Tag: World Health Organization

  • WHO To Review Policies After Denying Vaccine

    WHO To Review Policies After Denying Vaccine

    Photo: Tom

    The World Health Organization is reviewing its policies after the global health body denied Medicago’s Covifenz Covid-19 vaccine emergency-use approval, according to The Times Colonist.

    The WHO denied the vaccine due to the company’s ties with the tobacco industry; Philip Morris is a minority stakeholder in Medicago.

    “Medicago was informed of this decision and has been apprised of WHO’s policies on tobacco,” the WHO stated.

    However, the WHO’s policies may change as the organization reevaluates its policies following the tobacco industry’s attempts to diversify into other categories.

    “WHO is currently holding discussions on how to address a general trend of the tobacco industry investing in the health industry,” the WHO said.

    Once the WHO makes a decision on its policies, the Medicago vaccine application could be reviewed.

    Medicago is waiting on a response from the WHO detailing why the vaccine application was denied. “Once we receive this, we will review the rationale and continue to discuss next steps with our partners and shareholders,” said Takashi Nagao, Medicago’s president.

  • WHO Likely to Reject Medicago Covid Vaccine

    WHO Likely to Reject Medicago Covid Vaccine

    The World Health Organization is unlikely to grant emergency approval Medicago’s tobacco plant-based Covid-19 vaccine due to the company’s ties to the tobacco industry, the CBC reported on March 17.

    The global health body has reportedly paused the process for pre-qualification of Medicago’s new Covifenz shot due to its link to Philip Morris International, which owns about one-third of the Canadian biopharmaceutical company.

    “Due to its connections [to PMI], the process is put on hold,” said Mariangela Simao, the WHO’s assistant director-general for drug access, vaccines and pharmaceuticals, at a March 16 media briefing.

    “The WHO and the U.N. have a very strict policy regarding engagement with the tobacco and arms [industries], so it’s very likely it won’t be accepted for emergency use listing,” she said.

    In February, Health Canada approved Covifenz for adults 18 to 64 years of age, making it the world’s first vaccine approved for human use that utilizes a plant-based protein technology. The Canadian government floated CAD173 million ($136.74 million) to help the company develop the jab and is so far the only country to approve it.

    In October 2020, Canada signed a deal to buy 76 million doses of Medicago’s vaccine, and the shot is expected to be made available to the public in May.

    In a statement published by the CBC, Medicago said it believes authorization decisions should be based on the quality, efficiency and safety of the vaccine, not who owns shares in the manufacturer.

    “It is our understanding that the WHO has made a decision to pause the approval of the vaccine and that this decision is related to Medicago’s minority shareholder and not to the efficacy and safety of the vaccine, which was demonstrated with the approval by Health Canada,” the statement reads.

    Derek Yach, a global health consultant, was aghast by the WHO’s  suggestion that it would reject Medicago’s vaccine based on the company’s relationship with PMI.

    “‘Pikuach nefesh’ is the ethical principle in Jewish law that the preservation of human life overrides virtually any other religious rule,” he said. “Most other religions support a variant of this. WHO violates this ethical principle when it denies people access to a lifesaving vaccine.”

    If the WHO follows through, the vaccine would be the first Western-manufactured Covid-19 shot to be rejected by the global health body, according to Bloomberg.

  • Ex-WHO Official Calls for Inquiry Into UN Body

    Ex-WHO Official Calls for Inquiry Into UN Body

    Photo: Alexey Novikov

    Robert Beaglehole, former director of the Department of Chronic Diseases and Health Promotion at the World Health Organization, has called for an independent inquiry into the global health body’s leadership’s reluctance to explore all option for reducing the health toll of smoking, according to an article written by Martin Cullip, international fellow of the Taxpayer Protection Alliance’s Consumer Center.  

    Speaking during the recent E-Cigarette Summit in London, Beaglehole said the Framework Convention on Tobacco Control failed to achieve success is because of the WHO’s unrealistic drive for nicotine abstinence and a resistance to less harmful products. He also criticized the FCTC’s obsession with youth vaping to the detriment of making alternatives available for adults who smoke.

    Beaglehole took issue also with the WHO’s reliance on funding from Bloomberg Philanthropies, which he sees as driving the WHO in the wrong direction due to Michael Bloomberg’s personal prohibitionist ideology towards vaping and nicotine use.

    The professor noted that wherever the WHO’s had implemented its MPOWER initiative, smoking rates have either risen or declined very slowly, while in countries that have embraced harm reduction, smoking prevalence has declined, often quite dramatically.

    Beaglehole said the WHO should lead, not obstruct, harm reduction strategies, noting that the WHO promotes harm reduction in realms such as illicit drug use and HIV/AIDS. Countries, he added, should be encouraged to adopt targets according to science-based recommendations, rather than ideology

    He said parties to the treaty should take advantage of the upcoming director-general election in May 2022 to question incumbent Tedros Adhanom Ghebreyesus about his organization’s approach to tobacco control.

  • The Stubborn Squad

    The Stubborn Squad

    Photo: Olrat

    In trying to engineer consumer choices, COP9 delegates persist in their Luddite approach.

