proposals for a TPP, and a trans-Atlantic U.S.-EU trade agreement, present particular and urgent threats to public health.
Strategies for Creating a 21st Century Trade Agreement:
Incorporating Health-Related Concerns
into Global Trade Negotiations and
We call on the United
States to advance a trade proposal
in the TPP
negotiations that will safeguard public health, advance tobacco control measures that contribute to
reducing the enormous burden
of disease related to tobacco use, and prevent
incursions by the tobacco industry against those
Trade agreements must guarantee nations’ rights to protect public health
from tobacco use.
Incorporate reference to the Framework Convention on Tobacco Control (FCTC) in trade agreements. Acknowledge
deference to FCTC principles, as an expression of the international consensus on
tobacco control, and affirm the right
of nations to protect public health from tobacco and tobacco products in the
text of all relevant chapters of trade agreements.
Incorporate in the text of each regional and bilateral trade agreement the
World Trade Organization (WTO) Doha Declaration on countries' rights to protect public health. The 2001 WTO
Doha Declaration on the TRIPS Agreement and Public Health affirms that WTO members may use "to the full" the flexibilities in the Agreement on Trade-Related Aspect of Intellectual Property
Rights (TRIPS) "to protect public health and, in particular, to promote
access to medicines for all." This
right can and should be extended to tobacco control measures.
the primacy of public health principles. Strengthen adoption and implementation of FCTC recommendations within and across nations to protect the public's health from tobacco and tobacco products.
2. The TPP must not undermine
the right and ability of participating countries from exercising their domestic sovereignty in order to adopt or maintain measures to reduce tobacco use and to prevent the harm it causes to public health.
Exclude tobacco control measures from existing and future trade agreements. The medical, health care, and public health community has consistently supported removing tobacco, tobacco products, and tobacco control measures from trade
agreements as the most effective solution.
Remove investor-state dispute settlement
(ISDS) provisions. Eliminate the rights of tobacco and other corporations to contest
governments' domestic sovereignty over public health and other policies, and to sue nations directly for financial damages through the global trade arena.
3. We must set trade policy through
a transparent process that involves the public.
Trade agreements and trade rules which may
affect public health should be discussed and debated publicly, and
in Congress, including preventing disease and death from tobacco.
Include effective public health representation
in setting trade policies
at the national, state, and local levels.
We further propose
that advocacy for these goals can be strengthened by identifying and communicating with
related constituencies concerned with trade: Labor, environment,
access to medicines, sustainable agriculture, sustainable economic development, internet
access; policy-makers at the local,
state and national levels.
on Smoking and Health, Laurent Huber,
MSFD, Director; Chris
Bostic, MSFS, JD, Deputy Director for Policy
American Academy of Family Physicians, Julie K. Wood, MD,
FAAFP, Vice President, Health of the Public and Interprofessional Activities
American Academy of Pediatrics, Jonathan D. Klein, MD, MPH, FAAP, Associate Executive Director and Director, Julius B. Richmond
Center of Excellence
American College of Obstetricians and Gynecologists, Barbara
Levy, MD, Vice President for Health Policy
American College of Physicians
Heart Association, American Stroke Association,
Terry Sue Mock, Senior Health Systems Policy Director
American Public Health Association, Georges
C. Benjamin, MD, FACP, FACEP (E), Executive Director
Center for Policy Analysis on Trade and Health (CPATH): Joe Brenner, MA, Co-Director; Ellen R. Shaffer, PhD MPH, Co-Director; Sohil Sud, MD, MA, Senior Fellow, CPATH, Senior
Pediatric Resident, UCSF
San Francisco Medical, Society, Steve Heilig, MPH
San Francisco Tobacco Free Coalition
Phillip Gardiner, Dr.PH, Program Officer,
Policy and Regulatory Sciences, Tobacco Related Disease Research Program*
