WHO Framework Convention on Tobacco Control
Encyclopedia
The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is a treaty
adopted by the 56th World Health Assembly
on May 21, 2003. It became the first World Health Organization
treaty adopted under article 19 of the WHO constitution. The treaty came into force on February 27, 2005. It had been signed by 168 countries and is legally binding in 174 ratifying/accessioned
countries. There are currently 21 non-parties to the treaty (11 which have not signed and 10 which have signed but not ratified).
The FCTC, one of the most quickly ratified treaties in United Nations history, is a supranational agreement that seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by enacting a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. To this end, the treaty's provisions include rules that govern the production, sale, distribution, advertisement, and taxation of tobacco. FCTC standards are, however, minimum requirements, and signatories are encouraged to be even more stringent in regulating tobacco than the treaty requires them to be.
The FCTC represents a watershed moment for international public health
; not only was the treaty the first to be adopted under WHO's Article 19, but it also marks one of the first multilateral, binding agreements regarding a chronic, non-communicable disease
.
The FCTC was furthermore a watershed moment for the European Union. According to Mamudu and Studlar, since the adoption of the FCTC in 2003, "shared sovereignty through multilevel governance has become the norm in the tobacco control policy area for EU members, including having one international organization negotiate within the context of another." Worldwide tobacco control set a precedent for EU Commission participation and negotiation in multilateral treaties, and further defined the powers and capabilities of the EU as a supranational entity.
Under the auspices of tobacco activist Ruth Roemer, the WHO urged individual countries throughout the 1980s and 1990s to adopt national laws that have been shown to reduce tobacco use. The FCTC, however, marked the first time that the WHO went so far as to enact its international legal powers to address the problem. In fact, Roemer herself was among the original group of academics and tobacco activists who supported the idea of a framework-convention protocol approach (the rest of the group included Allyn Taylor, Derek , and Judith Mackay).
The idea for a multilateral treaty regarding tobacco control gained traction in 1994 at the Ninth World Conference on Tobacco or Health in Paris, France, when Roemer and Taylor presented their strategy for international legal action. Roemer and Allyn, along with Judith Mackay, were successful, and their proposal was adopted as one of the conference's first resolutions.
In 1995, the World Health Assembly (WHA), in Resolution 48.11, requested that the director general "report to the 49th World Health Assembly on the feasibility of developing an international instrument, such as guidelines, a declaration or an international convention on tobacco control to be adopted by the United Nations." In compliance with Resolution 48.11, the WHO employed Roemer and Taylor to draft a background paper on the various mechanisms available to the WHO in effectively controlling tobacco use worldwide. It was this background paper that provided a concrete recommendation for a framework convention, as opposed to alternative international legal action. According to it proponents, a framework convention would "promote global cooperation and national action for tobacco control."
Roemer and Taylor's proposal was met with some skepticism. Allan Brandt, the esteemed Harvard University historian of the tobacco industry, reports, "some considered it unrealistic, impractical, and overly ambitious, and preferred a nonbinding 'code of conduct." However, with the support of Derek , head of the Policy Coordination Committee at the WHO, the proposal gained momentum. Derek Yach became the first Director of the Tobacco Free Initiative in 1998 and steered development of the FCTC from then till its adoption in March 2003. Subsequently, Gro Harlem Brundtland was elected director general of the WHO in 1998. Brundtland, a Norwegian medical doctor with a Master of Public Health degree from Harvard University, threw her full support behind the idea for a binding multilateral treaty on tobacco control. Alongside malaria treatment and prevention, the nascent Framework Convention rose to the top of her agenda at the WHO.
A framework convention is typically justified for problems that necessitate international cooperation to effectively formulate policy. Prior to the FCTC, the majority of framework conventions addressed "environmental issues that were outside the control of individual nations." Thus, in proving that a framework convention was needed for tobacco control, treaty advocates invoked tobacco-related issues that could not be resolved by the actions of individual countries, such as the smuggling of tobacco and the leakage of tobacco advertisements from countries which lacked stringent regulation to those with restrictions on where and to whom tobacco companies could market their products. This initial justification of the framework convention is manifested in the preamble of the final version of the FCTC, which states the following issues as central to the treaty's aims:
The treaty is notable for its unprecedented inclusion of nongovernmental organizations throughout the negotiation and drafting processes. According to Elinor Wilson, the past Vice-President of World Heart Federation, "the FCTC is an excellent example of government/non-governmental collaboration through the Framework Convention Alliance resulting in global public health gains." Such collaboration between NGOs and the WHO forever changed the way that the WHO treats nongovernmental organizations, and in 2002 the WHO constitution was amended to reflect this shift in relations.
