Environmental Engineering Reference
In-Depth Information
the extent to which national control measures could be undermined by the global
tobacco industry:
The actions of individual countries can be ineffective, primarily because of the globalization
of trade, marketing, and information. Corporate interests in profits are no longer confined
by geography. Moreover, the globalization of the tobacco industry's marketing strategies
have contributed to a breakdown in local and national cultural barriers to tobacco use.
advertising and smuggling do not stop at national borders (brundtland 2000).
In this context of global change the Fctc was portrayed as 'a global complement
to national actions', an instrument capable of regulating 'globalized public health
threats, such as tobacco smuggling and cross-border advertising' (brundtland 2000).
Indeed, the negotiation of the Fctc can be regarded as the paradigmatic example
of the wHo's interest in developing new forms of health governance in response
to globalisation 'as an organizational strategy that promised survival and, indeed,
renewal' (brown, cueto, and Fee
2006).
1
Negotiating the FCTC
While the content of the final text is clearly vitally important to the future prospects
of the FCTC, its significance as an innovation in health governance resides primarily
in the process of its negotiation. this process has been discussed elsewhere (collin
2004, 2005; collin, lee, and bissell
2004; Yach
et al. 2007; wilkenfeld 2005). but an
understanding of the Fctc in the current context requires illustration of key features
such as the role of the world bank, the contribution of member states, and the terms
of civil society participation. the attempts of tobacco companies to undermine the
negotiations are then considered in more detail below.
The World Bank and the FCTC
establishing a broad-based accommodation with the world bank was a prerequisite
for Brundtland's reform strategy, reflecting both the dominant status of international
finance organisations within the Un system and the world bank's
de facto
displacement of the wHo as the world's leading international health agency (brown,
cueto, and Fee
2006; Buse and Walt 2000). The FCTC is doubtless less significant in
this context than brundtland's adoption of the disability-adjusted life year (DalY)
in assessing the cost effectiveness of health interventions, an approach taken from the
World Development Report 1993
(Yamey 2002b; see also world bank 1993); it also
also is less significant than the retreat from the Health for all agenda (thomas and
Weber 2004) or the prominence afforded officials from the International Monetary
Fund (IMF), the World Trade Organization (WTO), and the World Bank within the
commission on Macroeconomics and Health (brown, cueto, and Fee
2006). but
the Fctc did provide a valuable context within which to consolidate the wHo's
