Franklin Apfel
With so much scary negativity around from Brexit to Trump and friends saying stuff like “I’m glad I’m old and have no kids” or “How sad, I didn’t manage to die before I got old” and feeling really bad about the dismal situation I/we are leaving our kids – I thought it’s (over) time to put some serious effort into reframing today’s realities and start looking for what Leonard Cohen called “cracks that let the light in.”
So where to begin? Overwhelmed with hourly tweets and emails from friends, the LA Times, Boston Globe, New Yorker, Netflix, Foreign Policy, Group-on, Starbucks, The Times, BMJ, Medscape, etc., it doesn’t take long to find some travesty that needs serious attention.
Last week, for example, I learned that Derek Yach with whom I worked at WHO in developing, promoting and passing the Framework Convention on Tobacco Control (FCTC) - a global treaty ratified by nearly 180 countries which have used it to strengthen tobacco control activities and curb tobacco related deaths, has taken a new job.
Derek announced that he is now the founder and soon to be director of a smoke-free world foundation funded by none other than our former ‘hazard merchant’ numero uno - Phillip Morris International (PMI). He boasts that the foundation has been given a budget commitment from PMI of 80 million US Dollars a year for 12 years (nearly 1 billion US Dollars!). The foundation’s goal includes: working towards a smoke (not tobacco!) free world through independent research on harm reduction products and identifying ways to help tobacco farmers’ shift to other crops and employments.
My first reaction was what a mind-f***k! Why, I asked myself, would Derek, the champion of the FCTC sell his credibility again (he worked for Pepsi for several years after WHO) to this nefarious industry - which produces, promotes and profits from a deadly product and consistently fights public health action to curb its use. How can he work for an industry that he himself has exposed as obstructing, lying and hiding (for decades), evidence related to the deadly impacts of its products. An industry that has used so many dirty tricks, again which he himself has exposed, to undermine public health and other opponents including the WHO (see here). Why is PMI putting this devil’s deal of 1 billion US dollars on the table now …what game are they playing?
I welcomed WHO’s quick, strong and clear response statement challenging this tobacco funded “foundation” and detailing how it violates the spirit and letter of the FCTC and pointing to ways that Phillip Morris International continues to undermine and fight the FCTC. WHO states clearly it will not take funds from this foundation and advises governments and others to do the same! (see here).
Foundation for a Smoke-Free World founder and president-designate Dr. Derek Yach answered back immediately (see here) with an open letter to Dr. Vera Luiza da Costa e Silva (the WHO director in charge of tobacco control) in which he moans about being judged prematurely and makes the case for supporting his soon to be tax –free foundation (US tax authority approval pending). He indicates that this 1 billion US dollar PMI funded agency will be academically, intellectually and politically independent. He points to his bylaws and articles of incorporation which are posted on his website. He emphasises that the new foundation will be free to criticise the tobacco and other industries when research exposes negative impacts and behaviours. He reemphasises his belief that significant development of harm reduction agents; e.g. like vaporised nicotine products, will provide the economic basis for companies like PMI to actually shift out of the tobacco business.
No mention is made of decades of evidence of PMI wrongdoing- most recently exposed by Reuters in July of this year, when Reuters published an expose on PMI behaviour related to the FCTC. According to this report, Philip Morris has come to view the FCTC as a “regulatory runaway train” driven by “anti-tobacco extremists” (see PowerPoint). “Confidential company documents and interviews with current and former Philip Morris employees reveal an offensive that stretches from the Americas to Africa to Asia, from hardscrabble tobacco fields to the halls of political power, in what may be one of the broadest corporate lobbying efforts in existence (see The Philip Morris Files). Dating from 2009 to 2016, the thousands of pages include emails between executives, PowerPoint presentations, planning papers, policy toolkits, national lobbying plans and market analyses. Taken as a whole, they present a company that has focused its vast global resources on bringing to heel the world’s tobacco control treaty. Philip Morris works to subvert the treaty on multiple levels. It targets the FCTC conferences where delegates gather to decide on anti-smoking guidelines. It also lobbies at the country level, where the makeup of FCTC delegations is determined and treaty decisions are turned into legislation.”
And now its putting 1 billion US dollars on the table to attract scientists and governments and WHO to “join” them in creating a “smoke-free” world. What are they and Derek up to? Does PMI really believe that given enough money, public health advocates and governments will work with and for them? What’s in it for PMI? In Derek’s letter, he makes no mention of the potential positive impacts his foundation can have on PMI current and future image, sustainability, competitiveness and economic plans. No mention is made of how, if or when PMI will phase out the tobacco business, end their obstructive behaviours to FCTC, stop advertising and promoting tobacco, especially in developing countries.
Little to no information is given on how much Derek and other hirelings will earn from this venture, what are the terms of his/their agreement with PMI, how will the foundation money be spent, where it will come from, what branding requirements go with the money etc. These are all questions that need answering but regardless of whether the foundation will be truly independent or end up to be a sham programme like every other Tobacco industry sponsored anti-tobacco programme to date, the framing of this initiative is clearly wrong.
While a 1 billion US dollar foundation model might appeal to Machiavellian personalities, who are willing to embrace an “ends justifies the means“ approach and ignore the source of their funding, it seems like a ‘no-brainer’ that such a Foundation model will never work.
There will always be obvious concerns about industry influence, control, transparency, trust and agenda setting roles. There will be fierce divides between those who sign up (e.g., “consequentialists” who are ok with ends justifying means approaches and can ignore the source of funds and behaviours of funders) and those that don’t (e.g. deontologists who see taking blood money from Big Tobacco as immoral). It will create big divides in the public health community. How then can we reframe this planned approach to avoid these inevitable outcomes? That is the question!
The only semi-successful model of reinvesting tobacco money in public health, is related to the Tobacco Settlements (e.g., see here), from herein called the ‘settlement model’. This ‘settlement model’ of redistribution works because it builds on a punishment / penalty frame that has a ‘cleansing’ effect on the money and clearly takes it out of Big Tobacco hands and control and allows it to be used righteously to correct wrongs and does not rely on an ends justifies means arguments.
In this case where PMI is ready to cough up 1 US billion dollars for independent research, we can by-pass the lawsuit and save a lot of money for all (except the lawyers).
To work, however, it needs to be cast in a much more transparent redemption frame. And the money needs to be put into the hands of independent agencies that exist without PMI sponsorship!
In this case, I would suggest that the FCTC itself could be the vehicle. PMI could make a voluntary donation (perhaps through a Member State) as a way of acknowledging previous wrongdoing (e.g., see interference with the FCTC process described in Reuters report above) and declaring their intent to go out of the tobacco business by 2030. PMI could then publish their withdrawal plan (that will, of course outline how they will protect their stockholders and stakeholders) and provide details of the research and products they think are needed to end the use of tobacco (e.g., as described by CEO of PMI, Andre Calantzopoulos, in Boca Raton in 2016). The FCTC would be greatly strengthened through the trebling of their budget and could agree on action plans through their existing mechanisms and the World Health Assembly.
And there would be unity in the public heath community as we march together towards a tobacco-free world!
(Views expressed are personal.)
(As head of communications for WHO Regional Office for Europe from 1995-2002, Dr. Apfel worked with senior WHO management on developing and implementing the UN Foundation funded - ‘Tobacco Kills - Don’t be Duped’ project – a global communication initiative in support of the FCTC.)