Much of the groundwork for the economic justification for the FCTC was laid by the World Bank. In order to counter concerns that international tobacco control legislation would unduly harm economies of which tobacco farming, manufacturing, and sale were an important part, the WHO cited a landmark World Bank publication entitled Curbing the Epidemic: Governments and the Economics of Tobacco Control (CTE), which asserted that tobacco control would not harm economies, other than a select few agrarian countries that were unusually dependent on tobacco production. Mamudu, Hammond, and Glantz reveal that "as a financial institution with substantial influence in developing countries, the Bank's publication of CTE threatened to undermine the tobacco companies' economic arguments" about the harmful effects of tobacco control.
Indeed, even before the treaty was publicly released, tobacco industry representatives embarked upon a concerted effort to thwart the efforts of FCTC drafters, in addition to participating policy-makers from individual WHO member states. Unable to argue against the overwhelming scientific evidence about tobacco's harmful health effects, the tobacco industry seized upon the FCTC's potential for economic harm. In response to the World Bank's CTE,the industry made a number of attempts to discredit the report, especially through the public relations efforts of the International Tobacco Growers' Association (ITGA) and by employing non-World Bank economists to release their own analyses. Between March 4–16 of the year 2000, the ITGA, financed by the tobacco industry, set out on what they dubbed a "Roadshow," during which ITGA representatives spoke to policy-makers in the developing countries of India, Kenya, Malawi, South Africa, and Zimbabwe, in addition to two "mini-Roadshows" in Argentina and Brazil, in order to voice ITGA opposition to the FCTC on the grounds that the CTE had underestimated the threat that tobacco control would pose to developing economies. Once negotiations for the FCTC were underway, the tobacco industry again made attempts to lessen the blow of international legislation on their business by lobbying delegates at the convention in Geneva. According to Mamudu, Hammond, and Glantz, however, "these efforts... did not undermine acceptance of CTE during the FCTC negotiations and CTE remained an authoritative economic analysis of global tobacco control."
Nevertheless, the FCTC acknowledges that its agenda will inevitably hurt farmers who currently depend on tobacco for their livelihoods. To that end, the treaty encourages Parties to help tobacco farmers make the transition from tobacco to alternative crops. Article 17 of the Framework Convention states: "Parties shall, in cooperation with each other and with competent international and regional intergovernmental organizations, promote, as appropriate, economically viable alternatives for tobacco workers, growers and, as the case may be, individual sellers." In particular, the FCTC favors sustainable development options over tobacco farming. To achieve this, Party governments and tobacco control advocates are encouraged to invest in better infrastructure, especially transportation, to ease farmers' access to new and foreign markets when making the transition, while simultaneously improving farmers' access to credit that may be necessary in converting their existing facilities.
World Map Status
is a non-party to the Framework Convention on Tobacco Control. When the signed treaty was put up for ratification, President George W. Bush failed to send the FCTC to the United States Senate for consideration, thereby preventing the full participation of the U.S in the implementation of the Framework Convention. In his book Cigarette Century, a finalist for the Pulitzer Prize, Allan Brandt characterizes Bush's reluctance in regards to the FCTC as "consistent with the failure to ratify other important conventions and the emerging ethos of American unilateralism."
Furthermore, the U.S. has sought to change certain provisions of the FCTC, but with limited success. Among the provisions opposed successfully were a mandatory ban on the distribution of free tobacco samples (which is now optional), a narrow definition of the term "minor" regarding the sale of tobacco (which now refers to domestic or national law) and broad limitations concerning the tobacco advertising, promotion and sponsorship (which were seen as violating free speech, and are now subject to constitutional limitations). Among the provisions unsuccessfully opposed by the U.S. were the requirement for warning labels to be written in the language of the country where the tobacco products are being sold, and the ban on deceptive and misleading descriptions such as "low tar" or "ultra-light", which might infringe on trademark
protections.
