The Framework Convention on Tobacco Control: promising start, uncertain future

Will the first global health treaty be allowed to live up to expectations? On 21 May 2003, to the sound of thunderous applause, the 192 member states of the 56th World Health Assembly unanimously adopted the first global health treaty, the Framework Convention on Tobacco Control (FCTC). A groundbreaking treaty which aims to curb tobacco use worldwide, the FCTC holds the potential to help reverse the global tobacco epidemic, particularly in low income countries. With tobacco projected to claim a billion lives this century,1 the stakes could hardly be higher. According to the World Bank, tobacco is responsible for half the diseases and deaths in developing countries.2 Although described by the tobacco industry as a “developed world obsession being foisted on the developing world”*, it was in fact developing countries which saved the FCTC from being gutted by a handful of developed countries which have no intention of ever implementing most of its provisions. Unlike other treaties, where developed countries dominate the debate, developing countries were vocal, spirited, and led the charge for most of the progressive provisions. The final agreement, reached after nearly four years of diplomatic manoeuvering and at times acrimonious negotiations, provides the basic tools for countries to enact comprehensive tobacco control legislation. Key obligations in the treaty encourage countries to: