Setting Priorities

    Photo: PixaBay

    The WHO needs to target more of its resources at communicable diseases.

    By George Gay

    Since it was suggested that the wellbeing of nonsmokers could be negatively affected by secondhand tobacco smoke, smoking has been banned in an ever-increasing number of public places, including workplaces, in more and more countries; and, in this way and to a large extent, the perceived problem has been solved while retaining most of the economic benefit the tobacco industry delivers.

    Since almost everybody in the world has been under some level of threat of contracting Covid-19, the disease caused by SARS-CoV-2, people have been banned from an ever-increasing number of public places, including workplaces, in more and more countries; and, in this way and to some extent, the spread of the virus has been slowed, though those measures have caused, are causing and will cause for an as-yet-unknown time untold social problems and a reduced economic output such that, according to at least one headline, the world is going bust—whatever that means.

    It takes about 40 years for a smoker to die of a smoking-related disease. It takes about three weeks to die of Covid-19.

    And yet … it’s tobacco that seems to be uppermost in the mind of the World Health Organization (WHO). The Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC) and the Meeting of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products was due to be held in November, according to a note on the FCTC website dated Feb. 5 and still current well into April. But there was no mention of the Conference of the Parties to the WHO Framework Convention on Pandemic Prevention and Control, or of the Meeting of the Parties to the Protocol to Eliminate Trading on Markets Known to Present a Significant Risk of Zoonotic Diseases.

    It’s true that, on April 27, the joint meeting was postponed until November 2021, but not, as one might have expected, because the WHO needed to have all hands to the Covid-19 pump, but: “In light of the COVID-19 global pandemic and its impact on the conduct of international global conferences and travel…” But surely, it cannot go ahead even then. I cannot believe that the countries that normally fund this event are going to put up the money for the ninth meeting of the Parties—not at this time. Not when their treasuries are in hock and it is clearly time to focus attention on a few of the health threats that, unlike the threat of tobacco, people cannot deal with themselves: pollution, pandemics and poverty, for instance.

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    Spectacularly unprepared

    It is staggering that the world was as ill-prepared as it was for the onslaught of SARS-CoV-2 (hereafter referred to as the coronavirus). Representatives of most countries have come together for eight international conferences to discuss tobacco and latterly the illegal trade in tobacco, which you have to perform intellectual somersaults to view as a health issue. Did they not come together to discuss what to do in the case of a coronavirus outbreak?

    It seems as though they didn’t since the world proved spectacularly underprepared despite the fact that the coronavirus is generally assumed to have arisen from the midst of a type of “wet market” (one that sells both live and butchered animals, some of them exotic) that is known to be one of the major risk factors for such virus outbreaks. It was underprepared despite the fact that the operation of this market was taking place within China, a country that plays a major role in the global market. And many countries were underprepared because they had fallen for the idea that the “free” market was sovereign. They had allowed to be outsourced their manufacturing capabilities, including those producing the personal protective equipment (PPE) that is vital during the sort of pandemic that has ensued, they had run down stocks of such equipment, and they had failed to put in place workable plans to ramp-up quick and local manufacturing of such PPE in the event of an emergency.

    In other words, we are dying from a perfect storm of markets: wet, global and “free.” Or rather, we are dying from a perfect storm of these markets plus the effects of the interference in two of them once the going got tough. Once the authorities in some countries realized that they had been left exposed in respect of PPE and ventilators, globalization lost its sheen, border gates were slammed shut and the “free” in free market was taken a step further so as to include the “hijacking” of PPE.

    The wet market in question was being operated in Wuhan, though it would be misleading to give the impression that if these sorts of wet markets were eliminated in China, the world would be safe. Similar markets are operated in other countries, and the risk of coronaviruses arises from many other sources, including the sorts of factory farming that supplies most of the meat consumed in the U.K., where I live. And while the problems caused by the coronavirus were exacerbated by China’s system, which tends to suppress what are viewed as negative messages, such systems are being taken up in other countries. In the U.K., we are building a cult of leadership—albeit one that is looking a little shaky at the moment—and have recently voted in a government that is itching to control the media, the message and, as a backstop, the courts. Given the narrowness and brittleness of the U.K. government’s ideology, it is not surprising that it has proved to be one of Europe’s most incompetent in the face of the coronavirus.

    Change ahead?

