This section examines how the WHO FCTC has, since its entry into force, been integrated into two major UN General Assembly initiatives: the non-communicable diseases (NCD) agenda and the 2030 Agenda for Sustainable Development. This inclusion has raised the political standing of the WHO FCTC,1 and demonstrates its broader influence on the global governance of tobacco control.
19.1.1 WHO FCTC and the NCD agenda
NCDs, also known as chronic diseases, are the leading cause of death worldwide. The main types of NCD are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. NCDs claim 41 million lives annually, representing 74% of all global deaths. The NCD burden is disproportionately high in low- and middle-income countries, where they account for 77% of all NCD deaths and are rapidly increasing.2 Tobacco use is a leading risk factor for NCDs.2 The WHO FCTC is therefore closely linked to the global NCD agenda.
The WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 (Global Action Plan on NCDs)3 sets a voluntary target of reducing premature mortality from the four major NCDs by 25% by 2025. This is to be substantially contributed to by a 30% relative reduction in the prevalence of tobacco use in persons aged 15 and over by 2025. Appendix 3 of the Global Action Plan on NCDs includes a menu of policy options colloquially known as the ‘Best Buys’ and other recommended interventions for the prevention and control of NCDs.4 The six ‘Best Buys’ for tobacco control reflect provisions in the WHO FCTC.5 This includes an action to ‘accelerate full implementation of the [WHO FCTC]’, to ratify or accede to it at the earliest opportunity, and to implement a number of measures contained in the WHO FCTC in accordance with the guidelines. In 2019, the Global Action Plan on NCDs was extended to 2030 to align with the 2030 Agenda for Sustainable Development at the 72nd World Health Assembly.6
The critical role of the WHO FCTC has also been recognised in the outcome documents of three high-level meetings of the UN General Assembly on NCDs. The 2011 Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of NCDs (paras [8] and [43(c)] )7 enshrines a commitment to accelerate implementation of the WHO FCTC by States Parties, encourages non-Parties to consider becoming a party to the treaty, and recognises the fundamental conflict of interest between the tobacco industry and public health. This commitment was reiterated in the Outcome Document of the 2014 High-Level Meeting of the UN General Assembly on the comprehensive review and assessment of the progress achieved in the prevention and control of NCDs,8 and in the 2018 Political Declaration of the Third UN High-Level Meeting on NCDs.9
The Conference of the Parties to the WHO FCTC (COP), which is the decision-making body of the Convention (further discussed in Section 19.2), has also played a role in integrating the WHO FCTC into the global NCD agenda, particularly through decisions made at its sixth and seventh sessions.10,11 For example, the Moscow Declaration, adopted at COP6, called on Parties to strengthen collaboration on tobacco control to achieve the voluntary target of a 30% relative reduction in the prevalence of current tobacco use among individuals aged 15 years and over by 2025.1,12
19.1.2 WHO FCTC and the Sustainable Development Agenda
Implementation of the WHO FCTC has also been recognised as playing an integral role to the attainment of the 2030 Agenda for Sustainable Development. Entering into force on 1 January 2016, the 2030 Agenda for Sustainable Development — adopted by the UN General Assembly in September 2015 by Member States including Australia — consists of 17 Sustainable Development Goals (SDGs) and 169 related targets.
The SDGs, for the first time, explicitly incorporated the WHO FCTC into the global development agenda. Goal 3, which is on ensuring healthy lives and promoting well-being for all at all ages, includes a specific target on WHO FCTC implementation. Under Target 3a, countries commit to strengthen the implementation of the WHO FCTC in all countries as appropriate.13 Implementation of the WHO FCTC contributes to the attainment of several other goals. These include goals on no poverty (as tobacco use is concentrated among disadvantage populations and tobacco-related illness drives poverty) (goal 1), gender equality (goal 5), decent work and economic growth (goal 8) and reduced inequalities (goal 10). The WHO FCTC also supports several environmental SDGs due to tobacco’s environmental impact from deforestation, intensive farming, manufacturing and waste.
The Addis Ababa Action Agenda, the outcome document of the Third International Conference on Financing for Development to support implementation of the SDGs, is a further example of the integration of the WHO FCTC and the global development financial agenda. It expressly identifies strengthened implementation of the WHO FCTC by Parties to the Convention and the need for support mechanisms to raise awareness and mobilise resources.14 It also recognises that ‘price and tax measures on tobacco can be an effective and important means to reduce tobacco consumption and health-care costs, and represent a revenue stream for financing for development in many countries.’14
The UN Development Programme has also integrated tobacco control into its work to advance the sustainable development agenda, including by supporting the integration of the WHO FCTC into development planning processes.1,15 Further, Australia’s first Voluntary National Review submitted on the 2030 Agenda for Sustainable Development highlighted Australia’s role as a global leader in tobacco control and that its comprehensive tobacco control measures have seen the age-standardised daily smoking prevalence drop from 22.3% in 2001 to 14.7% in 2014-15.16
The COP has also played a role in contributing to this integration. The Delhi Declaration, adopted at COP7 – the first COP since the adoption of the SDGs, called on parties ‘to actively pursue the achievement of SDG Target 3.a and strengthen the implementation of the WHO FCTC’.17 The WHO’s Global Strategy to Accelerate Tobacco Control: Advancing Sustainable Development through the Implementation of the WHO FCTC 2019–2025 adopted at COP8 in October 2018 similarly highlights the need for integration of WHO FCTC obligations with the sustainable development agenda.18 The following sections of this chapter provide an overview of the substantive provisions of the WHO FCTC, including the compliance and enforcement mechanisms supporting its implementation, and the treaty’s impact and influence on other legal regimes. The chapter concludes by examining the treaty’s implications for Australia, with case studies on the role of the WHO FCTC in relation to Australia’s tobacco plain packaging measures, and the legal obligations placed on Australian public agencies and officials by the WHO FCTC as set out in Australian Government guidance.
