The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is a treaty adopted by the 56th World Health Assembly held in Geneva, Switzerland on 21 May 2003. It became the first World Health Organization treaty adopted under article 19 of the WHO constitution. The treaty came into force on 27 February 2005. It had been signed by 168 countries and is legally binding in 181 ratifying countries. There are currently 15 United Nations member states that are non-parties to the treaty (nine which have not signed and six of which have signed but not ratified).
For some background to the establishment see Origins of the WHO Framework Convention on Tobacco Control
The FCTC, one of the most quickly ratified treaties in United Nations history, is a supranational agreement that seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by enacting a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. To this end, the treaty's provisions include rules that govern the production, sale, distribution, advertisement, and taxation of tobacco. FCTC standards are, however, minimum requirements, and signatories are encouraged to be even more stringent in regulating tobacco than the treaty requires them to be.
The Fourth Pillar of the Framework Convention on Tobacco Control: Harm Reduction and the International Human Right to Health
The Framework Convention on Tobacco Control (FCTC), while successful in its execution, fails to acknowledge the harm reduction strategies necessary to help those incapable of breaking their dependence on tobacco. Based on the human right to health embodied in Article 12 of the International Covenant on Economic, Social and Cultural Rights, this article contends that international law supports a harm reduction approach to tobacco control. Analyzing the right to health as an autonomy-enhancing right, countries must prioritize health interventions to promote those treatments most likely to increase autonomy among those least able to control their own health behaviors. Harm reduction can involve the use of novel, purportedly less hazardous tobacco products. By dissociating nicotine from the ancillary carbon monoxide and myriad carcinogens of smoking, these tobacco harm-reduction products may allow the individual smoker to retain addictive behaviors while limiting their concomitant harms. These less hazardous products, while not offering the preferred benefits of abstaining from tobacco entirely, might nevertheless become a viable strategy for buttressing individual autonomy in controlling health outcomes. Working through the FCTC framework, countries can create the international regulatory and research capacity necessary to assess harm-reduction products and programs.
Excellent piece from The Counterfactual by Clive Bates as he explains: Options for WHO FCTC involvement in ENDS to be positive for global public health
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The FCTC has failed to make measurable progress on its core mission, to reduce smoking. Indeed smoking rates have increased by 500 cigarettes per person in many LMICs (Acording to this report https://www.bmj.com/content/365/bmj.l2287) .
Something clearly needs to be done differently. Embracing THR would likely help, but institutional change is required before this can happen. Pressure is being put on UK and NZ particularly, to both use their influence to change the direction of the WHO. The UK is uniquely placed to apply leverage, as a major funder of the FCTC operation, to the tune of £4 million per year. In addition the UK Government has provided staff (on secondment) and additional grants to the WHO for the FCTC.
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