by Dr Helmy Haja Mydin. First published in The New Straits Times 10 October 2015

The medical fraternity welcomes news that the final agreement of the Trans-Pacific Partnership Agreement (TPPA) that was recently announced in Atlanta protects the rights of participating nations to adopt tobacco control measures. This is a major victory for Malaysia, which has led the fight for a tobacco carve-out.

This tacit acknowledgement of the unique nature of tobacco should not go unnoticed. After all, cigarette smoking is the only openly traded commodity that kills its consumers when used as intended. Over six million people die every year due to their addiction to cigarettes. The over 4000 chemicals contained within a cigarette makes it the number one modifiable risk factor for a number of diseases; from cancer to heart attacks and strokes. Furthermore, the United Nation estimates that half of the world’s children are exposed to cigarette smoke – which makes efforts at tobacco control today important for the citizens of tomorrow.

The removal of Big Tobacco from investor-state dispute settlement provisions allows the twelve participating nations to persevere with measures for tobacco control without fear that the companies will use the TPPA to launch financially crippling legal challenges. Australia is currently battling a legal challenge to its act mandating all cigarette packages be made plain (i.e. without colourful branding), but most countries are unable to fight prolonged court cases. Prohibitive costs had led to the Uruguayan government almost repealing a tobacco control measure but they were rescued by the Bloomberg Philanthropic Trust and the Gates Foundation.

The concessions announced by our International Trade and Industry Minister, Datuk Seri Mustapa Mohamed, is a triumph for public health advocates who have been running a counter-lobby to the tobacco industry. It also runs against the commonly perceived view that negotiations have been dominated by countries with greater economic clout, with little regard for the views of developing countries. Notably, all participating nations are signatories to the World Health Organisation’s Framework Convention on Tobacco Control with the exception of the United States of America.

It is essential that these exclusions and restrictions are applicable to the tobacco industry only, and not the start of a slippery slope of exclusion for other commodities. Tobacco is unique for the reasons mentioned above. Facilitating free trade in other goods with measures such as abolishing import tariffs should be encouraged. Free trade has a track record for addressing poverty. Alleviating poverty is the single most effective public health intervention as it leads to improvements in numerous health-related indices such as lower infant mortality rates and higher life expectancies.

The TPPA also allows Malaysia better access to a market of 800 million people, equivalent to two-fifths of the global economy. This provides greater opportunities for expansion. However, the greater exposure also means that local players will need to buck up as they face stiffer competition from abroad. This can lead to significant changes in the manner that business in conducted, and the socioeconomic effects of certain policies, such as the opening up of the Internet in Vietnam, will be more difficult to predict.

The concessions against the tobacco industry should be welcomed by the rakyat and NGOs such as the Malaysian Council for Tobacco Control. However the devil, as always, will be in the details. Over the next few months, the final agreement will undergo vetting nationally and will also be open to public consultations. Loopholes should be identified and the substance of the TPPA should be made stronger. While we should be stringent in protecting our interests, we should also be wary of populist anti-trade rhetoric that seek to derail efforts at greater international co-operation.

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Dr Helmy Haja Mydin is a respiratory physician in Pantai Hospital Kuala Lumpur and a Founding Associate of the Institute for Democracy and Economic Affairs (IDEAS).

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