It gives me great pleasure to be in India today - this is a country and a people close to my heart. I am especially pleased to be speaking to an audience of some of the world’s best legal and public health experts.

We come from a wide range of backgrounds, such as public health, medicine, law, media, economics and social sciences. What has brought us here to Delhi is our common resolve to highlight the grave problems arising from tobacco in the developing world. This meeting will explore possible means to address these problems, taking into account developing country perspectives. It will be one of many important contributions over the next months and years towards a strong international legal tool to fight tobacco, the Framework Convention on Tobacco Control.

Ladies and gentlemen,

India, with its myriad of cultures and its complex economic and social realities, in many ways mirrors our new globalized world. But despite its diversity, its disparities and its conflicts, a strong sense of unity - has kept this immense nation - which harbors nearly one sixth of humanity - together in a viable and vivid democracy.

The rest of the world is only slowly waking up to this realization that all of us, no matter the physical, cultural or economic distance, are dependent upon each other. One region’s poverty is another region’s lost opportunity. One area’s industry may be another area’s environmental disaster, and one country’s disease outbreak today, may be another country’s epidemic tomorrow.

In 1987, the World Commission on Environment and Development, which I had the privilege to chair, came up with the concept of ‘’sustainable development’’ on the basic premise that development needs of nations must be met in a way that allows future generations to fulfill their own aspirations.

Enshrined in this concept was the whole notion of solidarity, the right to knowledge and access to basic life-sustaining information for all nations and people. That idea is now institutionalized globally in a series of environmental treaties. It has entered the vocabulary of policy makers.

We will add health to that illustrious list.

The importance of the role of health in overall development is being rapidly embraced by governments around the world. It is a conceptual shift not unlike that which took place with the environment 25 years ago. Increasingly, governments realise they need to integrate health into the broader context of development. They are also beginning to look at investments in health as more than simply a mere consumption expenditure. Instead, health is increasingly being seen as a major opportunity for growth, productivity, human progress and poverty alleviation.

My point of departure is a broad reading of the role of health in development. WHO is indeed the specialised agency on health - but the purpose of our work is not only to combat ill-health - although that remains key - it is also to promote healthy populations and communities - and indeed to demonstrate how wise health interventions can spur development.

There was a period in development thinking - not so long ago - when access to public services, such as health and education, would have to wait until countries had developed a certain level of physical infrastructure and achieved a certain level of economic strength. Once countries had become fully industrialised - large outlays on health care seemed appropriate and necessary. Indeed, it was seen as a sign of national prosperity and success.

Experience and research over the past few years have shown that such thinking was at best simplified, and at worst plain wrong.

We have seen that developing countries which invest relatively more on health in an effective manner are likely to achieve higher economic growth. In East Asia, for example, life expectancy increased by over 18 years in the two decades that preceded the most dramatic economic take-off in history. A recent analysis for the Asian Development Bank concluded that fully a third of the Asian "economic miracle" resulted from these gains.

We have also observed how health spending in some of the world’s richest countries can reach very high levels and still not provide necessary and quality health services to all their citizens.

Health is not only an important concern for individuals, it plays a central role for the society in achieving sustainable economic growth and an effective use of resources. And health is even emerging as an important element of national security.

With globalization, all of humankind today paddles in a single sea. There are no health sanctuaries.

Diseases cannot be kept out of even the richest of countries by rearguard defensive action. The separation between domestic and international health problems is losing its usefulness as people and goods travel across continents. Two million people cross international borders every single day, about a tenth of humanity each year. And of these, more than a million people travel from developing to industrialized countries each week.

This is not only an issue of infectious diseases. With an explosion of international trade, travel and media, new cultural influences spread faster than ever before, driven by economic aspirations, entertainment and advertising. Many of the effects are positive, but we also see drastically negative effects, such as unhealthy changes in diet - and the rapid spread and increase of tobacco-use.

