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Proceedings INGCAT International NGO MObilisation Meeting Geneva, 15-16 May, 1999.

WHO and NGO Partnerships
for Global Tobacco Control
Gro Harlem Brundtland, MD Director-General,
World Health Organisation

Distinguished guests,

I am delighted to be speaking at this forum. A year ago in this very room, I told the Executive Board that health is everybody's concern and that together, we as an organisation, would strive the place public health at the top of national and internal ional agendas.

A year into my new responsibilities, I remain convinced that this is the way to go. We have to take a broad view on health issues. Health is not just about hospitals, x-rays and tablets. Health is about life and living and individual and social responsibility. It leaves nobody indifferent. Heal th is everybody's concern. At the dawn of the next century we have to ensure that health issues emerge and remain as a major area of national and internatior al concern and action.

This will not happen automatically. We have to seize the initiative. The good news is that we have science and evidence, truth, public heuth and justice on our side. With clear objectives, concerted action and a little bit of luck. we should be able to make our point.

WHO cannot do this alone. The NGO community is a natural ally in our struggle to give health and related issues tie profile they deserve in places where policy is made land resources are allocated. It was a campaign goal to integrate the NGO community more closely into our work. The Tobacco Free Initiative (TFI) has taken the lead in ensuring NGO presence in all its activities.  Some NGOs serve on TFI's Policy and Strategy Advisory Committee while others are already working in the Region.  

Health is about life and living and individual and social responsibility.   It leaves nobody indifferent. Very early in its life, TFI called a small group of international, NGOs and media people to a seminar on tobaccd industry disclosures here at WHO. This was part of its search for the best evidence in addressing a key public health issue, and to look at the role of an international organisation like WHO in profiling and addressing it. Clearly WHO has the scientific and moral authority necessary for global tobacco control.

It was pointed out to us that WHO should help collect and collate evidence to show how the tobacco industry had positioned itself. WHO is serious about enlarging the scope of NGO interaction further. Whilie we have met with small groups of NGOs in the past year, this is the first time that we have what can be called a WHO-NGO meeting. It seems only right thilt we are directing our combined energies at tobacco.

Make no mistake. Diven;e and different as we and our constituencies are, we face a common threat from the tobacco epidemic. Whether we represent farming communities, women's organisations, professional medical groups or consumer organisations, we all stand to lose if we do not stem the tide of tobacco that kills people even as it saps national treasuries.

Tobacco kills 4 million people per year. By 2030, tobacco will kill 10 mill ion people per year, over seventy percent in the developing world. There is nothing inevitable about this -we don't have to helplessly count the dead. As we go from one century to the next taking with us astounding gains in medicine and science, one story that stands as woefully neglected is the tobacco story.

The reasons for this appalling neglect are many, but none of them are scientific, just or reasonable. That makes our struggle both easy and difficult. Easy because the science that underpins our action is indisputable. Difficult because the tobacco industry's spread and grip is as silent as the epidemic itself.

The globalisation of tobacco trade and marketing , represents a real challenge for us. As the tobacco industry documents make clear, the industry acts as a global force.

That is why public health :1eeds to cross borders, and itself serve as a global force.

I spoke of the NGO comrrcunity as a "natural ally" in our search for justice and equity. I speak from personal experience. Over ten years ago the World Commission on Environment and Development, which I had the honour to chair, gave me ample opportunity to see just how effective the NGO movement can be in shepherding national debates dn an international issue.

It was clear to all of us in the Commission that if sustainable development was to have any meaning, it would have to be integrated into the broader equation of development, environment and equity. The "NGO- eye" was quick to spot this critical link. We all had to be curious, innovative and daring.

The NGO World has o ten been first to identify threats to society. Whether it be the question of breast-milk substitutes or landmines, saving trees, the world's water resources or protecting future generations from a nuclear holocaust, the NGOs have pushed governments and policy makers to act on the evidence.

In the area of human rights and individual freedoms, the role of the NGOs has been particularly remarkable. Stone walls have crumbled and tanks have stopped rolling because NGO action has helped governments and societies re-write rules and in some cases, even history. The list is long, the actions many. But what unites all these strug gles is the search for justice whether it be social, political or economic. Public health belongs to this league.

And now back to tobacco. WHO and its Member States are in the process of negotiating a Framework Convention on Tobacco Control (FCTC). It will be the first time that we, as an Organisation, are exercising our constitutional mandate to negotiate conventions.  Through the convention process, we want to unite the best of science, best of evidence, best of law and best of economics to address a public health threat that kills one human being every ten seconds.  People should expect nothing less from the world's lead health agency.

Tobacco is a global problem that needs global solutions such as those that will be crafted though the FCTC process.  Our intentions are clear.  We don't expect the world to be smoke free just because of our work.  Neither do we expect our task to be easy.  But we believe that the process of negotiating this Convention will serve to hold up mirrors and spread knowledge, commitment and the necessary awareness.   The FCTC will provide a long-term mechanism for co-ordinating the actions of countries and communities in addressing the tobacco pandemic.

The world counts 1.2 billion smokers today.  If our combined efforts succeed in holding that figure or bringing that down by two to three hundred million, we would have advanced the cause of public health in a significant way.

We now have new insights thanks to the court cases in the United States.   We now have documentary evidence to show how the tobacco industry systematically subverted science, sold addiction as an act of free choice and spared no one as they claimed new markets, increasing the number of victims.  The World No Tobacco Day this year focuses on cessation.  But to every person out there who may be thinking of lighting the first cigarette today, I would like to say don't, your addiction may be programmed.

In our view there is no freedom more sacrosanct than the public's right to know and the right to make informed choices.  As for our priorities, they will be decided by science and evidence.  The evidence on the ground tells a horrible tale of public health disaster brought about by tobacco and tobacco smoke.

The obvious question now is -- what role do NGOs play to help the FCTC process?  As we see it, the primary role of NGOs is to establish networks, formulate expectations from Member States (as well as from the WHO), provide technical expertise on issues, and monitor and expose abuses.

NGOs working together in a loose network can help mobilise public and political support for the FCTC.  A major contribution of the NGO community to our process would be to cut through the dense and opaque "diplomatese and legalese" that surround the issues thereby rendering them more human so that their public health impact becomes visible.  The non-governmental sector can educate and activate.

The FCTC is not just any Convention - it is potentially a public health movement.  WHO does not and cannot have any ready-made solutions.  WHO can only act as a ctalyst.  The right mix of policy interventions will be decided by Member States, by parliaments, governments and civil society.

This is why we need your work and support.  We are in this together, tosave lives and to give children and young people a real choice.

Thank you.