    By George Gay

    A lot of silly comparisons have been drawn between the October/November Conference of the Parties (COP26) to the Framework Convention on Climate Control and the November Conference of the Parties (COP9) to the Framework Convention on Tobacco Control (FCTC). One even had it that the two were of equal importance. No. The first concerned an existential crisis for humanity. The second seemingly dallied with dissonance theory as it examined how a single organization could, at one and the same time, try to stop people smoking while strengthening the supply chains that get cigarettes into their hands. In my view, the difference in importance between the two was such that, given COP26 ended with few firm significant commitments, and, consequently, the earth is set to become uninhabitable by humans, the battle of words waged over COP9 amounted to little more than the proverbial fight between two bald men over a comb.

    But others clearly thought differently, so the pressure on the Parties to the FCTC was intense ahead of and during this year’s COP, or as intense as it could have been given the secretive nature of the event. Perhaps the intensity was ramped up because the tobacco harm reduction (THR) deniers at the FCTC, like the climate change deniers, were starting to feel the heat; were starting to show signs that they were coming to realize they had lost or were losing the argument; and because those who support a THR strategy were glimpsing light at the end of the tunnel. Perhaps, too, it was because the Covid-19 pandemic had made people more familiar and comfortable with internet meetings and performances, which enabled THR advocates and consumers to broadcast their side of the argument throughout COP9, while the quit-or-die protagonists and THR deniers at the FCTC, as has become usual, were hunkered down, almost incommunicado—shut off from the infectious ideas and opinions of others, including those whose lives they were attempting to manipulate and control.

    It is not without irony that the failures of the WHO in respect of the devastating pandemic led to changes to the COP9 and MOP2 meetings.

    Of course, there was some official communication around COP9 as when in August the Convention Secretariat issued a media release blaming the Covid-19 pandemic for the fact that planned face-to-face sessions at The Hague, Netherlands, had had to be ditched in favor of virtual meetings; on Nov. 8–13 in the case of COP9; and on Nov. 15–18 in the case of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products. It is not without irony that the failures of the World Health Organization—along with those of many governments, institutions, companies and individuals—in respect of the devastating pandemic led to changes to the COP9 and MOP2 meetings. Perhaps if the WHO had had its eye more on viruses than on tobacco … Oh, never mind. But it is worth noting here that in the same release, the Secretariat announced it had “released the first group of documents…” relating to COP9, because the use of the word “released,” rather than, say, “published,” is instructive as to who seems to be in the driving seat at the FCTC—and it isn’t the Parties.

    Advertisement

    Influencing Product Choices

    Looked at one way, the fighting at and on the fringes of COP9 was over the promotion of different products and methods aimed at influencing the consumer product choices made by smokers who are being told, by those who claim to know best, that they, the smokers, should quit the product they are currently using, even though its consumption is perfectly legal. It makes me wonder how many of those calling for smokers to quit their habit drink alcohol, which is probably, in the West, the most socially destructive legal consumer product available—the only legal consumer product I can think of that dulls the brain when used as intended by manufacturers. Hypocrisy, like alcohol, is legal and is leaned upon heavily.

    The fighting is justified by both sides on the grounds that it is over the most efficacious way of getting smokers to quit and thereby adding a few more years to their lives. Whether all smokers want to make this trade-off seems to be seen as of little importance and, in this respect, I would like to applaud Clive Bates for including the following gentle but important reminder in his pre-COP9 published piece “Prohibitionists at Work: How the WHO Damages Public Health Through Hostility to Tobacco Harm Reduction”: “Not everything in life is subordinated to maximizing life expectancy.” Drinkers, of course, will be aware of this.

    What we are witnessing is a commercial fight between the purveyors of nicotine-replacement therapy products, which are promoted by the WHO and not discounted by THR supporters, and the purveyors of THR products, which are frowned upon by the WHO.

    In reality, and in part, what we are witnessing is a commercial fight between the purveyors of nicotine-replacement therapy products, which are promoted by the WHO and not discounted by THR supporters, and the purveyors of THR products, which are frowned upon by the WHO. But, to my way of thinking, there is a vital difference between the approaches of the two sides. I am not going to go into details here because most of the relevant arguments are already familiar to readers of this magazine and because anybody who wants to refresh their knowledge may visit Bates’ excellent piece. But at its most basic, the difference amounts to the fact that those pushing the THR message are offering less risky and hugely less risky substitute products to those smokers who are considering or who have decided they want to quit smoking highly risky combustibles and have not been able to do so using other methods, while the FCTC is intent on discouraging the use of THR products and, instead, forcing all smokers to quit, largely through pricing them out of the market by encouraging governments to apply unconscionable levels of taxes. Unfortunately, some of those who support THR are not above calling for higher taxes on combustibles or describing tobacco tax hikes as “progress” or “success.”

    Advertisement

    Sensible Voices

    Seemingly, the main item to have emerged from the bureaucratic thicket of the COP9 concerned a decision to launch an investment fund that will offer another source of financial support. “This lays a foundation for financial stability for the future implementation of the WHO FCTC,” a post-conference press note stated. “The fund will complement existing revenue received from Parties through assessed contributions and extra budgetary support.”

    I don’t know how this fund will be operated and possibly wouldn’t understand it if I were to be told, but something about the announcement strikes me as important. It seems to me to indicate the Secretariat is perhaps concerned about future contributions from the Parties, and, if this is true, I would say it shows the glimmer of an unusual connection with reality. Sensible voices are starting to be raised. The Philippines’ foreign affairs secretary, Teodoro Locsin Jr., reportedly told the conference that the latest scientific information must be considered in trying to solve the global smoking problem, adding that a balanced and evidence-based approach to safer nicotine products was needed. The Philippines was making progress in moving away from harmful products by introducing products with similar satisfaction but causing far less harm.

