A NEW TACK AT WHO?

A WHO report on the prevention and control of noncommunicable diseases (NCDs) reveals an important change in direction, in our view. Specifically, WHO is adopting a monitoring mechanism that will rely on a WHO-convened consortium of institutions, including the Access to Nutrition Foundation and others. This approach follows the recognition that, “WHO has not been able to finalize a concrete self-reporting tool, including related indicators, that non-State actors could use to publish their own contributions on their own websites for independent comparison and assessment.”

According to the above-mentioned WHO report, the key considerations in the approach to “register and publish contributions of non-state actors to the achievement of Sustainable Development Goal Target 3.4” include the following strategies:

1. “WHO will develop a mechanism to assess the progress of food and beverage sector companies on meeting global nutrition targets.”
2. “The WHO-convened consortium will develop a common protocol to monitor policies and practices of food companies.”
3. “A key part of the process is engagement with company representatives to understand their policies and commitments.”
4. “The monitoring mechanism will rely on a WHO-convened consortium of institutions, independent from the food and beverage manufacturers.”
5. “Funding that would not raise conflicts of interest will be sought from donors.”
6. The model represents “a test case for the overall contribution of the private sector to the achievement of the nine voluntary targets for NCDs and Sustainable Development Goal (SDG) Target 3.4.”

The Foundation for a Smoke-Free World aims to positively influence SDG 3 Target 3.4, “By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being.” Progress toward this target is measured through Indicator 3.4.1, “Mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease.”

THE FOUNDATION’S STRATEGY – TOBACCO INDUSTRY TRANSFORMATION

The Foundation’s first action of its Industry Transformation initiative, a core pillar of its overall mission to achieve a smoke-free world within this generation, is the Tobacco Transformation Index. The Tobacco Transformation Index, as it pertains to the tobacco industry, adopts many – arguably all – of the criteria listed by WHO regarding the food and beverage industry above: assessing progress toward targets, developing a common protocol to monitor policies and practices, employing company engagement, utilizing a consortium of institutions, and funding that will not raise conflicts of interest through a pledge agreement. In fact, the Tobacco Transformation Index will go beyond those criteria by investing in significant global stakeholder engagement and independent expert oversight. The Foundation has awarded contracts, after an extensive Request for Proposals (RFP) process, to global market research company Euromonitor International and leading consulting firm and think tank SustainAbility to collaborate on developing the Tobacco Transformation Index.

The Foundation will develop and implement the Tobacco Transformation Index as a means to critically evaluate tobacco industry progress and assess actions taken that undermine progress toward a smoke-free world. We will encourage the development of metrics that investors and policy makers understand, value, and utilize. To accomplish this undertaking successfully, we must and will engage all stakeholders with the material ability to effect this change for the good. SustainAbility has been awarded responsibility to lead the stakeholder engagement process, with the research support of Euromonitor International, to gain the input and feedback of leading global health professionals, tobacco control experts, policy makers, academics, investors, and financial analysts. This work will launch shortly.

THE ENDS AND MEANS

We commend the Access to Nutrition Foundation (ATNF) for its work. ATNF has demonstrated substantial progress since launching its first Global Index, assessing the largest food and beverage manufacturers globally, in 2013. Indeed, we researched and evaluated two “case study” Indexes, Access to Nutrition and Access to Medicine, in laying the groundwork for the Tobacco Transformation Index. The Foundation also respects the accomplishments of the WHO Framework Convention on Tobacco Control (WHO FCTC). However, we believe that the instruments – specifically WHO FCTC and MPOWER – have become the “end” in the minds and hearts of some in tobacco control and public health. In our view, this thinking is not properly focused on the more than 1 billion smokers in the world today, 80% of whom live in low- and middle-income countries, and it lacks empathy for the individual smokers afflicted with preventable but impending disease and premature death.

The Foundation believes it is essential to leverage the experience and insight of experts, and to facilitate open, constructive dialogue about what information stakeholders need to hold the tobacco industry accountable and to accelerate progress in efforts toward worldwide smoking cessation. From its inception in 2017, the Foundation has identified the need to independently and objectively monitor and report on industry actions as one mechanism to achieve its purpose. The Foundation is now establishing the Tobacco Transformation Index as a means to bring about the end of smoking in this generation.