Healthcare News

Concerns Over Influence Of Tobacco Firms In Low Income Countries - Mexico, Uzbekistan And Editorial

April 21, 2017

This week's BMJ raises serious concerns about the influence of global tobacco companies when they invest in low income countries.

For example, in 2004 the Mexican government agreed on tobacco control measures with the tobacco industry in return for contributions to a public health fund. The terms of the agreement included abandoning tax increases and restricting health warnings on cigarette packages. It also provided the industry with a tax subsidy worth $50 million.

These elements conflict with the World Health Organisation's antismoking treaty, the Framework Convention on Tobacco Control (FCTC), which Mexico ratified days before the agreement with the industry was announced.

The agreement comes with considerable future costs, warn the authors. It binds the fund to industry sales and makes it difficult for Mexico to enact stricter controls in future. It also provides the industry with an opportunity to improve its public image.

"We are concerned that this agreement is yet another example of industry efforts to seek voluntary agreements rather than endure effective government legislation as required by the FCTC," say the authors. "We urge Mexico to reconsider its pact with the tobacco industry and caution other nations against following its example."

Another article analyses British American Tobacco's erosion of health legislation in Uzbekistan. Using corporate documents, the authors show how BAT overturned legislation that banned advertising and smoking in public places as part of its investment conditions.

After the deal, tobacco advertising in Uzbekistan became ubiquitous, they write. Tobacco consumption has reportedly increased by 7% to 8% annually, primarily among young people, and cigarette sales rose by over 50% between 1990 and 1996. By 1999, BAT had achieved a market share of over 70%.

Documents suggest that such policy influence has not been confined to Uzbekistan. Safeguards are needed to prevent transnational tobacco companies influencing health policy when investing in low income countries, they conclude.

These experiences, as well as those in other developing countries, show that the tobacco industry has adapted to changing circumstances with ever more sophisticated strategies to protect its profits and forestall meaningful tobacco control legislation, argue Professor Stanton Glantz and Ernesto Sebrie in an accompanying editorial.

Seductive deals like the one in Mexico are incompatible with the FCTC, yet the WHO has not said whether the agreement violated the treaty. Failing such action, the multinational tobacco companies will replicate the Mexican agreement elsewhere, creatively using the Framework to consolidate their position and undermine global tobacco control, they warn.

BMJ Editor, Fiona Godlee adds: "It is depressing to hear from Ernesto Sebrie and Stanton Glantz that WHO has been silent about countries that fail to honour its framework convention on tobacco control. WHO took a brave stand a few years ago in facing up to its own tobacco links. Now is the time for WHO to speak out again."

Emma Dickinson
BMJ-British Medical Journal