12.43. The representative of the World Health Organization (WHO) said that, as the WHO had previously stated in this forum, tobacco use was one of the greatest threats to public health the world had ever faced, and the single most preventable cause of death in the world today. Globally, tobacco consumption killed nearly six million people a year through both direct use and the deadly effects of second-hand smoke - more than 70% of whom resided in low- and middle-income countries.
12.44. Tobacco also represented the leading modifiable risk factor in the fight against the growing epidemic of non-communicable diseases (NCDs). NCDs, primarily cancers, diabetes, cardiovascular and chronic lung diseases, currently accounted for 63% of all deaths worldwide. These diseases killed an astounding 36 million people each year, with nearly 80% of deaths occurring in low- and middle-income countries.
12.45. As necessary tobacco control measures continued to be implemented in developed countries, the tobacco industry, through aggressive marketing and interference practices, had shifted some time ago its focus to new markets in the developing world. As a result, tobacco-attributable mortality was rapidly increasing in developing countries, and, by 2030, more than 80% of the world's tobacco deaths would occur in low- and middle-income countries. Given that smoking caused 30% of all cancers, including greater than 70% of all lung cancers, 40% of chronic respiratory diseases, and nearly 10% of all cardiovascular diseases, it was a critical moment in the global effort to curb the tobacco epidemic through the introduction of necessary public health interventions under the WHO FCTC, like the measure under consideration here.
12.46. The economic costs of tobacco use were equally as devastating as the public health costs. Though the tobacco industry routinely cited the economic contribution of tobacco, the reality was that tobacco use put an enormous financial burden on countries, in addition to the fact that tobacco and poverty were inextricably linked at the individual level. Nationally, the costs of tobacco use encompassed increased health-care costs, lost productivity due to illness, premature death, and widespread environmental damage. Thus, as tobacco consumption rates and tobacco-related illnesses increased in developing countries, so did tobacco-related healthcare costs. Additionally, conservative estimates suggested that tobacco's more than US$500 billion drain on the world economy exceeded total annual health expenditures in low- and middle-income countries.
12.47. The economic burden of NCDs, with tobacco representing the largest risk factor, was also staggering. Recent macroeconomic simulations suggested that, over the next two decades, cardiovascular disease, chronic respiratory disease, cancer, and diabetes, would cause a cumulative output loss of more than US$30 trillion, representing 48% of global GDP in 2010. This in turn would push millions of people across the planet below the poverty line. She said that, because NCDs would result in long-term macroeconomic impacts on labour supply, capital accumulation and GDP worldwide, with the consequences most severe in developing countries, strong public health interventions, like the plain packaging measure under deliberation here, were relevant in addressing both health and economic concerns.
12.48. She said that the WHO wished to draw the Council's attention to the fact that the impact of tobacco and NCDs on both public health and country economies had been highlighted at the recent United Nations High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, held in September 2011 in New York. At that meeting, the UN General Assembly, comprised of Heads of State, had adopted a Political Declaration which recognized the fundamental conflict of interest between the tobacco industry and public health, and wherein Member States unanimously committed to advancing the implementation of multi-sectoral, cost-effective, population-wide interventions in order to reduce the impact of NCD risk factors.
12.49. The WHO was of the view that the implementation of plain tobacco product packaging, representing a legitimate tobacco control measure, would have a substantial impact on tobacco consumption, was fully in line with the spirit and intent of the outcome of the UN High-level Meeting, and was in accordance with international legal obligations under the WHO FCTC.
12.50. Another representative of the WHO said that the FCTC had been negotiated under the auspices of the WHO in response to the globalization of the tobacco epidemic, and had been in force since 2005. Like other international legal instruments, States that were party to the FCTC undertook certain obligations. The number of States that were party to the Convention had risen to 176 - only 14 of the current 159 WTO Members were not Party to the FCTC. New Zealand had signed and ratified the FCTC among the first forty States that were required for the entry into force of the Convention.
12.51. She said that the FCTC contained a number of provisions that were relevant to the issue of plain packaging of tobacco products. As noted during previous sessions of the TRIPS Council, the FCTC set out in Article 5 the general obligations of Parties, including, inter alia, the obligation to "develop, implement, periodically update and review comprehensive multi-sectoral national tobacco control strategies, plans and programmes in accordance with" the FCTC. The recognition by the States Parties of the effectiveness of comprehensive multi-sectoral measures in the fight against the global tobacco epidemic was a theme that recurred throughout the Convention and the obligations it contained. It was through the implementation of such a comprehensive multi-sectoral approach that the tobacco control measures contained in the FCTC were most effective.
12.52. Turning to the matter of the plain packaging measures for tobacco under discussion, she said that Article 11 of the Convention required Parties to adopt and implement effective measures in respect of the packaging and labelling of tobacco products, including health warnings and other appropriate messages. According to the most recent Party reports on implementation, which were required pursuant to Article 21 of the Convention, 93 Parties had reported to have banned descriptors on packaging and labelling that were misleading, deceptive or likely to create an erroneous impression of the product, and 104 Parties had reported to have adopted policies requiring tobacco product packaging to carry health warnings describing the harmful effects of tobacco smoke. In addition, 97 Parties had introduced measures to ensure that health warnings were large, clear, visible and legible. After seven years of implementation, Article 11 was one of the articles of the Convention attracting the highest implementation rates among Parties.
12.53. She said that another specific provision of the FCTC that had been previously noted in this Council was Article 13, which required Parties to undertake a comprehensive ban of all tobacco advertising, promotion and sponsorship. That comprehensive ban had to be read in light of the broad definition of "tobacco advertising and promotion" which, according to Article 1(c) "means any form of commercial communication, recommendation or action with the aim, effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly." The Guidelines for the implementation of Article 13 adopted by consensus by the Parties included "packaging and product design features" on the indicative list of forms of advertising, promotion and sponsorship. The most recent Party reports indicated that 86 Parties had introduced a comprehensive ban on tobacco advertising, promotion and sponsorship.
12.54. The governing body of the Convention, the Conference of the Parties or COP, had adopted at its 4th session in November 2010 the Punta del Este Declaration (Decision FCTC/COP4(5)) regarding public health policy, international trade and the activities of the tobacco industry. The Punta del Este Declaration reiterated the firm commitment of Parties to the FCTC "to prioritize the implementation of health measures designed to control tobacco consumption" and made specific reference to Articles 7 and 8 of the TRIPs Agreement, as well as to paragraphs 4 and 5(a) of the Doha Declaration on the TRIPS Agreement and Public Health.