    At the same time, if the new financial arrangements are predicted to make the FCTC’s star shine brighter in the future, I think the observers are looking through the wrong end of the telescope, unless, at the same time, the FCTC shifts its focus from quit-or-die to harm reduction. The Philippines’ delegation bravely set the scene for a new direction that, if it is not taken, will see the FCTC’s star implode under the weight of its own contradictions. For instance, the U.K. cannot in all conscience turn up in Panama in 2023, where COP10 is scheduled to be held, showing support for a quit-or-die policy while prescribing harm reduction devices at home. And other countries will surely follow this lead. The Secretariat and its allies are defying logic, and it is possible to do that only for so long. I would venture to say their time is running out.

    A Healthy Body Securing the Supply Chain

    Meanwhile, it surely has to be the case that the three-year-old MOP will collapse even though it, too, is to seek out a new funding stream. The idea that a so-called world health organization is involved in policing the illegal trade in tobacco products again defies logic and seems to hark back to the time when the U.S. Food and Drug Administration seemed to become directly involved (it might still be so involved) in sending underage people into shops to catch retailers selling tobacco products to such people.

    It might take a little time for the MOP nonsense to be exposed, of course, because there is unlikely to be any opposition from the tobacco industry. A press note published to coincide with the opening day of MOP2 said, in part, “During this meeting, Parties will discuss a number of issues, including ways of securing the supply chain of tobacco products….” You have to wonder whether this was meant as a joke. An international health organization is bent on securing the supply chain of tobacco products? Really?

    Certainly, the MOP is a confused entity, partly because of the hopelessly optimistic goal built into the name of the protocol that it is supposed to oversee. Announcing MOP2, a press note referred in the first two paragraphs to its aims as being eliminating, which is in the name, but also stopping and combatting the illegal trade of tobacco products. I guess such vagueness helps guard against the time that an audit of progress is made.

    As far as I could see, MOP2 ended with little more than a few vague promises whose meaninglessness was underscored by the overuse of the word important. “Importantly, MOP2 agreed to strengthen international cooperation to ensure greater assistance between Parties—an important step that is expected to accelerate the adoption of best practices and support the introduction of innovations,” a closing note said. “The Parties also adopted a strategy for mechanisms of assistance and mobilization of financial resources to deepen the implementation of the Protocol.” Hmm.

    An international health organization is bent on securing the supply chain of tobacco products? Really?

    Having said this, I have some sympathy for the WHO. Once most countries had signed up to the ludicrous idea that a global health organization should become involved through the FCTC in trying, among other things, to engineer consumer choices, it was headed into unfamiliar territory. However, it has only itself to blame for the Luddite approach it has taken in the face of the development of new generation tobacco and nicotine products that are far less risky than are combustible cigarettes and that for many smokers provide a satisfactory substitute for combustibles.

    OK, some might argue—in a near-perfect world, but one in which the rights of cigarette smokers were, as usual, pushed to the side—that the WHO might be justified in taking the actions it has. After all, it claims the global prevalence of tobacco use among people 15 years of age and older decreased from 29 percent in 2005 to 22 percent in 2019 and will continue to decrease. Of course, it would be impossible to say why this decrease has occurred, but even if you accept that it is down to FCTC strategies, that doesn’t mean those strategies should be continued exclusively in the future if there are new strategies that can speed things along.

    In addition, we are in the grip of a global pandemic, which has, in general, been poorly handled and led to the deaths of millions of people; we are likely to be ravaged by other pandemics because no meaningful preventative measures are being taken; we are facing an existential environmental crisis; and we are dying in ever-increasing numbers from a global pollution pandemic. At such a time, we need the WHO to focus on risks such as these because these are the risks over which people have little or no control. Smoking is a choice.

    George Gay is Tobacco Reporter’s European editor, but his territory spans the globe. Based in London, George has covered the tobacco industry since 1982, initially for a U.K.-based publication and since 2004 for Tobacco Reporter. George’s understanding of industry issues, combined with his keen sense of observation and dry wit, have earned him a loyal following among Tobacco Reporter’s readers.
  • Fighting the Last War

    Fighting the Last War

    A new report by Knowledge-Action-Change urges the World Health Organization to embrace safer nicotine products.

    By George Gay

    On the face of it, it seems odd that a case has to be made for the promotion of safer nicotine products (SNPs) as part of a global tobacco harm reduction (THR) strategy. But making this case, in large part, is the aim of a report published by the U.K.-based public health agency Knowledge-Action-Change (KAC) and launched at a hybrid event on Oct. 27 in London. And it has to be said that the case needs to be made, as becomes clear toward the end of the report, in a section looking toward the future, where it is stated that it is a “moral imperative” that the World Health Organization and its allies retrench from their current “intransigent and obstructive position of not only refusing to accept any positive health benefits from SNPs but actively campaigning against their use.”

    I would agree wholeheartedly with the general sentiment being expressed here, but invoking morality is problematic, I believe. The idea of an overarching morality is not universally accepted because a lot of people believe “morality” resides in the preferences individuals or groups of people have. And, in fact, Harry Shapiro, the author of the report Fighting the Last War: The WHO and International Tobacco Control, seemed to acknowledge this point when, speaking at the launch, he said everybody working in tobacco control was aiming to reduce smoking but that tobacco control split into two broad camps: one comprising those who supported SNPs and THR and the other comprising those who didn’t. This was a good concession to make because having the word “war” in the title of the report seemed to be pointing us back down a road we surely don’t want to travel.