To date there are 20 other non-party states, 9 (as the U.S.A.) that have signed but not yet ratified (Argentina
, Cuba
, Czech Republic
, El Salvador
, Ethiopia
, Haiti
, Morocco
, Mozambique
, Switzerland
) and 11 that have not signed (Andorra
, Dominican Republic
, Eritrea
, Indonesia
, Liechtenstein
*, Malawi
, Monaco
, Somalia
, Tajikistan
, Uzbekistan
, Zimbabwe
).
According to Nikogosian, "most parties have now passed or are renewing and strengthening national legislation and policies to meet their obligations under the treaty." A 2010 update on the progress of FCTC implementation reported that 80% of Parties currently facilitate public information and/ or education programs on the dangers of tobacco, in addition to curbing underage tobacco consumption through laws that forbid retailers from selling tobacco products to minors. Furthermore, 70% of Parties have made "large, clear and visible health warnings" mandatory for tobacco packaging. However Nikogosian warns that the treaty is merely a "tool," and that its effectiveness hinges on how Parties implement the guidelines it sets forth. Going forward, FCTC implementation proves most difficult for developing and transition economies, due to a rift between their need for tobacco control and the resources to which they have access in meeting FCTC guidelines.
Treaty
A treaty is an express agreement under international law entered into by actors in international law, namely sovereign states and international organizations. A treaty may also be known as an agreement, protocol, covenant, convention or exchange of letters, among other terms...
adopted by the 56th World Health Assembly
World Health Assembly
The World Health Assembly is the forum through which the World Health Organization is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states....
on May 21, 2003. It became the first World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
treaty adopted under article 19 of the WHO constitution. The treaty came into force on February 27, 2005. It had been signed by 168 countries and is legally binding in 174 ratifying/accessioned
Vienna Convention on the Law of Treaties
The Vienna Convention on the Law of Treaties is a treaty concerning the international law on treaties between states. It was adopted on 22 May 1969 and opened for signature on 23 May 1969. The Convention entered into force on 27 January 1980. The VCLT has been ratified by 111 states as of November...
countries. There are currently 21 non-parties to the treaty (11 which have not signed and 10 which have signed but not ratified).
The FCTC, one of the most quickly ratified treaties in United Nations history, is a supranational agreement that seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by enacting a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. To this end, the treaty's provisions include rules that govern the production, sale, distribution, advertisement, and taxation of tobacco. FCTC standards are, however, minimum requirements, and signatories are encouraged to be even more stringent in regulating tobacco than the treaty requires them to be.
The FCTC represents a watershed moment for international public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
; not only was the treaty the first to be adopted under WHO's Article 19, but it also marks one of the first multilateral, binding agreements regarding a chronic, non-communicable disease
Non-communicable disease
A non-communicable disease, or NCD, is a medical condition or disease which is non-infectious. NCDs are diseases of long duration and generally slow progression. They include heart disease, stroke, cancer, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and...
.
The FCTC was furthermore a watershed moment for the European Union. According to Mamudu and Studlar, since the adoption of the FCTC in 2003, "shared sovereignty through multilevel governance has become the norm in the tobacco control policy area for EU members, including having one international organization negotiate within the context of another." Worldwide tobacco control set a precedent for EU Commission participation and negotiation in multilateral treaties, and further defined the powers and capabilities of the EU as a supranational entity.
Background
The WHO has long been active in preventing the myriad health issues that result from tobacco consumption. As the leading cause of preventable death globally, tobacco has seen an upsurge in both its consumption and its fatality rate worldwide with the increasing interconnectedness of the global economy. Thus, while tobacco related-diseases differ from the communicable diseases that have traditionally been the concern of the WHO, the effects of globalization have made tobacco increasingly relevant for such intergovernmental authorities.Under the auspices of tobacco activist Ruth Roemer, the WHO urged individual countries throughout the 1980s and 1990s to adopt national laws that have been shown to reduce tobacco use. The FCTC, however, marked the first time that the WHO went so far as to enact its international legal powers to address the problem. In fact, Roemer herself was among the original group of academics and tobacco activists who supported the idea of a framework-convention protocol approach (the rest of the group included Allyn Taylor, Derek , and Judith Mackay).
