Stopping the scourge: tobacco control goes global.

obacco-related illnesses killed 4 million people worldwide in 1998, a toll that is expected to more than double by 2020, according to the World Health Organization (WHO). Within 25 years, tobacco is expected to exceed infectious disease as the leading cause of morbidity and mortality worldwide, according to a 1 November 1996 Science report by Christopher J. L. Murray of Harvard University and Alan D. Lopez of the WHO. The developing world will be the hardest hit by tobacco's onslaught. Although per capita cigarette consumption in developing countries (1,370 in the late 1990s) falls far short of that in the developed world (2,400), the former is climbing while the latter drops, driven down by health concerns. According to a 2000 report by WHO officials in volume 78, issue 4, of the Bulletin of the World Health Organization, at current smoking uptake rates tobacco will kill about 100 million of the 300 million Chinese males now under 29 years of age. Furthermore, says the report, " Penetration of new markets by aggressive multinational companies , facilitated by the liberalization of trade and investment, is one of the factors that have prevented the public health community from effectively implementing tobacco control policies. " But that may be about to change. The WHO is in the midst of developing the Framework Convention on Tobacco Control (FCTC), an international treaty to constrain the spread of tobacco growth and usage worldwide. One hundred ninety-one member countries are participating in the effort, and 50 of these—including the 5 permanent members of the United Nations Security Council—have pledged financial and political support. Says Gro Harlem Brundtland, director-general of the WHO, " The challenge for us comes in seeking global and national solutions in tandem for a problem that cuts across national boundaries, cultures, societies, and socioeconomic strata. " The first meeting of the Intergovernmental Negotiating Body of the FCTC took place in Geneva, Switzerland, in October 2000. It followed two working group meetings and the 2000 World