Stanton Glantz, PhD, Director, Center
for Tobacco Control Research and Education, University of California, San Francisco*
L. Barnes, JD, Health Sciences Clinical Professor; Eric Crosbie; Mariaelena Gonzalez,
PhD; Heikki Hiilamo, PhD; Lauren Lempert, JD MPH
Holly Jarman, PhD, Research
Assistant Professor, Center for Law, Ethics & Health / Department of Health Management & Policy, University of Michigan
School of Public Health*
Wendy Max, PhD, Professor
of Health Economics, Co-Director, Institute for Health & Aging, University of California, San Francisco*
Michael Ong, MD PhD, Associate Professor-in-Residence of Medicine,
University of California, Los Angeles*
Marty Otañez, PhD, Assistant Professor, Anthropology Department,
University of Colorado, Denver*
Heather Wipfli, PhD, Associate Director, USC Institute for Global Health, Assistant Professor, Department of Preventive Medicine and School of
Donald Zeigler, PhD, Adjunct
Associate Clinical Professor, University of Illinois at Chicago School of Public Health. Retired
Director of Prevention and Healthy Lifestyles, American Medical Association*
* Organizations listed for
Click here to download Conference Background and Overview on Trade and Tobacco Control
"Understanding how the tobacco industry exerts its influence through trade rules and
curtailing these loopholes is of the utmost urgency for safeguarding and strengthening the authority of the FDA Center for
Tobacco Products, for securing and expanding California measures at the local and state levels to reduce environmental exposure
to the toxic effects of tobacco smoke and residue, and to regulate nicotine and tobacco products."
Click here to download en espanol
CONTROL DEL TOBACO Y ACUERDOS COMERCIALES: ESTRATEGIAS PARA EL CAMBIO DE POLÍTICAS
EN EL SIGLO XXI1. Los acuerdos comerciales deben garantizar el derecho de las naciones a proteger la salud pública en contra
del consumo de tabaco.
Incorporar referencias al Convenio Marco para
el Control del Tabaco (CMCT) a los acuerdos comerciales. Incorporar en
el texto de cada acuerdo comercial regional y bilateral la Declaración de Doha referente al derecho que tienen los
países a proteger la salud pública. Fortalecer la primacía
de los principios de salud pública.
2. El ATP
no debe socavar el derecho ni la capacidad de los países para que ejerzan su soberanía nacional al momento de
adoptar o mantener disposiciones para reducir el uso de tabaco y prevenir el daño que ocasiona a la salud pública.
** Excluir de los acuerdos comerciales presentes y futuros las disposiciones
para el control del tabaco.
** Eliminar las disposiciones
relativas al arreglo de diferencias entre inversor y Estado (ISDS, por sus siglas en inglés).
3. Tenemos que establecer políticas comerciales mediante un proceso transparente que involucre al público.
**Los acuerdos y reglas comerciales que podrían afectar
la salud pública tendrían que ser debatidos y discutidos públicamente, y en los Congresos, incluyendo
la prevención de muertes y enfermedad ocasionadas por el tabaco.
** Incluir una representación efectiva de
la salud pública al establecer políticas comerciales en los ámbitos nacional, estatal y local.
Click to download Intro Power Point: Shaffer, Sud, Brenner
Click to download Brenner: Lessons from CPATH Successful Campaign on Australia FTA
Click to download Jarman: Trade-Proofing Tobacco Control
ADDITIONAL RELATED ARTICLES
Shaffer, Brenner, Houston, Tobacco Control: International trade agreements: a threat to tobacco control
Glantz, Gonzalez: Effective tobacco control is key to rapid progress in reduction of non-communicable diseases
Jarman: When trade law meets public health evidence: the WTO and clove cigarettes
Max, Sung: The Disproportionate Cost of Smoking for African Americans in California
Drope, Lenucha: Tobacco control and trade policy: Proactive strategies for integrating policy norms
Mackey, Evolution of Tobacco Labeling and Packaging: International Legal Considerations and Health Governance
Wipfli, Health Policy: Power of the process: Evaluating the impact of the Framework Convention on Tobacco Control negotiations
Medicine and Public Healh Testimony to Congree on TPP and Tobacco, Dec. 28, 2012
Medicine and Public Health Statement on TPP and Tobacco, May 2012