The idea for a multilateral treaty regarding tobacco control gained traction in 1994 at the Ninth World Conference on Tobacco or Health in Paris, France, when Roemer and Taylor presented their strategy for international legal action. Roemer and Allyn, along with Judith Mackay, were successful, and their proposal was adopted as one of the conference's first resolutions.
In 1995, the World Health Assembly (WHA), in Resolution 48.11, requested that the director general "report to the 49th World Health Assembly on the feasibility of developing an international instrument, such as guidelines, a declaration or an international convention on tobacco control to be adopted by the United Nations." In compliance with Resolution 48.11, the WHO employed Roemer and Taylor to draft a background paper on the various mechanisms available to the WHO in effectively controlling tobacco use worldwide. It was this background paper that provided a concrete recommendation for a framework convention, as opposed to alternative international legal action. According to it proponents, a framework convention would "promote global cooperation and national action for tobacco control."
Roemer and Taylor's proposal was met with some skepticism. Allan Brandt, the esteemed Harvard University historian of the tobacco industry, reports, "some considered it unrealistic, impractical, and overly ambitious, and preferred a nonbinding 'code of conduct." However, with the support of Derek , head of the Policy Coordination Committee at the WHO, the proposal gained momentum. Derek Yach became the first Director of the Tobacco Free Initiative in 1998 and steered development of the FCTC from then till its adoption in March 2003. Subsequently, Gro Harlem Brundtland was elected director general of the WHO in 1998. Brundtland, a Norwegian medical doctor with a Master of Public Health degree from Harvard University, threw her full support behind the idea for a binding multilateral treaty on tobacco control. Alongside malaria treatment and prevention, the nascent Framework Convention rose to the top of her agenda at the WHO.
Negotiation, drafting, and economic implications
It took three years for negotiators to come to an agreement on the terms of the FCTC. After being adopted by the World Health Assembly, the policy-making arm of the WHO, it officially went into effect in February 2005.A framework convention is typically justified for problems that necessitate international cooperation to effectively formulate policy. Prior to the FCTC, the majority of framework conventions addressed "environmental issues that were outside the control of individual nations." Thus, in proving that a framework convention was needed for tobacco control, treaty advocates invoked tobacco-related issues that could not be resolved by the actions of individual countries, such as the smuggling of tobacco and the leakage of tobacco advertisements from countries which lacked stringent regulation to those with restrictions on where and to whom tobacco companies could market their products. This initial justification of the framework convention is manifested in the preamble of the final version of the FCTC, which states the following issues as central to the treaty's aims:
- the dramatic increase in worldwide tobacco consumption;
- the escalation in smoking and other forms of tobacco consumption by children and adolescents
- the impact of all forms of advertising, promotion, and sponsorship aimed at encouraging tobacco use
The treaty is notable for its unprecedented inclusion of nongovernmental organizations throughout the negotiation and drafting processes. According to Elinor Wilson, the past Vice-President of World Heart Federation, "the FCTC is an excellent example of government/non-governmental collaboration through the Framework Convention Alliance resulting in global public health gains." Such collaboration between NGOs and the WHO forever changed the way that the WHO treats nongovernmental organizations, and in 2002 the WHO constitution was amended to reflect this shift in relations.
Much of the groundwork for the economic justification for the FCTC was laid by the World Bank. In order to counter concerns that international tobacco control legislation would unduly harm economies of which tobacco farming, manufacturing, and sale were an important part, the WHO cited a landmark World Bank publication entitled Curbing the Epidemic: Governments and the Economics of Tobacco Control (CTE), which asserted that tobacco control would not harm economies, other than a select few agrarian countries that were unusually dependent on tobacco production. Mamudu, Hammond, and Glantz reveal that "as a financial institution with substantial influence in developing countries, the Bank's publication of CTE threatened to undermine the tobacco companies' economic arguments" about the harmful effects of tobacco control.