Disease and death do not stop at national borders, but still our efforts to fight them are far from being sufficiently international. The time has come for both health and foreign policy to reflect the needs of the world’s public with greater emphasis on international health security and its contribution to world peace. Foreign policies and international business practices must acknowledge transnational threats of disease, the dangers of trade in products and technologies that are harmful to health, economic and health disparities between and within countries and population growth. Countries must collaborate to develop strategies that ensure sustainable human security.

As the world’s leading health agency seeking value for our constituents we have chosen our setting - we will play an active role in this work; as a facilitator, as a provider of evidence and best practices - and as a moral compass.

Ladies and gentleman,

One of the most important political legacies of this century has been the universal ideal of human rights that are now irreversible as tenets of international law. The past 30 years have seen the birth of hundreds of organizations around the world that have given a voice and a focus to issues that affect our lives on a daily basis. Our search for justice is as old as we are. Our search for life in harmony with laws - whether they be natural laws or those that have developed over centuries - is as old as humanity himself. Access to basic health is, in the final analysis, a search for justice.

It is my firm belief that where there is no vision, there is no progress. The success of our vision lies in the hands of our Member States.

As nations feel increasingly compelled to co-operate with each other to solve their problems, the development of binding global public health norms and commitments will become crucial. Although international health law is still in a nascent and dynamic stage of development, it must address both the positive and negative health impact of globalisation. Consequently, health development in the 21^st century is likely to make wider use of international legal instruments to take advantage of the opportunities afforded by global change and to minimize the risks and threats associated with globalisation.

Today, our focus is tobacco. But the work we do on tobacco has wider consequences. As the composition of the global burden of disease changes, so must the emphasis of our work. In addition to continue with the past century’s very successful effort to limit or eliminate infectious diseases, the work we are doing on a Framework Convention on Tobacco Control stakes out the way disease must increasingly be fought and prevented in this brand-new century. This is the first time WHO is exercising its constitutional right to negotiate a set of globally binding rules. The Framework Convention is a product and a process and a public health movement.

Turning principle into practice is not an easy task, but we will lead the way and as I said, I am counting on your help. Our task is not to produce worldwide regulations. It is to build a International legal framework which will assist and support countries in their national regulation process.

The success of our approach will depend on political commitment, capacity building in public health law and economics, public support and effective enforcement. Legislation and regulation have to strike a balance between individual freedom and public needs and interests.

For the next few days, you will hear about the science, economics and politics of tobacco control. We know that tobacco use is a risk factor for some 25 diseases. It was here in India in 1964 that the first link between oropharyngal cancer and chewing tobacco was identified. Studies from eastern India were the first in the world to link palate cancer to the chewing of tobacco.

As the recent report of the World Bank has clearly documented, the risks to health and health systems from tobacco are widely underestimated. So are tobacco industry tactics. When I first looked into the issue of tobacco use world-wide I was unprepared for what I was to learn about the extent and manner in which the tobacco industry was marketing a product that killed half of its consumers. I was appalled to see how the tobacco industry had subverted science, economics and political processes to market a lethal and inherently defective product that imposed a massive burden of disease and death on countries.

I am outraged by what I learn with each passing day about the tobacco industry from previously secret documents that have now come to light mainly due to court cases in the United States, in particular Minnesota. I want to use this platform to call on national and international public health experts to work with their Constitutions as well as their countries’ international commitments to help prevent and combat this man-made epidemic. Let us craft the world first truly viable public health Convention.

Tobacco is freely allowed to kill one person every eight seconds. That is four million preventable deaths per year. Today in India, tobacco kills 670,000 people every year. In China, if present smoking patterns continue, about a third of the 300 million Chinese males now aged 0-29 will eventually be killed by tobacco. Countries like Canada and Sweden that had long bucked the tobacco epidemic now see it reappearing again. No country and no people are safe from the tobacco menace.

