A global anti-tobacco treaty that came into force yesterday needs strengthening fast if it is to curb a killer that claims 5 million lives a year, a leading expert said.
Dr Derek Yach, the World Health Organization's former anti-tobacco chief who oversaw the drafting of the treaty, hailed the accord known as the Framework Convention on Tobacco Control as a first step.
However, he told reporters in an exchange of e-mails Thursday and Friday, the treaty lacks what are known in UN jargon as "protocols" -- additional agreements that toughen specific areas of a looser accord.
"The Framework without protocols is toothless," said Yach. "Yet even preliminary work on these is over a year from even being discussed, let alone planned for."
Yach, now professor of global public health at Yale University, was deeply involved in four years of often bitter negotiations brokered by the UN health agency. The talks led to the treaty being finalized in May 2003.
The accord aims to reduce substantially the number of deaths from tobacco-related illnesses -- such as cancer and heart disease -- which WHO estimates kill one smoker every 6.5 seconds.
There are an estimated 1.2 billion smokers in the world. WHO surveys show that smoking rates among 13- to 15-year-old children are about 20 percent, and health officials fear a disease time bomb as the world's population grows.
By 2010, the annual death toll is expected to double to 10 million -- with 70 percent of the victims in developing countries least able to pay for treating smoking-related illnesses.
The treaty -- usually known to insiders as the FCTC -- requires countries that ratify it to restrict tobacco advertising and sponsorship, put tougher health warnings on cigarettes and limit the use of language like "low-tar" and "light." They also are meant to enact price and tax hikes, create controls on secondhand smoke and sales of cigarettes to youngsters, as well as clamp down on smuggling.
But governments, particularly those that have few existing anti-tobacco policies, need clear guidelines on what exactly they should do, said Yach.
"Evidence suggests that the only way to have a rapid impact on deaths from tobacco is to step up cessation efforts and combine them with smoke-free policies," he said. "However, the language of the FCTC is relatively weak on these issues."
With the new rules in place, studies suggest the demand for cigarettes would only fall 1 percent to 2 percent a year, WHO officials have said.
"No targets were ever discussed for the FCTC, so we do not have a sense of what constitutes success," said Yach. "Is a 2 percent decline good news, or should we aim for 6-8 percent?"
"The degree of urgency for reducing consumption remains low, certainly compared to a program like `3 by 5' with a clear goal," he said, referring to a WHO plan to get HIV/AIDS drugs to 3 million people in poor countries by the end of this year.
Poor countries also will need substantial financial help to get the treaty's provisions in place, Yach said.
With the tobacco accord in force, ratifying countries are supposed to enact the reforms. There are no penalties if they fail to do so, but their record would be examined at future UN anti-tobacco conferences, the first of which is scheduled for February next year.
"Now that this global treaty has become international law, it is no longer business as usual for `Big Tobacco,'" said Akinbode Oluwafemi of Environmental Rights Action, a Nigerian-based group that was part of a global coalition supporting the treaty.