Indeed, even before the treaty was publicly released, tobacco industry representatives embarked upon a concerted effort to thwart the efforts of FCTC drafters, in addition to participating policy-makers from individual WHO member states. Unable to argue against the overwhelming scientific evidence about tobacco's harmful health effects, the tobacco industry seized upon the FCTC's potential for economic harm. In response to the World Bank's CTE,the industry made a number of attempts to discredit the report, especially through the public relations efforts of the International Tobacco Growers' Association (ITGA) and by employing non-World Bank economists to release their own analyses. Between March 4–16 of the year 2000, the ITGA, financed by the tobacco industry, set out on what they dubbed a "Roadshow," during which ITGA representatives spoke to policy-makers in the developing countries of India, Kenya, Malawi, South Africa, and Zimbabwe, in addition to two "mini-Roadshows" in Argentina and Brazil, in order to voice ITGA opposition to the FCTC on the grounds that the CTE had underestimated the threat that tobacco control would pose to developing economies. Once negotiations for the FCTC were underway, the tobacco industry again made attempts to lessen the blow of international legislation on their business by lobbying delegates at the convention in Geneva. According to Mamudu, Hammond, and Glantz, however, "these efforts... did not undermine acceptance of CTE during the FCTC negotiations and CTE remained an authoritative economic analysis of global tobacco control."
Nevertheless, the FCTC acknowledges that its agenda will inevitably hurt farmers who currently depend on tobacco for their livelihoods. To that end, the treaty encourages Parties to help tobacco farmers make the transition from tobacco to alternative crops. Article 17 of the Framework Convention states: "Parties shall, in cooperation with each other and with competent international and regional intergovernmental organizations, promote, as appropriate, economically viable alternatives for tobacco workers, growers and, as the case may be, individual sellers." In particular, the FCTC favors sustainable development options over tobacco farming. To achieve this, Party governments and tobacco control advocates are encouraged to invest in better infrastructure, especially transportation, to ease farmers' access to new and foreign markets when making the transition, while simultaneously improving farmers' access to credit that may be necessary in converting their existing facilities.
Requirements
Significant provisions of the treaty require that parties implement the following measures:| Topic | Measure | Articles |
|---|---|---|
| Lobbying Lobbying Lobbying is the act of attempting to influence decisions made by officials in the government, most often legislators or members of regulatory agencies. Lobbying is done by various people or groups, from private-sector individuals or corporations, fellow legislators or government officials, or... |
Call for a limitation in the interactions between lawmakers and the tobacco industry. | Article 5.3 |
| Demand reduction Demand reduction Demand reduction refers to efforts aimed at reducing public desire for illegal and illicit drugs. This drug policy is in contrast to the reduction of drug supply, but the two policies are often implemented together... |
Tax and other measures to reduce tobacco demand. | Article 6 & 7 |
| Passive smoking Passive smoking Passive smoking is the inhalation of smoke, called secondhand smoke or environmental tobacco smoke , from tobacco products used by others. It occurs when tobacco smoke permeates any environment, causing its inhalation by people within that environment. Exposure to secondhand tobacco smoke causes... |
Obligation to protect all people from exposure to tobacco smoke in indoor workplaces, public transport and indoor public places. | Article 8 |
| Regulation Regulation Regulation is administrative legislation that constitutes or constrains rights and allocates responsibilities. It can be distinguished from primary legislation on the one hand and judge-made law on the other... |
The contents and emissions of tobacco products are to be regulated and ingredients are to be disclosed. | Article 10 |
| Packaging and labeling | Large health warning (at least 30% of the packet cover, 50% or more recommended); deceptive labels ("mild", "light", etc.) are prohibited. | Article 9 & 11 |
| Awareness Awareness Awareness is the state or ability to perceive, to feel, or to be conscious of events, objects or sensory patterns. In this level of consciousness, sense data can be confirmed by an observer without necessarily implying understanding. More broadly, it is the state or quality of being aware of... |
Public awareness for the consequences of smoking. | Article 12 |
| Tobacco advertising Tobacco advertising Tobacco advertising is the advertising of tobacco products or use by the tobacco industry through a variety of media including sponsorship, particularly of sporting events. It is now one of the most highly regulated forms of marketing... |
