What a human rights lens can bring to tobacco control

Carolyn Dresler, MD, MPA

Special THANK YOU to Stephen Marks, Docteur d’état, Dipl, IHEIand – the many partners from HRTCN – Human Rights and Tobacco Control Network

Helena Nygren-Krug

Health & Human Rights team

Department of Ethics, Equity, Trade, & Human Rights (ETH/IER)

The Fundamental Challenge

Utilizing a HRBA framework for PH should increase the public’s awareness of the societal NEED to look at PH and HR

– specifically in reference to tobacco control

Tobacco Control and Human Rights

• Tobacco control has as a major aim:– to stop the morbidity and mortality of humans

from tobacco use.

20

18

16

14

12

10

8

6

4

2

0

2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050

PROJECTED MORTALITY PATTERNS

CU

MU

LA

TIV

E D

EA

TH

S (

Mill

ion

s)

Cessation & Prevention

Human Rights Based Approach• Human Rights: not only includes physical

and mental health, but societal and environmental conditions that enable that state of good health– Advocates – Public Health practitioners– Lawyers – policy and litigation– Specific expertise – addiction,environment– Others

• ECOSOC, UNESCO, UNICEF, FAO, ILO, Global Compact, UNEP, WTO,IMF, UNDP; World Bank

– THE OTHER SIDE – Tobacco Industry

Who has rights?• All humans: ”Whereas recognition of the

inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world” (Universal Declaration of Human Rights)

• All humans equally• All humans as individuals

• All human rights are important – inter-related– inter-dependent

• Application of human rights has no boundaries, no state lines (International Criminal Court; Kyoto; Land Mine)

Agency and Duty

Agency:– the state of being in action or of exerting

power; operation– a means of exerting power or influence;

instrumentality

Duty:– the binding or obligatory force of something

that is morally or legally right; a moral or legal obligation

Online Dictionary

HRBA to Tobacco Control

• Principle of progressive realization– Obligation to take steps using the maximum available resource– Deliberate, concrete & targeted steps– Distinguish government: incapacity vs unwillingness– Use indicators (structural, process & outcomes) and benchmarks

• HRBA methodologies developed after 1997 UN reform, (UN common understanding on the HRBA)

– Consistent goal: further realization of rights– Consistent process:– Consistent outcome: capacity development at national level to

have duty bearers to meet their obligations

• The role of capacity development

Types of human rights obligations

Obligation to

Respect Protect Fulfill

Duty-bearer to prevent others interfering with the enjoyment

of the right

Duty-bearer to refrain from

interfering with enjoying the

right

Duty-bearer to adopt appropriate measures towards full realization of

the right

Human Rights Documents

International Bill of Rights:• Universal Declaration of Human Rights (1948)

• International Covenant on Civil and Political Rights (1966)

• International Covenant on Economic, Social and Cultural Rights (1966)

Human Rights Documents (con’t)

• International Convention on the Elimination of All forms of Racial Discrimination (1969)

• Convention on the Elimination on All Forms of Discrimination Against Women (1981)

• Convention on the Rights of the Child (1989)

Regional Documents

• European Convention for the Protection of Human Rights and Fundamental Freedoms

• American Convention on Human Rights

• African Charter on Human Peoples’ Rights

What is ‘good’ health

• Desired outcome of public health endeavors

• Combination of physical, mental and social well-being – all addressed, as all are important

• Having good health is a requirement to enjoy other human rights (inter-connectedness)

• HR interventions must be evidence-based, reach the most vulnerable, and be effective in reducing mortality/morbidity

What Rights?

• Right to health• Right to a healthy environment• Right to work under ‘just and favorable

conditions’ (UDHR, Article 23);ICESCR Article 6• Right to information• Right to food – affordable, adequate, appropriate• Right to water• Right to non-discrimination on basis of sex; right

to education: for women

Right to health• UDHR – Article 25: ‘the right to a standard of living adequate

for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services’

• WHO definition: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’

• ICESCR - Article 12: ‘recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

• Ottawa Charter for Health Promotion (1986)– Health promotion is a ‘process of enabling people to

increase control over and to improve, their health’ with ‘the fundamental conditions and resources for health are: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity’

General Comment 14

• access of safe and potable water,• safe and healthy working conditions and a

healthy environment, • access to health-related education and

information,• “prevention and reduction of the population’s

exposure to harmful substances such as …harmful chemicals or other detrimental environmental conditions that directly or indirectly impact upon human health.”

