New Delhi: Last week, the innocuously named Foundation for a Smoke Free World (FSFW), was once again embarrassed by the World Health Organisation (WHO). The WHO’s director general Dr Tedros publicly condemned the efforts of this foundation to influence anti-smoking and public health policy globally.
This is the foundation’s third denouncement from the WHO.
The FSFW was set up in 2017 with $80 million funding from the tobacco company Philip Morris International (PMI), which makes Marlboro cigarettes among others.
The Wire has learnt that the WHO’s director general Dr Tedros Adhanom Ghebreyesus made strong public comments about this foundation during the WHO’s executive board meeting in Geneva last week. This was during a discussion on the role of non-state actors in the WHO.
A delegate who was present at this meeting told The Wire that a few countries and non-state actors had raised the issue of this PMI funded foundation and its overtures into public health by promoting e-cigarettes. The issue came up because delegates were uncomfortable with a letter written by the foundation’s president Derek Yach in January, to the members of the WHO’s executive board, asking for a partnership.
Tedro’s comments in Geneva were later followed up by tweets from two of the WHO’s official handles.
“WHO will NOT partner with Philip Morris-funded Foundation for a Smoke-Free World nor any other group funded by the tobacco industry. Governments and the public health community should follow this lead,” said the WHO in a tweet. It also included a short video that said, “Stop tobacco industry interference.”
WHO will NOT partner with Philip Morris-funded Foundation for a Smoke-Free World @SmokeFreeFdn nor any other group funded by the tobacco industry.
Governments and the public health community should follow this lead https://t.co/i3lcUPkA8B #NoTobacco #EB144 pic.twitter.com/uw0H5y312K
— World Health Organization (WHO) (@WHO) January 31, 2019
Another official handle of the WHO also commented on the issue, referencing Article 5.3 of the Framework Convention on Tobacco Control (FCTC). This article asks public health stakeholders to ensure that their tobacco control policies are protected from commercial and other vested interests.
WHO FCTC’s Art. 5.3 obliges Parties to act to protect public health policies from commercial & other vested interests of the tob industry in accordance w/national law. Art. 5.3 s’guidelines state clearly that govts should limit interactions w/ the tob industry & avoid partnership
— WHO FCTC (@FCTCofficial) February 1, 2019
Why does the FSFW want to partner with the WHO?
In Derek Yach’s letter to the WHO in January, he tries to convince the global health body why they should partner with his foundation.
“As you meet this January in Geneva, we hope you will review and consider how best to work with the Foundation to facilitate a rapid reduction in the use of lethal cigarettes,” says Yach in his letter.
Yach worked extensively with the WHO in preparing the FCTC which was adopted in 2003. The FCTC seeks to control tobacco use globally and is prescribes measures to ensure freedom from the influence of the tobacco industry. He calls himself a “lead architect” of the convention.
In Yach’s letter, he says his foundation is “ready to accelerate work with WHO” and that the latter should “consider how best to work with the Foundation to facilitate a rapid reduction in the use of lethal cigarettes” and that the foundation’s work should be “full leveraged by the WHO.” He says it is important that his foundation’s goals are aligned with and support the WHO and FCTC.
Why is the WHO condemning the FSFW’s work?
The FSFW has enthusiastically courted the WHO despite the latter’s two denouncements in September 2017. The Wire reported that Derek Yach was still undeterred. As of December 2017, he was still writing to top officials at the WHO, seeking for a partnership.
In 2017, in a press release, the WHO said it would not partner with the foundation and neither should other governments or the larger public health community. Another press release said collaborating with the FSFW would be a breach of the FCTC because of the tobacco industry’s interference in this foundation, in this case, Philip Morris, which has given $80 million to it.
In response, Yach asked the WHO to withdraw the press releases from its website.
Hundreds of other organisations denounce the foundation
Last month, 300 organisations and individuals wrote to the WHO, asking them to reject the foundation’s attempts at partnership: “Reinforce WHO’s 2017 notice to governments and the public health community to reject any affiliation with FSFW,” they said.
With this third statement from the WHO, the global body has reinforced their 2017 dismissal of the foundation.
In 2017, The Wire reported that professors at top public health schools like at the Institute of Development Studies, London School of Economics and University College London have refused to partner with this foundation. Some 17 US universities, including Harvard and Johns Hopkins, also rejected the funding later.
Some global health organisations have called the foundation’s grants a “billion dollar bribe” and “blood money”. The American Cancer Society says the foundation exhibits a “new twist out of the tobacco industry’s deadly playbook”.
Does this foundation want to end smoking?
The Foundation for a Smoke Free World was set up in 2017 with the sole funding of $80 million from Philip Morris.
Despite the funding, the foundation claims to be independent of Philip Morris and says they “cannot engage in activities designed to support PMI’s interests.” They claim to be interested in promoting smoke-free alternatives to cigarettes, such as e-cigarettes.
But this is directly in the interest of PMI: the company has been lobbying in the US for approval of their e-cigarette product named iQOS. A series of Reuters investigations showed alleged “irregularities” in the clinical trials for the iQOS and that PMI officials have also been lobbying health officials around the world.
Yach’s letter to the WHO ends with this line: “Our goal is the same—to end smoking in this generation.”
However here again, the foundation comes up ambiguous. Twelve months ago, The Wire reported that the foundation refused to answer if its funder, PMI, should stop making cigarettes.
It is thus unclear how the foundation visualises and hopes to achieve a “smoke-free world,” even as cigarette production thrives, which would seem to be at odds with the foundation’s mandate.
E-cigarettes have been marketed as alternatives to conventional pre-rolled cigarettes, with the claim that they have “reduced harm” in comparison to cigarettes. Yet, it is not clear what other harms they may have. It is also not clear if e-cigarettes will act as a gateway into cigarette smoking, especially for young smokers.
For example, companies like Juul have been facing criticism for packaging their e-cigarettes in a way that are attractive to young consumers, targeting school-going children with the product. Incidentally, Philip Morris has been spun off from Altria and Altria bought a 35% stake in Juul in December 2018.
A recent article in The Wire noted that e-cigarettes like Juul “could be the future of quitting, or it could just be the future of the smoking habit”.