Author: Franklin Apfel MD, MHS, originally published October 6 2017 - Having worked on developing and implementing the UN Foundation funded - ‘Tobacco Kills - Don’t be Duped’ project - a global communication initiative in support of the Framework Convention on Tobacco Control (FCTC), while working at the World Health Organization (WHO), developing, promoting and passing the FCTC - a global treaty ratified by nearly 180 countries which have used it to strengthen tobacco control activities and curb tobacco related deaths, I am concerned about the recent budget commitment of Phillip Morris International (PMI) of 80 million US dollars a year for 12 years (nearly 1 billion US Dollars!) in the Foundation for a Smoke-Free World rather than the FCTC itself.

Though the Foundation for a Smoke-Free World founder and president-designate Dr. Derek Yach was a co-worker on the FCTC, there are, I believe, obvious concerns about industry influence, control, transparency, trust and agenda setting roles. There will be fierce divides between those who sign up  (e.g., “consequentialists” who are ok with ends justifying means approaches and can ignore the source of funds and behaviours of funders) and those that don’t (e.g. de-ontologists who see taking money from Big Tobacco as immoral). It will create big divides in the public health community.  How then can we reframe this planned approach to avoid these inevitable outcomes?  

Dr. Yach emphasises his belief that significant development of harm reduction agents; e.g. like vaporised nicotine products, will provide the economic basis for companies like PMI to actually shift out of the tobacco business.  However, he makes no mention of how, if or when PMI will phase out the tobacco business and stop advertising and promoting tobacco, especially in developing countries. There are questions that need answering in the framing of this initiative.

A Stronger Possibility for Reinvesting Tobacco Money in Public Health

I think that the only semi-successful model of reinvesting tobacco money in public health, is related to the Tobacco Settlements (e.g., see here), from herein called the ‘settlement model’. This ‘settlement model’ of redistribution works because it builds on a punishment / penalty frame that has a ‘cleansing’ effect on the money and clearly takes it out of Big Tobacco hands and control and allows it to be used righteously to correct wrongs and does not rely on an ends justifies means arguments. 

In this case, where PMI is ready to donate 1 US billion dollars for independent research, the donation needs to be cast in a much more transparent redemption frame. Though Dr. Yach indicates that this 1 billion US dollar PMI funded agency will be academically, intellectually and politically independent and points to bylaws and articles of incorporation posted on the website, the money, I believe,  needs to be put into the hands of independent agencies that exist without PMI sponsorship.

Suggested Way Forward 

In this case, I would suggest that the FCTC itself could be the vehicle. PMI could make a voluntary donation (perhaps through a Member State) as a way of acknowledging previous wrongdoing (e.g., see interference with the FCTC process described in Reuters report above) and declaring their intent to go out of the tobacco business by 2030. PMI could then publish their withdrawal plan (that will, of course outline how they will protect their stockholders and stakeholders) and provide details of the research and products they think are needed to end the use of tobacco (e.g., as described by CEO of PMI, Andre Calantzopoulos, in Boca Raton in 2016). The FCTC would be greatly strengthened through the trebling of their budget and could agree on action plans through their existing mechanisms and the World Health Assembly.  

And there would be unity in the public health community as we march together towards a tobacco-free world! 

Views expressed are personal.

As head of communications for WHO Regional Office for Europe from 1995-2002, Dr. Apfel worked with senior WHO management on developing and implementing the UN Foundation funded - ‘Tobacco Kills  - Don’t be Duped’ project – a global communication initiative in support of the FCTC.

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