General Comment 14

• ‘The improvement of all aspects of environmental and industrial hygiene’ (from Article 12 ICESCR): “refers to the minimization, so far as is reasonably practicable, of the causes of health hazards inherent in the working environment.”

• AND: ‘discourages the abuse of alcohol, and the use of tobacco, drugs and other harmful substances’

Paragraph 15 of GC 14

General Comment 14 - Children

• paragraph 23 of GC14:– states to “provide a safe and supportive environment

for adolescents, that ensures the opportunity to participate in decisions affecting their health, to build life-skills, to acquire appropriate information, to receive counselling and to negotiate the health-behaviour choices they make.”

– 700 million children – SHS in public/homes (WHO 1999 report)

– 100,000 children in tobacco labor in Malawi• 32% of Green Tobacco Smoke in ages 14-19

General Comment 14

Violations of the obligation to protect:– This category includes such omissions as the

failure to regulate the activities of individuals, groups or corporations so as to prevent them from violating the right to health of others; the failure to protect consumers and workers from practices detrimental to health, eg. by employers and manufacturers of medicines or food; the failure to discourage production , marketing and consumption of tobacco, narcotics and other harmful substances,….”

Paragraph 51 of GC 14

Right to a healthy environment . . .

• ICESCR – Article 7: ‘right of everyone to… safe and health working conditions’

• ICESCR – Article 15: ‘recognize the right of everyone…to enjoy the benefits of scientific progress and its applications’

• CRC - Article 17: discusses the child’s right to information aimed at the promotion of his or her social, physical and mental health

• CRC - Article 32: child is to be protected from economic exploitation; doing work that is ‘likely to be hazardous or to interfere with the child’s education’

India: Right to healthy environment

• India –High Court of Kerala banned public smoking based on a right to a healthy environment – 1999

• Supreme Court issued ban in 2001

• National legislation for smokefree policies into effect 2004

Three Legs of the Argument

Magnitude of Magnitude of the problemthe problem

Right to TC derives from the right to life and right to health

Tobacco Tobacco when used when used

as intended, as intended, killskills

The role of Capacity Development

UN Norms

• Norms on the responsibilities of transnational corporations and other business enterprises with regard to human rights (2003) :

• Paragraph 13:– Transnational corporations and other business enterprises shall

act in accordance with fair business, marketing and advertising practices and shall take all necessary steps to ensure the safety and quality of the goods and services they provide, including observance of the precautionary principle. Nor shall they produce, distribute, market, or advertise harmful or potentially harmful products for use by consumers.

• Can a human rights lens act as a counterweight to the international trade regimen?

UN Global Compact• Principle 1: Businesses should support and respect the protection of

internationally proclaimed human rights; and

• Principle 2: Make sure that they are not complicit in human rights abuses.   Principle 3: Businesses should uphold the freedom of association and the effective recognition of the right to collective bargaining;

• Principle 4: the elimination of all forms of forced and compulsory labour;

• Principle 5: the effective abolition of child labour; and • Principle 6: the elimination of discrimination in respect of employment

and occupation.  Principle 7: Businesses should support a precautionary approach to environmental challenges;

• Principle 8: undertake initiatives to promote greater environmental responsibility; and

• Principle 9: encourage the development and diffusion of environmentally friendly technologies.    Principle 10: Businesses should work against corruption in all its forms, including extortion and bribery. 

Special Rapporteurs

2002: Commission on Human Rights • Special Rapporteur• Right of everyone to the enjoyment of the

highest attainable standard of physical and mental health

• Paul Hunt– Infectious disease, safe water, sanitation, violence,

poverty, migration of health professionals

• Anand Grover

Special Rapporteurs

• 2005: Special Representative on HR and transnational corporations and other business enterprises

• John Ruggie– A) to provide views and recommendation on

ways to strengthen the fulfillment of the duty of the State to protect all human rights from abuses by transnational corporations and other business enterprises, including through international cooperation;

Global Opportunism

• International Markets—A New Frontier– The global marketplace = clean slate

for methods outlawed in the U.S.