    Misguided and Irrational

    Having said that, this is a good report aimed at challenging the direction of travel of tobacco control under the auspices of the WHO’s Framework Convention on Tobacco Control (FCTC) ahead of the Conference of the Parties to the FCTC, COP9, which was due to take place virtually on Nov. 8–13 (after this report was written). In doing so, the report seeks to address what must surely be one of the most unsound and unreasoned strategies ever to have arisen within the international health community. Put briefly, it is about the WHO and its allies being not immoral but, more worryingly, misguided and irrational.

    According to the WHO, an epidemic of cigarette smoking is currently causing the deaths of 8 million people a year, usually referred to as “premature deaths,” a phrase up there with “pre-ordering” in the list of linguistic curiosities. But while a number of SNP products have been developed that can wean people off tobacco smoking, the most powerful international body charged with protecting the health of people around the world has decided it would be best not to use these products but to apply the old “quit-or-die” patch to the gaping wound. After all, quit-or-die has a long track record whereas the products being offered up are—mention it only in hushed tones—new or newish. The fact that the long track record of quit-or-die is, like the art of bleeding patients, one largely comprising failure seems not to enter the thinking of the WHO and its allies.

    But perhaps this isn’t fair. The report makes the point that the number of smokers worldwide has remained at 1.1 billion for the past 20 years, during which time, I understand, the world’s population rose from 6.11 billion to 7.75 billion, so it could be argued that the number of smokers would, without intervention and with all other things having remained equal, have risen to 1.38 billion. So what has occurred might not be failure, I guess, but it is hardly a galloping success.

    Of course, it might be said correctly that individuals and states are not bound to follow the WHO’s advice, but it is often the case that they do, perhaps because of the peculiar tendency of humans to create or invent institutions or belief systems and then slavishly accept the advice purportedly coming out of them, no matter how daft, rather than go back and question whether there was a fault in the original idea that gave rise to the institution or belief system.

    But I would not recommend going back to question the setting up of the WHO itself, which, to my mind, should be a powerful force in the global fight against transmissible diseases, but to question the WHO’s FCTC, whose provisions are used to steer the direction of travel of the international tobacco control movement.

    A Matter of Interpretation

    Harry Shapiro

    The report does an excellent job of explaining the roles of the WHO, the FCTC, the Conference of the Parties to the FCTC and the FCTC secretariat, the relationship between them and the decision-making processes they employ. This section of the report doesn’t make encouraging reading, however, though it largely defends the FCTC’s provisions and blames the way they are interpreted for the failure to embrace SNPs and THR. It is said that the provisions of the FCTC are no bar to the consideration of scientific advances, new technologies, economic circumstances and the concept of THR. But this is surely no reason to keep heading down the same road hoping things are miraculously going to get better, especially given that the seemingly unaccountable FCTC secretariat is making much of the running, and nation states tend to go with the flow, unlike when they discuss other global issues such as trade. There have been eight FCTC-based COP meetings since the COP first met in 2006, and I cannot help thinking that, given the lack of progress it has made in 15 years of working with the FCTC, the decent thing to do would be to put the COP and the FCTC out of their misery.

    One of the problems identified in respect of COP meetings is that they are almost totally exclusive, owing to a particular interpretation of an FCTC provision. And a comparison is made in the report, and was repeated by others at the report launch, of the FCTC COP meetings and those associated with the Framework Convention on Climate Change (FCCC). The tobacco COPs were said to be shrouded in a level of secrecy comparable to U.N. Security Council meetings whereas to be an observer at the FCCC COP, it was necessary only to demonstrate representation of a national or international body and relevant experience. The inference was that if more people were allowed to observe and even take part in the tobacco COP, things would be better.

    I hate to spoil the party here, but the comparison is a little out of proportion, to my way of thinking. Tobacco COPs look at consumer choices involving various tobacco and nicotine products whereas the FCCC COPs are about trying to prevent the whole of humankind going belly up. The comparison seems also to gloss over the evidence. As I write this, the FCCC COP, COP26, is about to start and is widely expected to end largely in a PR-burnished failure, with the result that the world will be plunged deeper into the existential crisis it is already in and from which it is unlikely to be able to row back. Having more participants doesn’t seem to guarantee success, at least not on its own, even where the fate of the earth hangs in the balance.

    Advertisement

    The Way Forward

    So, how could things be arranged to ensure a more beneficial outcome to the problem of tobacco smoking? Well, through the employment of THR, where harm reduction is defined in the report as “a range of pragmatic policies, regulations and actions that either reduce health risks by providing safer forms of products or substances or encourage less risky behaviors with an important role in championing social justice and human rights for people who are often among the most marginalized in society.” One of the most frustrating aspects of the refusal of the WHO and parties to the FCTC to embrace THR is that the WHO employs harm reduction in respect of other health issues. Such an inconsistent stance is difficult to understand, but then perhaps there is a visceral satisfaction in bleeding the patient, either actually or metaphorically, through taxation, the main weapon in the quit-or-die armory. Increasing tobacco taxation is held up as a quit-or-die success story, but, in fact, it is a strategy that further impoverishes the often less well-off while providing a boost for black marketers.

