Global public health policy has taken a step in the wrong direction as negotiations continue between the United States and 11 other countries regarding the Trans-Pacific Partnership (TPP) trade agreement.
The United States Trade Representative (USTR), the primary U.S. governmental agency responsible for negotiating international trade policy, recently abandoned its stance that would have tightened regulations for tobacco companies regarding their ability to challenge domestic tobacco control measures.
The USTR’s backpedaling has enormous public health ramifications globally. According to the American Cancer Society Cancer Action Network (ACS CAN), over 1 billion people worldwide will die this century as a result of tobacco. That’s 11 percent of the globe’s population.
The USTR initially proposed language in the TPP that would have created “safe harbors” so that domestic tobacco control measures could not be challenged by the tobacco industry. Increasingly, “Big Tobacco” and its allies are using international trade agreements to dispute local tobacco control laws. For example, in Australia, tobacco companies are challenging the legitimacy of the country’s law requiring that cigarettes can only be sold in plain packaging. While in Uruguay, Philip Morris International is protesting the nation’s statute regarding the use of large, graphic health warnings on its packaging.
Moreover, the new USTR proposal does not even recognize tobacco as a uniquely harmful product that should be regulated differently than mangoes or coffee beans or some other generally benign commodity. The ruling fails to recognize the overwhelming global support for increased tobacco control measures. The World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC), which 177 countries have ratified, explicitly states that signatories are obligated to implement more stringent tobacco control measures.
Embarrassingly, the United States has not ratified the FCTC and appears to be headed in the exact opposite direction from the rest of the world on this matter. It comes down to a cost-benefit analysis – apparently the $145 billion of annual tobacco related revenue is worth more to U.S. policymakers than the health and well-being of billions of people worldwide.
The public health ramifications are particularly stark for people living in the developing world, where 49 percent of men use tobacco. Eleven percent of women in the developing world use tobacco products, and that figure is on the rise. The long-term health costs associated with tobacco related illness and disease for these individuals is astronomical.
The interconnectedness of public health and poverty alleviation is clear. A healthy population is much more likely to experience improved economic conditions than one that is hampered with enormous health care costs that they cannot afford.
As Dr. Oleg Chestnov, Assistant Director-General of the WHO, stated, “We have the tools and we have the will. Millions of lives stand to be saved–we must act together and we must act now.” His optimistic view is inspiring, but the USTR’s ruling on the TPP is certainly not helping his cause.
– Aaron Faust