    But we shouldn’t despair. I keep reading how, after we come through this pandemic, things must change. For instance, it’s said that inequality must be reduced significantly. This is a nice idea, but given what happened after the 2008 financial crash, a little naive, I think.

    One of the changes that is much touted has it that a lot of people whose jobs are now undervalued and underpaid will henceforth be recognized for the essential work they do and will be paid accordingly. Of course, this predicted change concerns mainly healthcare and other workers without whom basic services cannot be maintained, but let’s look at the tobacco industry. Will this brave new way of looking at the world change the lot of the tobacco grower, who, by definition, is an essential worker when it comes to producing tobacco products? I don’t think so. They will continue to live on a pittance while those performing nonessential jobs and those performing no jobs will snap up the big tobacco money. 

    But let’s look on the bright side. Perhaps one of the changes will deliver a different type of advantage. Perhaps we will try to hang onto the environmental benefits that have seen pollution reduced over many cities partly because people have been making fewer journeys during lockdowns. Again, it’s a nice idea but unlikely. Such change would require bold political and business leadership at a time when many of the countries of the world are led by people who have so little imagination that they cannot see we have a problem or who are so in hock to the current system that they daren’t change direction. In a scene that reflects the end of the film, Dr. Strangelove, some airlines, for instance, are jostling for public money so that they will be able to take to the skies again en masse once lockdowns are lifted. You can laugh at the idea of a “mineshaft gap” only when it’s part of a film.

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    Ramping up pressure

    In fact, very little changes. Anti-tobacco crusaders have used the coronavirus to try to scare smokers (and, in some cases, vapers) into quitting. At a time of high anxiety, they have ramped up the pressure on smokers by putting forward the idea that they are at especial risk if they contract Covid-19. Looked at from one direction, this is common sense. Smoking affects the lungs—organs that the coronavirus attacks. But the one thing that we know about Covid-19 is that we know very little about it; so, I would suggest that it behooves anti-tobacco activists to take this into account before speculating. Indeed, it might be wise from their own point of view to exercise a little caution. They are going to look rather daft if, as seems possible at the moment, it is found that smoking and, more particularly, nicotine, is a defense against contracting the coronavirus.

    I’m sure that some of the people using the coronavirus as a means of scaring smokers half to death are well meaning. But I cannot say the same for those who have been putting forward the idea that tobacco is not an essential item and so should not be on sale during lockdowns, especially since in many countries tobacco products are available at the sorts of shops that are open anyway because they sell food. This idea, I take it, comes from what must be the puritanical fringe. But the puritans too should exercise some caution—on two counts. They need to bear in mind that one crucial aspect of a lockdown is that you keep as many people on side as is possible. And they need to be aware of the fact that they, also, are going to look more than a little daft if smoking and nicotine turn out to comprise a defensive weapon.

    And there are aspects of this idea that simply don’t make too much sense. We are told that smokers are addicted to their habit and find it nearly impossible to quit. So, what do politicians think is going to happen when they cut the official tobacco supply to addicted smokers, especially if those smokers suspect that smoking could be a defense against contracting the coronavirus? The likelihood is that there will be an increase in the illegal trade, which won’t, because of the nature of that trade, be observing social distancing. And it is a racing certainty that tax revenues will fall—at a time of special need for such revenue.

    Targeting resources

    But let me flip back to the beginning of this piece because I might have given the wrong impression. I support the institution of the WHO and do not think that the president of the U.S., Donald Trump, was wise to threaten to cut his country’s funding for the organization, though I can understand why he is feeling a little cross with it.

    As is stated above, however, the WHO needs to target more of its resources at communicable diseases such as the coronavirus that is now running amok across the world. It can backpedal on tobacco. The tobacco and nicotine industries, with their ever-improving, new-generation products can do a better job than the WHO in reducing and, eventually, eliminating smoking. This is the sort of area where the “free” market does work.

    What the WHO doesn’t need to do is be the cause of thousands of people flying around the globe to come together in November 2021 to discuss a problem that others can solve. Holding the FCTC meeting will cause pollution and, even at that time perhaps, before the world has figured out how to interact with nonhuman animals in a civilized manner, send out the wrong message about bringing people together for major international meetings.

    Finally, it needs to be remembered that tobacco, unlike novel viruses, cannot pose an existential threat to civilization. For the WHO and its members to concentrate on tobacco is reckless.