    Under a section titled “What can be done? New thinking for the 21st century,” it is said that parties to the FCTC should press for more evidence-based discussions on THR and SNP. This is a nice thought, but given the history laid out in the report, I wonder if it can lead anywhere helpful. I’m sure COP participants believe they are making evidence-based decisions already, but my guess is, to get back to my original point, they are viewing only the evidence that is able to squeeze through their locked-in “moral” filters. The more alcohol they quaff together, the more they come together in the belief that nicotine is evil and shouldn’t be enjoyed. Evidence is no guarantor of success. The EU’s deadly ban on snus, a ban that defies all reason, has been upheld in the courts.

    Under the same section, it is said also that a pragmatic route forward could be the establishment of a working group on THR to take the FCTC forward into the 21st century in a world where SNPs are now available. This, too, is a good thought, but again, given the history laid out in the report, one that might be difficult to pull off. Still, nothing ventured, nothing gained, and the report describes five ways in which such a working group might be able to move things forward.

    One of the key starting points is said to be disaggregating combustible and more dangerous oral tobacco products from safer noncombustible products. But is this likely when, in a world where we hang onto the belief that the U.S. Food and Drug Administration is the paragon of scientific reason, that agency feels it right, and has the right, to “deem” electronic cigarettes to be tobacco products?

    It is easy to become gloomy about the situation, especially when it is considered that even if a smoker is saved from a tobacco-related death through switching to an SNP, she is anyway more likely now to die of a pollution-related disease (for which there is no COP), or, slightly further into the future, the effects of a climate change event.

    But, looking on the bright side, there is a powerful and growing force in support of THR, and it was on display at an event in London on the day following the launch of the Fighting the Last War report. The THR scholarship program, which is described as the jewel in the crown of the KAC, was the subject of a separate report, Tobacco Harm Reduction Scholarship Program: The First Three Years 2018–2021, which describes how the program has built an extensive network of advocates raising awareness of THR around the world.

    The report is worth reading. Although I was aware of the program, I had no idea how extensive it had become. Since its launch, the program has attracted 260 applications and has taken on 75 scholars from 33 countries, 18 of whom have gone on to enhanced scholarships. But perhaps the most significant figures are those describing how 95 percent of the scholars are still working in THR, 27 percent full-time, 50 percent part-time and 18 percent on a voluntary basis.

    The Oct. 28 event was an opportunity also to celebrate the life of Kevin Molloy (1957–2021), who, from 2018 until earlier this year, was head of the scholarship program.

    The Fighting the Last War report, which is part of a series of Global State of Tobacco Harm Reduction reports from KAC, and the scholarship program are funded by grants from the Foundation for a Smoke-Free World, a U.S. nonprofit organization that had no role in the planning or execution of either project.

    George Gay is Tobacco Reporter’s European editor, but his territory spans the globe. Based in London, George has covered the tobacco industry since 1982, initially for a U.K.-based publication and since 2004 for Tobacco Reporter. George’s understanding of industry issues, combined with his keen sense of observation and dry wit, have earned him a loyal following among Tobacco Reporter’s readers.
  • Critics: WHO Tobacco Trends Report ‘Celebrating Failure’

    Critics: WHO Tobacco Trends Report ‘Celebrating Failure’

    Photo: Syda Productions

    The World Health Organization’s fourth WHO global tobacco trends report, which was released today, shows that there are 1.3 billion tobacco users globally compared to 1.32 billion in 2015. This number is expected to drop to 1.27 billion by 2025. 

    Sixty countries are now on track to achieving the voluntary global target of a 30 percent reduction in tobacco use between 2010 and 2025;  two years ago, only 32 countries were on track.

    According to the WHO, millions of lives have been saved by effective and comprehensive tobacco control policies under the Framework Convention on Tobacco Control and by measures taken under the global health body’s MPOWER initiatives (Monitoring tobacco use, Protecting people from tobacco smoke, Quitting tobacco, Warning about the dangers of tobacco, Enforcing tobacco advertising, promotion and sponsorship bans and Raising taxes on tobacco).

    “It is very encouraging to see fewer people using tobacco each year and more countries on track to meet global targets,” said WHO Director-General Tedros Adhanom Ghebreyesus in a statement. “We still have a long way to go, and tobacco companies will continue to use every trick in the book to defend the gigantic profits they make from peddling their deadly wares. We encourage all countries to make better use of the many effective tools available for helping people to quit and saving lives.”

    To see numbers reduce from 1.32 billion to 1.30 billion tobacco users over five years cannot be argued as evidence of a successful strategy.

    Gerry Stimson, emeritus professor at Imperial College London and project director for the Global State of Tobacco Harm Reduction

    Critics, by contrast, said the WHO report showed tobacco control failing. “As the WHO publishes its latest global tobacco trends report, it trumpets falling tobacco use. But the global health institution is celebrating failure,” said Gerry Stimson, emeritus professor at Imperial College London and project director for the Global State of Tobacco Harm Reduction.

    “To see numbers reduce from 1.32 billion to 1.30 billion tobacco users over five years cannot be argued as evidence of a successful strategy. Eight million lives are lost every year due to smoking-related disease. What we are seeing is evidence of a dereliction of public health duty.”

    Stimson lambasted the WHO for failing to consider reduced-risk products in its strategy.

    “With modern safer nicotine products, these technological disruptors such as vaping devices, nicotine pouches [and] heated-tobacco products, we have the means at our disposal to end smoking and to end it soon,” he said.

