The text of the Framework Convention on Tobacco Control (FCTC)-agreed by 171 countries at the beginning of March-was regarded by the World Health Organisation as "a real milestone in the history of global public health". The text covers tobacco taxation, smoking prevention and treatment, illicit trade, advertising, sponsorship and promotion, and product regulation, and is due to be presented to the World Health Assembly later this month for adoption. Once adopted, the FCTC will be opened for signature on June 16 by member states, and the treaty will come into force shortly after it has been ratified by 40 countries. All signatory parties will have to implement comprehensive tobacco-control programmes and strategies under what will become the first legally binding international treaty on tobacco control.
'If [George W] Bush does not sign, though' comments the editorial, 'the FCTC will become another example of the "dangerous rise of American exceptionalism", where the USA opts out of collective action claiming that international laws apply only to other countries.'
The editorial concludes: 'The evidence that tobacco products kill or disable is incontrovertible…Remember your people's health, President Bush, and that of non-Americans, and sign the current text of the FCTC without further ado.'
A commentary (The dangerous rise of American exceptionalism, p 1579) by Martin McKee and Richard Coker from the London School of Hygiene and Tropical Medicine, UK, gives a wider perspective on US Government policies and their public-health implications. They comment: "In the international arena the USA has opted out of a series of collective initiatives, many of which have potentially important consequences for health, security, and human rights. These initiatives and treaties include topics such as the banning of land-mines, the International Criminal Court, and the promulgation of antiballistic missiles. The decision to send captured fighters from Afghanistan to Guantanamo Bay, Cuba, where they are held in legal limbo, is viewed by some as a withdrawal from the Geneva Convention. In other areas, US officials have stayed at the table but sought to undermine effective action, as with the Framework Convention on Tobacco Control or the quest for concerted action on climate change (the Kyoto Protocol)." They conclude: "The USA has always prided itself in being different, and diversity can often be a strength, but it is in nobody's interests if it becomes too different from the rest of the industrialised world."
Contact: Professor Martin McKee, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
T) 44-207-927-2229;
E) martin.mckee@lshtm.ac.uk
Journal
The Lancet