I have occasionally heard comments to the effect that smoking is mainly an industrialized country problem and that WHO should focus its energies on fighting the traditional diseases of poverty, such as malaria, tuberculosis and childhood diseases. Such comments are understandable but misinformed.

If unchecked and unregulated, by 2030, tobacco will kill 10 million people each year. Seventy percent of those deaths will occur in the developing world, with India and China in the lead. If nations do not act individually and together, in the next 30 years, tobacco will kill more people than the combined death toll from malaria, tuberculosis and maternal and child diseases. Every tobacco related death is preventable. That is our message. That is our challenge.

Fifty years ago the world found a solution for polio. Today we are on the verge of eradicating it. Fifty years ago scientists and researchers linked tobacco to cancer and other diseases. I wish I could tell you that the world has risen to the tobacco challenge as vigorously and unequivocally as it fought polio. The unacceptable reality about tobacco is that the health community has lost out to the tobacco industry aggressively seeking new markets and newer victims. The world will have little cause to rejoice over the health gains of the eradication of polio if we continue to remain unprepared for, and indifferent to, new challenges such as the one posed by tobacco.

One of the first things that I did at the WHO was to ask our Member Countries to give us a mandate to negotiate the Framework Convention. This new legal instrument is expected to address issues as diverse as tobacco advertising and promotion, agricultural diversification, product regulation, smuggling, excise tax levels, treatment of tobacco dependence and smoke-free areas.

The Framework Convention process will activate all those areas of governance that have a direct impact on public health. Science and economics will mesh with legislation and litigation. Health ministers will work with their counterparts in finance, trade, labour, agriculture and social affairs ministries to give public health the place it deserves. The challenge for us comes in seeking global and national solutions in tandem for a problem that cuts across national boundaries, cultures, societies and socio-economic strata.

An early ally has been UNICEF and the Convention on the Rights of the Child. While the Convention on the Rights of the Child does not explicitly include tobacco, several of its articles address over-arching values essential to safe and healthy development of children and as of this year, the States’ reporting guidelines have now been amended to include tobacco.

For tobacco, this means that the interests of the child take precedence over interests of the tobacco industry. Later as I share with you some tobacco industry tactics to promote tobacco to children, you will see why this is important.

Within the United Nations Family, The World Bank is an essential partner in global tobacco control. Their 1999 report effectively shows that over the long term economies will benefit from tobacco control. They highlight a basic economic fact. If people stop spending on tobacco, they will spend on other goods and services that will generate more jobs and revenue than those from tobacco.

We also have a close working relationship with FAO. Together, we are reaching out to tobacco farmers to ensure that when successful tobacco control reduces demand for tobacco, the economic consequences will be minimized.

Our decision to use legally binding mechanisms to circumscribe the global spread of tobacco on the one hand, and to regulate the product itself on the other, is based on sound science and irrefutable documentary evidence. The science that underpins our work is unequivocal - a cigarette is the only freely available consumer product which, when consumed as intended by manufacturers, kills. Let us never forget that.

Nicotine is addictive. A cigarette is not just tobacco leaves rolled in a strip of paper. It is a highly engineered product. The tobacco industry has studied our saliva and central nervous systems to determine the right dose of nicotine to deliver so that addiction occurs and is sustained. Other tobacco products, whether they be beedies, snuff, gutka or spit tobacco, are no less addictive - nor lethal.

Imposing international norms on a global industry that seemingly without qualms can make huge profits from a product that kills is not an easy task. It is our firm belief that to develop a truly meaningful global treaty to control tobacco, our Member States must have a clear understanding of the tobacco industry and its tactics.

Fifty years is a blink of time in a millennium, but fifty years is a long time to sustain a deliberate deception that causes death and disease. For almost fifty years, the tobacco industry has known that tobacco products cause deadly diseases. I am speaking to an audience of lawyers and public health experts - I chose my words carefully. The tobacco industry which acts as a global force is in the business of selling deception. Deception in science, public health and economics. Internal tobacco industry documents that have now become public bear eloquent testimony to this.

