Global tobacco control policymaking: An insight into the FCTC Conference of the Parties decision-making process

Tobacco use is a global public health problem, accounting for over 5 million annual deaths and estimated to reach a total of one billion deaths by the end of the 21st century. In 2003, 192 countries unanimously adopted the WHO Framework Convention on Tobacco Control (FCTC), the first global public health treaty, to deal with this problem. The FCTC created the Convention Secreatariat to administer the treaty and the Conference of the Parties (COP) to develop guidelines for the provisions. To date, analyses existed on development and implementation process of the FCTC, but there is no study on the decision-making process of the COP. This study used participant observation research method to monitor activities of the fourth COP meeting in November 2010 in Punta del Este, Uruguay, and also interviewed participants to provide insight into the COP process. The entire COP decision-making process has been driven by consensus, which alleviates inter-state tensions, but a source of stalemate and opportunity for any state to waterdown the guidelines. Additionally, real decision-making power lies with subcommittees and committees, not the plenary. Especially, Committee B, which deals with budgetary and issues of cooperation wields the most power. While this study provides first-hand insight into the COP process, it helps public health professionals to figure out influential venues in the COP process to channel their efforts and resources to where they can make significant impact in developing norms for global tobacco control to improve global health.