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References
1. Zhou S and Liberman J. The Global Tobacco Epidemic and the WHO Framework Convention on Tobacco Control—The Contributions of the WHO's First Convention to Global Health Law and Governance, in Research Handbook on Global Health Law. Burci G and Toebes B, Editors. Edward Elgar Publishing; 2018.
2. World Health Organization. Noncommunicable Diseases Fact Sheet. 16 September 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
3. World Health Organization. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020. Available from: https://www.who.int/publications/i/item/9789241506236
4. World Health Organization. Tackling NCDs: Best Buys and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases. 2017. Available from: https://apps.who.int/iris/handle/10665/259232
5. Director-General - World Health Organization. Political Declaration of the Third High-Level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, and Mental Health: Draft Updated Menu of Policy Options and Cost-effective Interventions for the Prevention and Control of Noncommunicable Diseases. 10 January 2023. Available from: https://apps.who.int/gb/ebwha/pdf_files/EB152/B152_6-en.pdf
6. World Health Assembly. Decision WHA72(11)—Follow-up to the Political Declaration of the Third High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. 28 May 2019. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72(11)-en.pdf
7. Sixty-sixth Session of the United Nations General Assembly. Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of Noncommunicable Diseases, A/RES/66/2. New York. 19 September 2011. Available from: https://digitallibrary.un.org/record/710899/?ln=en.
8. Sixty-eighth Session of the United Nations General Assembly. Outcome Document of the High-Level Meeting of the General Assembly on the Comprehensive Review and Assessment of the Progress Achieved in the Prevention and Control of Non-communicable Diseases, A/RES/68/300. New York. 10 July 2014 Available from: https://digitallibrary.un.org/record/777809?ln=en.
9. Seventy-third Session of the United Nations General Assembly. Political Declaration of the Third High-Level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases - Time to Deliver: Accelerating our Response to Address Non-communicable Diseases for the Health and Well-Being of Present and Future Generations, A/RES/73/2, 10 October 2018. Available from: https://digitallibrary.un.org/record/1648984?ln=en.
10. Conference of the Parties to the WHO Framework Convention on Tobacco Control (Seventh Session). Contribution of the Conference of the Parties to Achieving the Noncommunicable Disease Global Target on the Reduction of Tobacco Use, FCTC/COP7(27), 12 November 2016. Available from: https://iris.who.int/bitstream/handle/10665/371488/fctc-cop-7-27-en.pdf?sequence=1.
11. Conference of the Parties to the WHO Framework Convention on Tobacco Control (Sixth Session). Towards A Stronger Contribution of the Conference of the Parties to Achieving the Noncommunicable Disease Global Target on Reduction of Tobacco Use, FCTC/COP6(16), 18 October 2014. Available from: https://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6%2816%29-en.pdf.
12. Conference of the Parties to the WHO Framework Convention on Tobacco Control (Sixth Session). Moscow Declaration, FCTC/COP6(26), 18 October 2014. Available from: https://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6(26)-en.pdf.
13. Seventieth Session of the United Nations General Assembly. Transforming Our World: The 2030 Agenda for Sustainable Development, ARES/70/1. New York. 2015. Available from: https://sdgs.un.org/2030agenda.
14. United Nations. Addis Ababa Action Agenda of the Third International Conference on Financing for Development. Addis Ababa, Ethiopia Available from: https://sustainabledevelopment.un.org/content/documents/2051AAAA_Outcome.pdf
15. United Nations Development Programme. Development Planning and Tobacco Control: Integrating the WHO Framework Convention on Tobacco Control into UN and National Development Planning Instruments. 4 December 2015. Available from: https://www.undp.org/publications/development-planning-and-tobacco-control-integrating-who-framework-convention-tobacco-control-un-and-national-development-planning.
16. Australian Government. Report on the Implementation of the Sustainable Development Goals. 2018. Available from: https://sustainabledevelopment.un.org/content/documents/20470VNR_final_approved_version.pdf.
17. Conference of the Parties to the WHO Framework Convention on Tobacco Control. Decision FCTC/COP7(29)—Delhi Declaration. 12 November 2016. Available from: https://fctc.who.int/publications/m/item/fctc-cop7(29)-delhi-declaration.
18. Conference of the Parties to the WHO Framework Convention on Tobacco Control. Measures to Strengthen Implementation of the Convention Through Coordination and Cooperation, FCTC/COP8(16), 9 October 2018. Available from: https://fctc.who.int/publications/m/item/fctc-cop8(16)-measures-to-strengthen-implementation-of-the-convention-through-coordination-and-cooperation.