Whatever reputation for competence and honesty the World Health Organisation might once have had has been destroyed by its response to Covid. It ignored Taiwan’s warnings, claimed China had averted or delayed hundreds of thousands of cases and protected the global community, said China was not hiding anything, and recommended China’s epidemic control policy to the world, saying there was no “clear evidence of human-to-human transmission” of the coronavirus.
Even after the doctors and journalists trying to expose the outbreak’s extent were brutally suppressed, Dr Tedros Adhanom Ghebreyesus, the WHO’s director-general, lauded the Chinese government for its “transparency” and for making us “feel safer.” And only after enormous international pressure did it take seriously the likelihood that the virus originated from a laboratory in Wuhan.
You might think that this experience would be sufficient to convince the organisation to become more open and transparent itself. But when it comes to tobacco control, it is a secret society.
In November the WHO will hold its ninth ‘Congress of the Parties’ — COP9 — and a Meeting of the Parties — MOP2 — to the Illicit Trade Protocol in The Hague, Netherlands, under the auspices of its Framework Convention on Tobacco Control. The conferences will consider, respectively, how to reduce rates of smoking, and how to address the large and growing illegal tobacco market.
Over the past several COPs, FCTC policymaking has become increasingly non-transparent. Complaints of exclusion from deliberations on the grounds that the process lacks transparency due to the lack of input from stakeholders are routinely ignored. During COP7, a group of tobacco farmers showed up outside of the meetings in Delhi to peaceably protest their continuing exclusion from deliberations. This prompted the Convention Secretariat to call upon security to round them up and bus them miles away, to a location where COP delegates could neither see nor hear them.
This time the public, media, and organizations and any individuals even remotely associated with tobacco interests have been banned. Law enforcement, the media, general public, and industry (not only tobacco manufacturers but everyone in the supply chain – retailers, farmers, aligned industries etc) are excluded. Even the international law enforcement organization Interpol is excluded from discussions concerning the prevention of illicit trade in tobacco.
Records of FCTC deliberations have been increasingly stripped bare, to the point that future COPs can be expected to produce summary reports that only cover conclusions and outcomes. There is no opportunity to meaningfully analyse them or understand who said what and why.
Interpol is the most prominent international organization seeking to put a stop to the illicit trade in tobacco products, yet it has twice been denied credentials to participate in FCTC discussions because it occasionally cooperates with certain tobacco companies to track shipments.
Combating the illicit tobacco trade is clearly an area in which governments and the tobacco industry have a synergy of interests that makes cooperation sensible and necessary. Tobacco product packaging and associated tracking mechanisms play a key role in preventing illicit trade and there are aspects of law enforcement policies designed to combat illicit trade that necessarily require implementation by tobacco interests.
The problem is, just like our own Commonwealth Health Department, the WHO abhors any association with the legal tobacco industry. Also like our Health Department, it stubbornly denies the potential for reduced-risk products such as vaping to contribute to a reduction in smoking rates.
There is a wealth of scientific evidence to show vaping is dramatically safer than smoking, whether it’s Public Health England declaring that vaping is at least 95% safer, or a recent study from Cancer Research UK that found those using e-cigarettes were 95% more likely to quit smoking than someone using no aid at all. Moreover, those using e-cigarettes are twice as likely to abstain from smoking as those using nicotine replacement therapies.
In New Zealand, a new survey by research house IRI for the New Zealand Taxpayers’ Union found more than two-thirds of vapers believe New Zealand’s approach to vaping as a tobacco harm reduction tool is world-leading and should be promoted overseas to save millions of lives. But the WHO refuses to listen.
The lack of openness and transparency by WHO is contributing to poor policy outcomes that, once adopted by member countries, have a deleterious impact on public health. This is the exact opposite of the organisation’s mission. There is no prospect of a balanced, evidence-led debate and decision-making process when so many actors, including those having direct knowledge of what works to reduce smoking, are excluded from the dialogue.
Australia is complicit in all this: from 1 October this year it is illegal for Australians to buy items such as nicotine e-cigarettes, nicotine pods and liquid nicotine either from overseas or locally without a prescription. And like the WHO, our government does not want to hear from anyone who might have a different view.
The problems caused by smoking are significant and reducing smoking is a legitimate public health objective. Illegal tobacco is a huge and growing international problem that costs US$40-50bn in lost tax revenue every year. Neither problem can be resolved by the WHO taking transparency lessons from China.
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