• New Products for Overseas Markets:– Products tailored for cultural

integration

• Global Impact– The WHO estimates more than 1

billion deaths from tobacco in the 21st Century.

[Philip Morris International] stock is going to be a cash cow. People in other countries smoke like chimneys. This company sells an addictive product legally. The dividends are high, profits are climbing. What’s not to like?

The Motley Fool investment website, July 2009

*Clearway Minnesota

International Organization for Standardization

DRAFT: Guidance on Social Responsibility

The Framework Convention for Tobacco Control

"If you want to go fast, go alone. If you want to go far,

work together“

Dr. M.ChanWHO Director General

Shadow Report: Tobacco in Brazil

Civil Society Participation

Shadow Report: Preventing and Reducing Tobacco Use in Brazil: Pending Tasks

33Also: PHAI working in Asia with shadow reports to CEDAW

The End!

Next Steps – Partners???

• Right to tobacco control Toolkit

• Public Health Advocacy Institute

• Public Health Law Center

• Involve regional health networks– Human Rights body under ASEAN Charter– Arab Human Rights Committee – Arab

League Covenant on Human Rights

• Statement of HRBA to tobacco control

Next Steps

• Use the FCTC compliance as an indicator of commitment to public health

• Get COP to establish subsidiary bodies to assess country reports

• Human Rights Dilemma Forum

• UN Day of General Discussion – leading to a General Comment

• CESCR – get on the committee agenda

• Conversation with Ruggie at lunchtime seminar at WHO

FAO PublicationUsing Human Rights Arguments and

Mechanisms to Improve Resource

Access for the Rural Poor

Edited by

Lorenzo Cotula

Contributing authors:

Lorenzo Cotula, Moussa Djiré and Ringo W. Tenga

Food and Agriculture Organization

of the United Nations

Rome, 2008

Food and Agriculture Organization

October 2009 – Methodological Toolbox on the Right to Food :• Right to Food into national legislation• Monitoring right to adequate food• Assisting governments is assessing the right to food• Exploring budgets to realize the right to food

The right to food and access to natural resources

• Overview 7

• Key concepts 9

• Plan of the study 11

• 1. The Right to Food and Resource Access – Conceptual Links 12

• 1.1 The legal sources of the right to food 12

• 1.2 The normative content of the right to food 14

• 1.3 Broader implications of the right to food 17

• 1.4 Linkages between the right to food and resource access 21

• 1.5 Conclusion 34

• 2. The Agriculture Policy Act (LOA) of Mali - Great Potential for Realizing the Right to Food through Equitable Access to Land and Natural Resources 36

• 2.1 Introduction 36

• 2.2 Context and historical background 37

• 2.3 Equitable access to land and natural resources 40

• 2.4. Practical implications 45

• 2.5. Conclusion 48

• 3. The Right to Food and Security of Pastoral Resource Rights in the United Republic of Tanzania 50

UNEP• Developing regional programs for

environmental sustainability

• Helping, upon request, environment ministries and other environmental authorities, in particular in developing countries and countries with economies in transition to formulate and implement environmental policies

• Environment Management Group – opportunity for discussion?

Smoker’s rights?

• Misuse of the term ‘right’ – as a human right• Legally protected behavior• Human rights are a higher order of protected

interests• HR to life and health trump legally protected

ability to smoke• This ‘legal ability to smoke’ may be superceded

for the better health of society• Includes SHS; advertising to youth

Cultural Integration

• Marlboro Man as a symbol of rugged independence.

• Tobacco products placed in movies, television shows and video games.

I said, “What’s the most masculine symbol you can think of?” And right off the top of his head, one of these writers spoke up and said a cowboy. And I said, “That’s for sure.”

- Advertising executive Leo Burnett, whose agency created the Marlboro Man

*Clearway Minnesota