February 12, 2003

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Up in smoke
The World Health Organization has spent three years crafting a global tobacco treaty. As negotiations come down to the wire, U.S. delegates appointed by President Bush's tobacco-friendly White House are gutting it.

By Tali Woodward

IF AN INTERNATIONAL conflict were killing five million people a year, you can be sure we would know about a major effort to stop the carnage. But few are aware that 190 countries are finalizing a treaty on tobacco, probably the most reliable global killer. Even fewer know how the United States is trying to eviscerate the treaty, which threatens the tobacco industry and with it the money the industry supplies the U.S. economy – and specifically the Republican Party.

According to World Health Organization projections, smoking will become the leading cause of death – claiming 10 million lives a year – by 2030. By then the number of tobacco-related deaths that occur in developing countries is expected to spike from 50 to 70 percent.

So in 1999 the WHO hatched a plan for a global treaty on tobacco control – the first time health advocates have ever pursued an international agreement.

The vast majority of countries involved in the Framework Convention on Tobacco Control quickly agreed on several goals. They wanted to exempt tobacco control from free-trade challenges, standardize tobacco packaging (banning terms such as "light" and "mild"), and initiate a crackdown on tobacco smuggling. Most also wanted to limit tobacco advertising as much as possible and agreed the treaty should urge countries to erect whatever barriers they could, given legal restraints.

Only Germany, Japan, and – most of all – the United States have contested these points. But as final talks begin Feb. 17 in Geneva, the treaty is a skeleton of earlier drafts. And whether the United States would sign any draft remains an open question.

Basically, this the Kyoto Accords of public health.

Dr. Tom Novotny headed the U.S. delegation to the FCTC until he resigned in May 2001, thoroughly disillusioned with the United States' intentions.

"In the beginning we had very strong support from the [Clinton] White House," said Novotny, who is now a professor at UC San Francisco. Of course, he told us, the delegation had to cope with pressure from the Jesse Helms-led Senate Foreign Relations Committee. And he acknowledged the delegation tried to discourage a total ad ban, well aware that one would never make it through Congress. But the delegates, who come from various federal agencies, such as the Department of Agriculture and the Food and Drug Administration, all agreed the underlying "purpose of this treaty was not trade or political influence, but was health," Novotny said.

Everything changed when President George W. Bush was elected. According to participants and observers from here and abroad, the U.S. delegation has virtually hijacked the consensus-based process, working publicly and behind the scenes to strip the treaty of significant reforms. The United States has fought particularly hard against the proposed advertising restrictions, though similar limits exist here. Ostensibly this is due to the tobacco industry's focus on expanding third-world markets.

UCSF professor Lisa Bero recently analyzed U.S. opinion on the FCTC and found overwhelming support for more stringent tobacco controls. But when she attended a Geneva hearing in October 2002, she told us, "the U.S. delegates were either quiet or obstreperous," only voicing criticism. In fact, she said, "the only arguments against [reforms] came from countries with strong financial dependence [on tobacco, like the United States]."

Before buying the argument that the nation's economy depends on tobacco revenue, health advocates ask us to consider the public cost. A UCSF study released last month found the state loses $16 billion a year – that's $475 a person – because of medical costs and lost productivity attributable to smoking. The country as a whole spent $76 billion on tobacco-related health care costs alone in 2002, according to the WHO.

"If you looked at it globally," Bero said, "I think the costs of tobacco-related illness would far outweigh [the profits]."

That's clearly not how the Bush administration sees it – and it's hard to imagine its members haven't been influenced by their personal connections to U.S. tobacco companies.

Bush's famously powerful chief of staff, Karl Rove, was a tobacco-industry lobbyist for five years, once earning $3,000 a month as a part-time political strategist for Philip Morris (which just changed its name to Altria). Daniel Troy, now the Food and Drug Administration's chief counsel, represented the tobacco industry when it sued the FDA over tobacco regulation. And Kirk Blalock, a former Philip Morris public-relations official, works as a business liaison for the Bush administration. Then there's Secretary of Health and Human Services Tommy Thompson, who received $72,000 in campaign contributions from Philip Morris executives when he was governor of Wisconsin – and has also advised the primary tobacco lobbying firm in Washington, D.C. Tobacco companies have given more than $20 million to Republican candidates for federal office since 1997, according to campaign-watchdog group Common Cause. Philip Morris alone has been the leading overall campaign contributor to Republicans since 1989.

"They're paying back their campaign contributors – and public health be damned," said Professor Stanton Glantz, director of the Center for Tobacco Control, Research, and Education at UCSF. "There's no rational explanation for this, in terms of the science."

Activists here hope a public outcry will force the U.S. delegation into a last-minute reversal in favor of tighter controls, but it's not the easiest time to get the public focused on another international issue. The WHO plans to adopt the FCTC in May; each member country would then be asked to approve the treaty.

"My opinion is that there's no chance that this administration will sign a tobacco treaty," Novotny told us. "And I think it's embarrassing that the United States shows so little leadership on international tobacco control. We have so many resources, and we bear so much of the responsibility in helping the tobacco companies open markets and spread this infection."

Join corporate-accountability group Infact, Novotny, and UCSF researchers at a rally to support the tobacco treaty, Wed/12, 11:30 a.m. Phillip Burton Federal Building, 450 Golden Gate, S.F.

Research assistance by Matthew Hirsch and Minnie McBride.

E-mail Tali Woodward at tali@sfbg.com.