Comprehensive ban, unless the national constitution forbids it. | Article 13 |
| Addiction Substance dependence The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:... |
Addiction and cessation programs. | Article 14 |
| Smuggling Smuggling Smuggling is the clandestine transportation of goods or persons, such as out of a building, into a prison, or across an international border, in violation of applicable laws or other regulations.There are various motivations to smuggle... |
Action is required to eliminate illicit trade of tobacco products. | Article 15 |
| Minors Minor (law) In law, a minor is a person under a certain age — the age of majority — which legally demarcates childhood from adulthood; the age depends upon jurisdiction and application, but is typically 18... |
Restricted sales to minors. | Article 16 |
| Research Research Research can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method... |
Tobacco-related research and information sharing among the parties. | Articles 20, 21, & 22 |
World Map Status
Non-parties
The United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
is a non-party to the Framework Convention on Tobacco Control. When the signed treaty was put up for ratification, President George W. Bush failed to send the FCTC to the United States Senate for consideration, thereby preventing the full participation of the U.S in the implementation of the Framework Convention. In his book Cigarette Century, a finalist for the Pulitzer Prize, Allan Brandt characterizes Bush's reluctance in regards to the FCTC as "consistent with the failure to ratify other important conventions and the emerging ethos of American unilateralism."
Furthermore, the U.S. has sought to change certain provisions of the FCTC, but with limited success. Among the provisions opposed successfully were a mandatory ban on the distribution of free tobacco samples (which is now optional), a narrow definition of the term "minor" regarding the sale of tobacco (which now refers to domestic or national law) and broad limitations concerning the tobacco advertising, promotion and sponsorship (which were seen as violating free speech, and are now subject to constitutional limitations). Among the provisions unsuccessfully opposed by the U.S. were the requirement for warning labels to be written in the language of the country where the tobacco products are being sold, and the ban on deceptive and misleading descriptions such as "low tar" or "ultra-light", which might infringe on trademark
Trademark
A trademark, trade mark, or trade-mark is a distinctive sign or indicator used by an individual, business organization, or other legal entity to identify that the products or services to consumers with which the trademark appears originate from a unique source, and to distinguish its products or...
protections.
To date there are 20 other non-party states, 9 (as the U.S.A.) that have signed but not yet ratified (Argentina
Argentina
Argentina , officially the Argentine Republic , is the second largest country in South America by land area, after Brazil. It is constituted as a federation of 23 provinces and an autonomous city, Buenos Aires...
, Cuba
Cuba
The Republic of Cuba is an island nation in the Caribbean. The nation of Cuba consists of the main island of Cuba, the Isla de la Juventud, and several archipelagos. Havana is the largest city in Cuba and the country's capital. Santiago de Cuba is the second largest city...
, Czech Republic
Czech Republic
The Czech Republic is a landlocked country in Central Europe. The country is bordered by Poland to the northeast, Slovakia to the east, Austria to the south, and Germany to the west and northwest....
, El Salvador
El Salvador
El Salvador or simply Salvador is the smallest and the most densely populated country in Central America. The country's capital city and largest city is San Salvador; Santa Ana and San Miguel are also important cultural and commercial centers in the country and in all of Central America...
, Ethiopia
Ethiopia
Ethiopia , officially known as the Federal Democratic Republic of Ethiopia, is a country located in the Horn of Africa. It is the second-most populous nation in Africa, with over 82 million inhabitants, and the tenth-largest by area, occupying 1,100,000 km2...
, Haiti
Haiti
Haiti , officially the Republic of Haiti , is a Caribbean country. It occupies the western, smaller portion of the island of Hispaniola, in the Greater Antillean archipelago, which it shares with the Dominican Republic. Ayiti was the indigenous Taíno or Amerindian name for the island...
, Morocco
Morocco
Morocco , officially the Kingdom of Morocco , is a country located in North Africa. It has a population of more than 32 million and an area of 710,850 km², and also primarily administers the disputed region of the Western Sahara...
, Mozambique
Mozambique
Mozambique, officially the Republic of Mozambique , is a country in southeastern Africa bordered by the Indian Ocean to the east, Tanzania to the north, Malawi and Zambia to the northwest, Zimbabwe to the west and Swaziland and South Africa to the southwest...
, Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
) and 11 that have not signed (Andorra
Andorra
Andorra , officially the Principality of Andorra , also called the Principality of the Valleys of Andorra, , is a small landlocked country in southwestern Europe, located in the eastern Pyrenees mountains and bordered by Spain and France. It is the sixth smallest nation in Europe having an area of...
, Dominican Republic
Dominican Republic
The Dominican Republic is a nation on the island of La Hispaniola, part of the Greater Antilles archipelago in the Caribbean region. The western third of the island is occupied by the nation of Haiti, making Hispaniola one of two Caribbean islands that are shared by two countries...
, Eritrea
Eritrea
Eritrea , officially the State of Eritrea, is a country in the Horn of Africa. Eritrea derives it's name from the Greek word Erethria, meaning 'red land'. The capital is Asmara. It is bordered by Sudan in the west, Ethiopia in the south, and Djibouti in the southeast...
, Indonesia
Indonesia
Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...
, Liechtenstein
Liechtenstein
The Principality of Liechtenstein is a doubly landlocked alpine country in Central Europe, bordered by Switzerland to the west and south and by Austria to the east. Its area is just over , and it has an estimated population of 35,000. Its capital is Vaduz. The biggest town is Schaan...
*, Malawi
Malawi
The Republic of Malawi is a landlocked country in southeast Africa that was formerly known as Nyasaland. It is bordered by Zambia to the northwest, Tanzania to the northeast, and Mozambique on the east, south and west. The country is separated from Tanzania and Mozambique by Lake Malawi. Its size...
, Monaco
Monaco
Monaco , officially the Principality of Monaco , is a sovereign city state on the French Riviera. It is bordered on three sides by its neighbour, France, and its centre is about from Italy. Its area is with a population of 35,986 as of 2011 and is the most densely populated country in the...
, Somalia
Somalia
Somalia , officially the Somali Republic and formerly known as the Somali Democratic Republic under Socialist rule, is a country located in the Horn of Africa. Since the outbreak of the Somali Civil War in 1991 there has been no central government control over most of the country's territory...
, Tajikistan
Tajikistan
Tajikistan , officially the Republic of Tajikistan , is a mountainous landlocked country in Central Asia. Afghanistan borders it to the south, Uzbekistan to the west, Kyrgyzstan to the north, and China to the east....
, Uzbekistan
Uzbekistan
Uzbekistan , officially the Republic of Uzbekistan is a doubly landlocked country in Central Asia and one of the six independent Turkic states. It shares borders with Kazakhstan to the west and to the north, Kyrgyzstan and Tajikistan to the east, and Afghanistan and Turkmenistan to the south....
, Zimbabwe
Zimbabwe
Zimbabwe is a landlocked country located in the southern part of the African continent, between the Zambezi and Limpopo rivers. It is bordered by South Africa to the south, Botswana to the southwest, Zambia and a tip of Namibia to the northwest and Mozambique to the east. Zimbabwe has three...
).
- Note: Liechtenstein, although not a WHO Member State, is eligible to become a Party to the WHO FCTC as a UN Member State.
Implementation, oversight, and future direction
The FCTC established two principal bodies to oversee the functioning of the treaty: the Conference of the Parties and the permanent Secretariat. In addition, there are over 50 different intergovernmental and nongovernmental organizations who are official observers to the Conference of the Parties.According to Nikogosian, "most parties have now passed or are renewing and strengthening national legislation and policies to meet their obligations under the treaty." A 2010 update on the progress of FCTC implementation reported that 80% of Parties currently facilitate public information and/ or education programs on the dangers of tobacco, in addition to curbing underage tobacco consumption through laws that forbid retailers from selling tobacco products to minors. Furthermore, 70% of Parties have made "large, clear and visible health warnings" mandatory for tobacco packaging. However Nikogosian warns that the treaty is merely a "tool," and that its effectiveness hinges on how Parties implement the guidelines it sets forth. Going forward, FCTC implementation proves most difficult for developing and transition economies, due to a rift between their need for tobacco control and the resources to which they have access in meeting FCTC guidelines.