    “Global State of Tobacco Harm Reduction estimates put the number of users of harm reduction products at 100 million worldwide. Many smokers are put off from switching, though, as a direct consequence of the distortion of public health messaging from the WHO and other tobacco control organizations funded by U.S. philanthropic interests that seem to care little for the health of current smokers.

    “Harm reduction is the third pillar of the tobacco control strategy named in the FCTC along with supply and demand reduction. We urge the WHO to integrate harm reduction into its approach to tobacco control as it already does for drug use and HIV/AIDS prevention and to address current deficits in the WHO’s MPOWER strategy by enabling it to become EMPOWERED—adding ‘Engage with affected communities,’ ‘Encourage smokers to switch to safer nicotine products’ and ‘Deliver accurate information about safer alternatives.’”

    Key findings of the WHO report include:

    • In 2020, 22.3 percent of the global population used tobacco, 36.7 percent of all men and 7.8 percent of the world’s women. Currently, 60 countries are on track to achieve the tobacco use reduction target by 2025.
    • The steepest decline in prevalence rates over time is seen in the Americas. The average rate of tobacco use there has gone from 21 percent in 2010 down to 16 percent in 2020.
    • The WHO’s African Region has the lowest average rate of tobacco use at 10 percent in 2020, down from 15 percent in 2010.
    • In Europe, 18 percent of women still use tobacco, substantially more than in any other region. Women in Europe are the slowest in the world to cut tobacco use. All other WHO regions are on track to reduce tobacco use rates among women by at least 30 percent by 2025.
    • Pakistan is the only country in the WHO’s Eastern Mediterranean region that’s on track to reach the tobacco reduction target. Four of the six countries in the world where tobacco use is increasing are in this region.
    • Southeast Asia currently has the highest rates of tobacco use, with around 432 million users, or 29 percent of its population. But this is also the region where tobacco use is declining fastest. The region is likely to reach tobacco use rates similar to the European region and the Western Pacific region by 2025.
    • The WHO Western Pacific region is projected to have the highest tobacco use rate among men (more than 45 percent) using tobacco in 2025.
  • COP9 Agrees to Strengthen Funding

    COP9 Agrees to Strengthen Funding

    Photo: Maksym Yemelyanov

    The Ninth Session of the Conference of the Parties (COP9) to the WHO Framework Convention on Tobacco Control has closed with an agreement to embark on an innovative multi-million-dollar financial plan to strengthen global tobacco control measures

    According to the WHO, a key milestone arising from COP9 is the decision to move forward with the development and launch of an investment fund that will offer a third source of support to help global tobacco control efforts. “This lays a foundation for financial stability for the future implementation of the FCTC,” the global health body wrote in a press note. The fund will complement existing revenue received from Parties through assessed contributions and extra budgetary support.

    This new initiative will source financial contributions beyond the traditional health sector, establishing a capital investment fund, the earned revenue of which will be used to support the activities of the convention. Recognizing the unique skills required to manage and sustain the fund, the governing body of the FCTC will be seeking the guidance of the World Bank, and will create an oversight committee, comprised of experts in financial and investment management representing the six WHO Regions and including observers from civil society to help guide the Fund.

    The event also saw the highest level of participation since the initiation of the COPs. In this week’s event, 161 Parties were present.

    For the first time, the whole of COP9 was open to the media, who observed sessions where tobacco control measures were discussed between the Parties, according to the WHO.

    “This demonstrates the enormous power of this COP9 where 161 sovereign states debated for four and a half days, and by consensus decided which topics they wanted to decide upon in this session, and which others they want to defer to COP 10,” said Adriana Blanco Marquizo, head of the convention secretariat.

    COP9 also adopted the “Declaration on WHO FCTC and recovery from the Covid-19 pandemic”, proposed by Iran, and co-sponsored by a broad group of parties. It stresses the need to protect public health policy from the commercial and vested interests of the tobacco industry, and that tobacco control measures, particularly increases in tobacco taxes, should be an integral part in pandemic recovery efforts.

     

  • New Report Questions WHO’s Vaping Stance

    New Report Questions WHO’s Vaping Stance

    A new report, published today, raises major questions about the anti-vaping arguments and approach of the World Health Organization and billionaire philanthropist Michael Bloomberg.

    The WHO and Bloomberg have both made clear their opposition to safer nicotine alternatives despite growing evidence of lower harm and efficacy for smoking cessation.

    The WHO’s tobacco control program is funded in part by Bloomberg Philanthropies. In July of this year, the two parties restated their joint position at the launch of the WHO Report on the Global Tobacco Epidemic, 2021: Addressing New and Emerging Products. In this report, the WHO emphasized that electronic nicotine-delivery systems are “a threat to tobacco control,” are harmful and should be banned or highly regulated. Bloomberg, in his capacity as the WHO Global Ambassador for Noncommunicable Diseases and Injuries and founder of Bloomberg Philanthropies, stated that tobacco companies are marketing new products such as e-cigarettes to “hook another generation on nicotine.”

    The International Network of Nicotine Consumer Organizations (INNCO) has now compiled a new dossier, titled Bloomberg, WHO and the Vaping Misinfodemic, containing statements and evidence from healthcare experts, leading academics, politicians, respected journalists and research organizations that question the stance of the WHO and Bloomberg on safer nicotine alternatives to smoking and the relationship between the two parties.