Tobacco litigation began in the United States 1954. But the major breakthrough came in the 1990s - in the States of Mississippi and Minnesota - with the revelations of millions of pages of documents forced from the files of the tobacco industry and with the framing of different types of legal theories that focused on the conduct of the tobacco industry.

For us, these documents show how and why the tobacco industry has been so successful in defeating public health objectives in the past and provide valuable lessons into how the public health community must come to terms with the tobacco industry to make progress in future. We believe the tobacco industry has fractured the tobacco issue by playing different tunes in different countries. In one it is labour, in another it is farmers, in a third it is marketing rights. We believe that through our Constitution and that of our Member States, we can restore the global and national picture so that the truth can emerge to benefit public health for all.

Consider this internal tobacco industry discussion. A document written by a tobacco industry lawyer in 1980 sets out some of the reasons for the tobacco industry’s refusal to publicly admit that smoking causes disease. The document was written at a time when the British and American Tobacco Group companies were considering changing their public stance on the issue of causation of disease. The lawyer opposed such a change, and wrote:

Tobacco companies also denied for decades that smoking was addictive. In private, they recorded in the fifties that smoking was addictive. In 1961, a top industry scientist wrote, "… smokers are nicotine addicts" In 1963, an industry lawyer wrote, "[N]icotine is addictive. We are, then in the business of selling nicotine, an addictive drug ...’’ In 1979, a tobacco executive considered the hypothesis that "high profits ... associated with the tobacco industry are directly related to the fact that the consumer is dependent upon the product"

The internal documents also demonstrate that the tobacco industry intentionally designed cigarettes to exploit their addictive potential. While nicotine is a naturally occurring component of the tobacco plant, the modern cigarette is a highly engineered and sophisticated product in both manufacture and design. Decades ago, the tobacco industry began to control and manipulate the level and form of nicotine in cigarettes in a variety of ways.

Publicly, the tobacco industry maintains that it does not want youth to smoke. Privately the tobacco industry has long recognised that the preservation of its market depends upon recruiting youth. As one document stated, "Younger adult smokers are the only source of replacement smokers ... If younger adults turn away from smoking, the industry must decline, just as a population which does not give birth will eventually dwindle" The tobacco industry documents are replete with discussions of marketing to youth and the need to increase market shares by enlisting youth.

The documents are an underused public health tool. But that is about to change.

There is some type of tobacco litigation underway in at least 15 countries ranging from personal injury class action litigation in Australia to health cost recovery in Canada to public interest petitions in India.

Last October I called for a preliminary inquiry into whether the tobacco industry has exercised undue influence over UN-wide tobacco control efforts including interfering with WHO’s work. Later this year I have called for a meeting of international regulators to set in motion the process of regulating tobacco. The jigsaw is falling into place.

One of the primary objectives of the tobacco industry is to frame tobacco use as an individual and behavioral decision. Adults can chose for themselves if they have full access to information. The same does not apply to children and adolescents. On a given day, between 82,000 and 99,000 young people - sometime as young as 8 - start smoking or chewing tobacco. Over eighty percent of smokers started before they were 18. By the time they find out, it is too late. The addiction has taken control.

The good news is that we can buck and reverse the global tobacco trend. We know what works and how. Taxes work and the young are especially susceptible to increased prices. Advertising and sponsorship bans work. Smoke free policies work.

Such policy interventions could, in sum, bring unprecedented health and economic benefits. WHO’s message is that there is a political solution to tobacco and it is routed through policy interventions and political vision.

The Framework Convention on Tobacco Control is a pathfinder in public health. It will assist in placing health at the top of national and international agenda and will create a debate on the wider issues and solutions to health problems.

We owe this to ourselves. We owe this more to future generations. Let us never forget that public health is a search for equity, solidarity and justice.