Director-General's Office

17th World Conference on Tobacco or Health

Dr Tedros Adhanom Ghebreyesus
Director-General of the World Health Organization

Cape Town, South Africa
7 March 2018

My brother Aaron Motsoaledi, honourable Minister of Health, Dr Flavia Senkubuge, President of the World Conference on Tobacco or Health, my sister Precious Malebona, Global Ambassador Michael Bloomberg, Mayor Patricia de Lille,

Honourable Ministers, distinguished guests, ladies and gentlemen.

It’s wonderful to be here in this beautiful city for this important conference.

I want to start by thanking the Government of South Africa for hosting us.

WHO is honoured to be a co-sponsor.

Also I would like to recognize the youth. Our hope is with you.

This is my first World Conference on Tobacco or Health. I wanted to be here personally to show that WHO may have a new Director-General, but we have the same determination to wage war on tobacco, and to win.

It’s a war that we have been waging for many years now, and together with Vera and her colleagues in the Convention, we remain steadfast in the fight.

It’s a war that we are winning.

Today, 6 in 10 people globally are protected by at least one of the six tobacco control best practices in the MPOWER package. That’s four times more people than in 2007 when WHO first introduced MPOWER to help countries implement the Convention.

It’s fitting that we are meeting in Africa because it is ground zero for the war on tobacco. Africa is at the heart of the Sustainable Development agenda, but is also seen as a growth market for the tobacco industry.

Africa has made great strides on some health issues, such as HIV/AIDS, but the tobacco problem is in its early stages and is not being given sufficient attention.

But there are many reasons for hope, and success stories to celebrate.

Gabon and Gambia have recently increased tobacco taxes.

Kenya is fighting the illicit tobacco trade through an advanced track and trace system;

Senegal implemented four tobacco control measures at the same time, including large graphic health warnings and a comprehensive ban on tobacco advertising, promotion and sponsorship.

Uganda has passed a comprehensive tobacco control law;

Graphic health warnings are now used in 8 African countries;

The West African Monetary Union is removing its ceiling on tobacco taxes;

And 13 of the 34 countries that have ratified the illicit trade protocol are in Africa.

Outside of Africa, countries like India, Nepal, Sri Lanka and Thailand have introduced large graphic health warnings.

Some megacities in China have implemented smoke-free laws.

In 2016, Uruguay won its landmark fight against Philip Morris over tobacco packaging and labelling.

And last year, four tobacco companies were forced to publish advertisements in U.S. newspapers and on TV channels admitting they had lied to the public about the dangers of smoking in their advertising and marketing campaigns.

And a number of other governments have fought off political and legal challenges to plain packaging or large graphic health warnings.

But there is more work to be done. We need to ensure that developing countries, some of which have the highest rates of tobacco consumption, take steps to implement the WHO Framework Convention on Tobacco Control.

We need more countries to introduce and increase tobacco taxes to drive down smoking rates and generate revenues to fund health systems.

We need to stop the illicit trade in tobacco products by bringing the WHO FCTC Illicit Trade Protocol into force.

And we need to do all of these things and more while fighting tobacco industry interference.

Just a few weeks ago, WHO’s Executive Board endorsed our new General Programme of Work – our strategic plan for the next 5 years.

It commits us to bold targets, including to see 1 billion more people enjoying better health and well-being by 2023. One of the key indicators for achieving that target is to reduce tobacco use globally by 25%.

We are working around the clock on pioneering initiatives, like using mobile and wireless technologies to help people quit, and the Partnership for Healthy Cities, where local leaders are learning from each other to create healthier urban environments. In these and other efforts we continue to partner with Bloomberg Philanthropies, the Bill and Melinda Gates Foundation and with many of you in this room.

Let me give you three key ways we can do that.

First, we must focus on accelerating implementation of the Framework Convention on Tobacco Control, especially in developing countries.

Today, the convention has 181 Parties. It has guidelines on implementation of many provisions and an optional protocol on illicit trade.

A great deal of work has been done since the Convention came into force in 2005 and now is the time for countries to live up to their commitments by accelerating the implementation of the Convention. For some countries this means ensuring that they comply with their obligations, such as tightening existing laws to eliminate smoking rooms and point-of-sale advertising.

Tobacco not only wrecks health and health systems; it’s a drain on economies and the environment.

Every year, tobacco use kills about 7 million people, and many more people develop serious illnesses such as cancers, chronic respiratory diseases and heart disease.

This tears families apart and has an entirely preventable impact on health systems.

Tobacco also costs the global economy more than US$ 1 trillion annually in health spending and lost productivity. This is unacceptable.

We could help offset this cost if all governments raised excise taxes by about 80 U.S. cents per pack of cigarettes.

This would increase revenues by 47%, or US$ 140 billion, which could provide much needed funding for health systems.