    This dossier comes just a week after the U.K. Department of Health and Social Care announced that e-cigarettes could be prescribed on the National Health Service, a world first. That move by the U.K. government provoked significant public debate around the polar opposite views toward safer nicotine alternatives, such as vaping, held by the British government and the WHO.

    The dossier also comes as the Parties to the WHO Framework Convention on Tobacco Control convene to discuss tobacco and nicotine policy.

    The outcomes from COP9 discussions will determine how international tobacco control policies are implemented at a country level across the globe to address the fact that 1.1 billion people still smoke worldwide and 8 million die every year from tobacco-related diseases.

    The dossier highlights nine reasons why serious questions need to be raised about the WHO’s and Bloomberg’s outright opposition to safer nicotine alternatives to deadly smoking. High on the list is their failure to distinguish between smoking addiction and nicotine dependence.

    They are shifting the harm focus from smoking to tobacco to nicotine—where it obviously doesn’t belong.

    Charles A. Gardner, executive director, INNCO

    “Effectively, through this failure, they are shifting the harm focus from smoking to tobacco to nicotine—where it obviously doesn’t belong—nicotine does not cause cancer, heart or lung disease. Smoking does,” says Charles A. Gardner, executive director at INNCO.

    This is backed up in the dossier by expert views on the profound difference between cigarette smoke and the drug, nicotine, including those expressed by Jamie Hartmann-Boyce, senior research fellow in health behaviors at the University of Oxford; John Britton, emeritus professor of epidemiology at the University of Nottingham and special advisor to the Royal College of Physicians on Tobacco; Adam Afriye MP; and a joint statement by 15 past presidents of the world’s top professional society in the field of tobacco control, the Society for Research on Nicotine and Tobacco.

    The report also scrutinizes the WHO’s role in COP events, with evidence suggesting that it is very controlling in terms of the agenda and attendance. Unlike COP26, these tobacco control COP meetings are described as “all but excluding the media,” “well-known for the routine ejection of the public from proceedings” and “notoriously secretive.”

    The dossier also reports on claims that the only tobacco control nongovernmental organizations (NGOs) allowed to attend are those who subscribe to the WHO’s tobacco harm reduction denialist stance. The U.K. Parliament’s All-Party Parliamentary Group for Vaping recently issued a warning about the participation at COP9 of The Union, a major global NGO funded by Bloomberg Philanthropies.

    “The Union [International Union Against Tuberculosis and Lung Disease] recently issued a major report titled Where Bans are Best: Why Low- and Middle-Income Countries Must Prohibit E-cigarette and HTP Sales to Truly Tackle Tobacco. The Union is one of Bloomberg Philanthropies’ two top tobacco control grantees—the other is the U.S.-based Campaign for Tobacco-Free Kids,” says Gardner.

    “We are a good case in point. INNCO, which represents and supports the rights of 98 million adults worldwide who use safer nicotine to avoid toxic forms of tobacco, has once again been denied observer status at COP9 (as it was denied at COP8 and at COP7).”

    The Bloomberg, WHO and the Vaping Misinfodemic report calls for:

    • Governments around the world to collectively challenge the WHO’s and Bloomberg’s current prohibitionist position on safer nicotine alternatives and to demand to know why, in the face of 8 million tobacco-related deaths every year, the tobacco control field is the only field of public health that rejects harm reduction
    • The formation of a global independent Tobacco Harm Reduction Working Group comprised of independent scientists, global health experts, specialist academics and people who use safer nicotine (ex-smokers)
    • Withdrawal of funding from and/or boycott of future Conference Of Parties (COP) tobacco control meetings until the WHO considers the overwhelming evidence that safer nicotine alternatives such as vapes, snus, nicotine pouches and heat-not-burn help smokers quit and save lives
    • Complete transparency in all tobacco control funding, grants and collaborations involving the WHO and Bloomberg
    • A full independent and international review into current and past tobacco control dialogue between Bloomberg Philanthropies, Bloomberg-funded NGOs and national governments in low-income and middle-income countries (LMICs) following allegations in the Philippines that the country’s Food and Drug Administration received funds from Bloomberg groups to support the implementation of the national tobacco control program
    • A complete review of the WHO’s public web-based Q&A on e-cigarettes, which has been described as “astonishingly bad.”

    The dossier also spotlights the EVALI (e-cigarette, or vaping, product-associated lung injuries) crisis of 2019. The U.S.-only outbreak of lung injuries caused by bootleg THC (cannabinoid) vape oils “cut” with one or more adulterants was wrongly reported to be caused by legal nicotine vaping.

    According to the report, the EVALI outbreak triggered Bloomberg Philanthropies to invest $160 million over a three-year period to prohibit all e-cigarette flavors other than tobacco flavor. EVALI is also still incorrectly referenced by the WHO in its Q&A on vaping products in response to the question as to whether e-cigarettes cause lung injuries.

    However, by early 2020, U.S. authorities identified vitamin E acetate, a cutting agent used in some bootleg THC vaping oils—mainly in U.S. states where cannabis remains illegal—as the primary cause of the outbreak.

    As reported in the dossier and which escaped the attention of the world’s media, last month, 75 global experts with no tobacco industry ties, including seven individuals who have served as president of the Society for Research on Nicotine and Tobacco, wrote to the CDC’s director asking her to change the name “EVALI” because it fails to alert THC vapers to their potential risks and it misleads smokers and nicotine vapers to believe e-cigarettes were the cause.

