50th DIRECTING COUNCIL 62nd SESSION OF THE REGIONAL COMMITTEE

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PAN AMERICAN HEALTH ORGANIZATION WORLD HEALTH ORGANIZATION 50th DIRECTING COUNCIL 62nd SESSION OF THE REGIONAL COMMITTEE Washington, D.C., USA, 27 September-1 October 2010 Agenda Item 4.17 27 September 2010 ORIGINAL: SPANISH WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL: OPPORTUNITIES AND CHALLENGES FOR ITS IMPLEMENTATION IN THE REGION OF THE AMERICAS Background 1. In September 2008, the PAHO Directing Council recognized that, notwithstanding some successful experiences in the Region in the area of tobacco control, progress has been uneven and it adopted Resolution CD48.R2 (1). 2. The references to this Resolution note with concern the increase in smoking among youth in some countries of the Region. Considering the aspect of gender, the main issue of the last World No Tobacco Day was tobacco marketing targeting women, the purpose of which was to raise awareness among governments about the growing smoking epidemic among women. Progress Report Regarding point 1(a) of the Resolution of the Framework Convention on Tobacco Control (FCTC) 1 3. Suriname and Bahamas ratified the Convention, bringing the number of States Parties to 27 (77% of the total PAHO Member States). 1 Table 1 shows the status of ratification of the Framework Convention on Tobacco Control (FCTC) in the Americas. The information provided is updated to 12 July 2010.

Page 2 Implementation of FCTC Measures Price- and tax-related measures to reduce the demand for tobacco Article 6 4. Although several countries (Bahamas, Brazil, Colombia, Guyana, Jamaica, Mexico, Nicaragua, Suriname, Trinidad and Tobago, and Uruguay) increased tobacco taxes, none ensured that they represent 75% of the retail price of tobacco products. At present, only three countries in the Region (Chile, Cuba, and Venezuela) have achieved this goal. Protection from exposure to tobacco smoke Article 8 5. Six countries (Canada, Colombia, Guatemala, Paraguay, Peru, and Trinidad and Tobago) joined the nations that have national or subnational legislation covering over 90% of the population that bans smoking in all enclosed public areas and work places, without exception. With Uruguay and Panama, this brings the total number of countries in the Region that are 100% smoke-free to eight. Conference of the Parties (COP) guidelines recommend that Article 8 be implemented within five years of the Convention s entry into force in each Party in December 2010; in six States Parties, this deadline will come and go without their having met this goal. Packaging and labeling of tobacco products Article 11 6. Six countries in the Region (Bolivia, Colombia, Mexico, Paraguay, Peru, and the United States) adopted regulations banning the use of misleading labels. They also required the use of pictorial warnings that occupy more than 30% of the main surfaces of tobacco product packaging. These six countries join the six pioneers (Brazil, Canada, Chile, Panama, Uruguay, and Venezuela), and Jamaica and Cuba (this last country is not a Party to the FCTC, therefore is not legally bound by it) that do not include images but meet the basic requirements of the FCTC, for a total of 14 countries that already comply with this measure. Furthermore, the Convention establishes a three-year period from the date the Convention enters into force for each Party as the deadline for compliance with this article. For 11 States Parties, this period will expire in December 2010 without their having met the article s minimum requirements. Tobacco advertising, promotion, and sponsorship Article 13 7. Colombia became the second country in the Region, after Panama, to pass a comprehensive law banning all forms of tobacco advertising, promotion, and sponsorship. Again, the Convention establishes a period of five years from the date the Convention enters into force for each State Party for implementation of this article. For 10 States Parties, this period will expire in December 2010 without their having fully complied with the provisions of this article.

Page 3 Table 1: Status of WHO Framework Convention on Tobacco Control (FCTC) in the Americas Mexico 28 May Brazil Costa Rica 21 August 2008 Panama 16 August Saint Lucia 7 November Suriname 16 December 2008 Canada 26 November Guatemala 16 November Bahamas 2009 Trinidad and Tobago 19 August Belize 15 December Argentina Uruguay 9 September Antigua and Barbuda 5 June 2006 Cuba Peru 30 November Venezuela 27 June 2006 Dominican Republic Honduras 16 February Dominica 24 July 2006 El Salvador Chile 13 June Ecuador 25 July 2006 Haiti Jamaica 7 July Paraguay Bolivia Guyana Barbados 15 September 15 September 26 September 2006 Grenada 14 August 2007 Nicaragua 9 April 2008 Colombia 10 April 2008 Saint Kitts and Nevis Saint Vincent and the Grenadines United States of America

Page 4 Regarding point 1(b) of the Resolution 8. PAHO has facilitated the sharing of experiences among countries to achieve implementation of the provisions of the Convention and facilitated technical cooperation agreements among countries. Regarding point 1(c) of the Resolution 9. There has been no significant progress on this point. In the vast majority of countries, there is still no intra- and interministerial unit to coordinate implementation of the FCTC, and when one does exist, it is rather weak. PAHO should play a more active role at the national level in helping the Region s ministries of health create or strengthen their coordinating units and in getting other relevant players involved. Regarding point 1(d) of the Resolution 10. Some subregional integration bodies, such as MERCOSUR and CARICOM, have made considerable progress by putting the issue of tobacco control specifically, discussions on the Convention and its effective implementation in their subregions of influence on their agendas. Regarding point 1(e) of the Resolution 11. There has been no significant progress on this point. PAHO should play a more active role at both the regional and national level in efforts to fund opportunities and support the preparation of proposals toward this end. Regarding point 2 of the Resolution 12. Seeking to make technical and financial support for Member States more effective and efficient, PAHO has promoted the articulation of partnerships and engaged in a coordinated effort with international and regional partners in the field of tobacco control. One example of this is the joint work with the Campaign for Tobacco-free Kids (CTFK) in Costa Rica, Guatemala, and Peru to push for the passage of tobacco control legislation and with the Inter-American Heart Foundation in El Salvador to promote ratification by that country of the Framework Convention on Tobacco Control (FCTC). 13. Furthermore, within the context of negotiations for the drafting of a Protocol on Illicit Trade in Tobacco Products (established within the framework of the FCTC), PAHO has worked with the FCTC Secretariat in fostering coordination between the health sector and sectors such as the economy, finance, and customs in the States Parties.

Page 5 14. It is important to point out that tobacco industry opposition is what is behind the slow progress. This opposition hinders all processes before, during and even after legislation has been passed. It bears noting that, in order to achieve significant progress in the Region, in addition to political will in the Member States, it will be necessary to join forces with civil society and other partners to take the appropriate action to curb the influence of the tobacco industry in the Region. To this end, the recommendations of Article 5(3) of the FCTC should be taken into account. Reference 1. Pan American Health Organization. WHO Framework Convention on Tobacco Control: Opportunities and Challenges for Its Implementation in the Region of the Americas (Resolution CD48.R2) [online], 48th Directing Council, 60th Session of the WHO Regional Committee for the Americas; 2008 29 Sept.-Oct.. 3; Washington, D.C.: PAHO; 2008 [cited 16 April 2010]. Available at: http://www.paho.org/english/gov/cd/cd48.r2-e.pdf. - - -