It would also increase cigarette prices by an average of 42%, leading to a 9% decline in smoking rates and at least 66 million fewer smokers.

That’s exactly why tobacco taxes were included in the Addis Ababa Action Agenda as a way of financing development. I was honoured to chair the negotiation.

WHO has also documented the environmental impacts of tobacco. In a report published last year, WHO showed the many ways tobacco harms the environment.

Tobacco production is extremely water-intensive. Large amounts of water are used in areas where tobacco farms and factories are located.

This can put severe stress on local water reserves.

As a side note, let me remind you that we are meeting in a city that is experiencing a profound water crisis. Please make sure that you use water responsibly this week.

In addition, countless trees have to be cut down to cure tobacco leaves, and the waste from tobacco also contains over 7000 toxic chemicals, including some that cause cancer.

Emissions from tobacco products contribute thousands of tonnes of human carcinogens, toxicants and greenhouse gases to the environment.

All of this can be prevented if countries take action to implement the convention. Our message is implement, implement, implement the Convention. It is comprehensive.

Second, we must eliminate the illicit trade in tobacco products.

The “legal” cigarette market is bad enough. But the illicit trade of tobacco products creates a shadowy market that not only destroys health, it fuels organized crime and deprives governments of tax revenues.

Imagine to what extent the tobacco industry is affecting the world in so many ways.

The Protocol to Eliminate the Illicit Trade of Tobacco Products will help countries put a stop to all this.

So far, 34 countries have ratified the protocol. We urgently need 6 more by the second of July this year for it to come into force.

I urge countries in this room that have not ratified the protocol to do so.

I am writing to all Parties to the Convention, encouraging them to ratify the Protocol and bring it into force.

And this brings me to my third and final point. We must strengthen our efforts and scale up our actions while facing increasing interference from the tobacco industry.

We are all familiar with the catalogue of deception, lies and half-truths in which tobacco industry specializes.

Last year we witnessed the launch of the Foundation for a Smoke-Free World. It’s name sounds good. It has a nice website. It says its ultimate goal is to eliminate smoking. It claims to be independent. It is funded by the tobacco industry itself.

In September 2017, I signed a statement making clear that WHO will not partner with the Foundation for a Smoke-Free World. We call on governments and the public health community to have nothing to do with this foundation.

Tobacco companies, pushing tobacco products, are not our partners in answering questions about the merits of tobacco harm reduction.

But this is just one example of industry interference. Other examples include attempts to bribe officials in governments.

Even internal tobacco industry documents indicate that these efforts were designed to normalize the company and its deadly products. It shows they are doing this for themselves, not for the poor people suffering from tobacco.

Let me assure you that WHO will not sit on its hands in the face of industry interference. For example, in Uruguay’s fight with Philip Morris, WHO and the Convention Secretariat provided an independent legal opinion on the merit of its tobacco control legislation. Of course our brother Michael Bloomberg also generously supported Uruguay to meet the heavy legal costs it incurred.

We have taken similar action to fight legal disputes over plain packaging in other countries.

As we modernize WHO and transform the organization we will not shy away from fights like these where sound science and public health policy is threatened by the tobacco industry.

We will also take action at the highest political levels.

I am honoured that four presidents – from Chile, Finland, Sri Lanka and Uruguay – have joined Dr Sania Nishtar in chairing the WHO Global Independent High-level Commission on NCDs, a body that also includes nine health ministers, including my brother Aaron, the former president of Botswana, civil society leaders and our friend Michael Bloomberg.

I have asked the Commission to come up with bold, innovative and practical recommendations to reverse the tide of the NCDs epidemic. I expect to receive its initial findings in June. The Commission will play an important role ahead of this year’s UN General Assembly High-level Meeting on addressing NCDs and promoting mental health and wellbeing.

I am urging all heads of state to participate in this UN meeting and demonstrate their country’s progress in addressing this immense – yet winnable – health challenge.

Ladies and gentlemen,

Ultimately, our tobacco control efforts must be embedded in efforts to achieve universal health coverage for all people, everywhere.

That means giving doctors, nurses and community health workers the information and tools they need to help people quit, and to provide treatment services for tobacco-related illness.

The best way to do that is in the context of strong primary care, that puts people and their health needs at the centre of service delivery. This also calls for movements in schools and heavy media campaigns. The three can bring strong results: primary health care, school interventions and media campaigns.

In this respect, prevention and care go hand in hand. If we do not protect people from tobacco now, the costs of health care, and economic loss, will be catastrophic.

WHO will continue to stand with you, and all who want to protect their people from the harms of tobacco.

We have made great progress. But we have a long road ahead of us. We must not stop. And we must work together.

Congratulations to all of you for your tireless efforts. You are on the right side of history.

To young people I say, be cool, don’t be a smoking fool!

I thank you.