    “I’ve spent 30 years in global health, including three years as a senior advisor on research to the WHO. For most of my career, I worked on HIV, TB, malaria, dengue, rabies, nutrition and child health issues. So, I’ve never seen anything as crazy as what’s happening now in tobacco control. What troubles me is how few people outside of my ‘little’ echo chamber, the community of millions of ex-smokers who use safer nicotine, knows what’s going on,” says Gardner.

    “There are 1.1 billion smokers now in the world, a situation that has barely changed in the last 20 years. The anti-harm reduction conservatism of the WHO and Bloomberg is not working.

    “That’s why we are calling for a global response in the form of a tobacco harm reduction working group and international governments collectively questioning and challenging the WHO[‘s] and Bloomberg’s prohibitionist and evidence-denialist approach to safer nicotine. Because we are ex-smokers who use safer nicotine. We see what’s happening, and we have great empathy for smokers and ex-smokers who vape.

    “The goal is simple. Save lives. Only the starting assumptions and strategies to get there differ. These can be debated. But this debate is unethical if it does not include people who have, themselves, made the transition from smoking to not smoking, using tobacco harm reduction products (nicotine patches, nicotine gum and lozenges, nicotine vapes, nicotine pouches, snus and HTPs).”

    “Our future policy recommendations will focus on the need to change research priorities, just as HIV/AIDS activists sought to do in the 1990s. Global tobacco control research priorities today are skewed toward finding harms of alternative nicotine products while ignoring—or not even exploring—benefits, in particular the potential therapeutic benefits of nicotine. The health benefits of medical marijuana are now recognized because of research. The potential therapeutic benefits of psilocybin are now being explored (e.g., for PTST and even for smoking cessation). However, research to explore those potential benefits was locked in amber for 30 years because of prohibitionist drug laws.”

  • WHO Tobacco Control Conference Kicks Off

    WHO Tobacco Control Conference Kicks Off

    Image: Tobacco Reporter archive

    The Conference of the Parties to the WHO Framework Convention for Tobacco Control (FCTC) today opens its ninth session (COP9). One significant point to be discussed by the Parties is a potential new funding strategy, seen as a means of strengthening and expanding the support that can be offered to Parties of the global health treaty.

    Parties at COP9 are expected to consider how to address a common problem described by many countries—the lack of sufficient financial resources to strengthen tobacco control measures. This will mean a plan to establish a capital investment fund is high on the COP9 agenda. The Parties will decide on the adoption of a mechanism for new income streams to help fight the tobacco epidemic.

    The proposal offers the opportunity to raise a targeted $50 million for the FCTC. A similar fund will be proposed for adoption at the second session of the Meeting of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products to take place later this month—but in the case of the Protocol, the fund proposed will be for $25 million to strengthen implementation of that treaty.

    In a press release, the WHO said it would continue pushing forward with comprehensive implementation of the FCTC as the real solution to the tobacco epidemic, despite what it described as tobacco industry efforts to “stir up confusion and falsely parade itself as a solution to harmful tobacco consumption.”

    The COP9 discussions Nov. 8-13 bring together Parties, representing countries, United Nations agencies, other intergovernmental organizations and civil society. The participants will be exchanging their experiences in implementing tobacco control measures and reducing the prevalence of tobacco use. They will also be looking at strategies that improve tobacco control efforts, amid what the WHO describes as “attempts by the tobacco industry to interfere in ending the tobacco epidemic that is killing over 8 million people annually.”

    During the conference, delegates will also be evaluating the most recent Global Progress Report, which was launched last week. A total of 148 Parties reported on the comprehensive tobacco control measures contained in the treaty. For example, in relation to progress on Article 11, two-thirds of Parties confirmed that the required health warnings are being displayed on tobacco product packaging and, 17 countries confirmed that they have adopted the requirements for plain packaging of tobacco products.

    Parties have reported that they have struggled to introduce comprehensive advertising, promotion and sponsorship bans. Many complained of persisting interference in policymaking by the tobacco industry.

    In her keynote speech at the opening of COP9, Adriana Blanco Marquizo, head of the Convention Secretariat referred to the ongoing COP 26, on Climate Change. There are important parallels between the Framework Convention on Climate Change and the WHO FCTC, she noted.

    “Both treaties aim to protect present and future generations,” said Blanco Marquizo. “It’s clear that tobacco damages the environment throughout its life cycle, from crop to post-consumer waste, contributing to deforestation, desertification, greenhouse emissions and plastic contamination. But probably the most important point shared at both COPs, is that the tobacco epidemic and climate change are both manmade and preventable.”

    Critics, by contrast, focused on the differences between the two COPs, with the Climate Change gathering welcoming public scrutiny and industry input, and COP9 convening behind close doors and banning dialogue with the industry.

    Immediately after COP9, the second Meeting of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products will be convened, Nov. 15-18. The Protocol is a separate treaty expanding Article 15 of FCTC.

  • COP9 Coverage

    COP9 Coverage

    The Stubborn Squad

    December 1, 2021

    In trying to engineer consumer choices, COP9 delegates persist in their Luddite approach.

    A Tale of Two COPs

    November 3, 2021

    The striking differences between this month’s UN climate gathering and the FCTC COP9.

    A Better Treaty

    October 25, 2021

    GTNF panelists offer suggestions for transforming the FCTC ahead of the ninthe Conference of the Parties.