Profile in Courage: The World Health Organization’s Lone Dissenters

The Eleventh Session of the Conference of the Parties (COP11) to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) was held in Geneva, Switzerland, from November 17-22. Member states sent delegations, and these representatives were expected to stick to the party line that vaping, heat-not-burn products and, incredibly, nicotine pouches are just as harmful as cigarettes and should play no role in smoking cessation. This dogma contradicts the wealth of evidence on these products’ relative safety and effectiveness as quit-smoking aids. Yet, there was a sea of conformity at COP11, and few dared to swim against the current. Member states such as Serbia and New Zealand courageously stood up for harm reduction even if it made WHO bureaucrats feel uncomfortable. For bringing some much-needed truth to a global agency untethered from reality, these dissenting countries are Profiles in Courage.

The WHO prefers that global taxpayers—who fund its operations—are left in the dark about what happens in its conferences.  The majority of COP11 was not accessible to the public or media that weren’t in attendance. Some portions of the week-long conference were live-streamed, including the opening and closing plenary sessions, but the majority of the meetings and discussions were not publicly viewable. In the sessions that were accessible, though, it quickly became clear that there were growing cracks in the WHO’s supposed consensus. As World Vapers’ Alliance Director Michael Landl noted, “Several countries, including Albania, North Macedonia, Serbia, New Zealand, The Gambia, Mozambique, and Saint Kitts and Nevis, openly voiced support for tobacco harm reduction and evidence-based regulatory approaches. At the same time, a number of influential states remained committed to traditional restrictive models, notably Brazil, India, and Denmark, underscoring an increasingly visible global divide.”

But because most of the WHO’s sessions are closed, the public will never get more than a glimmer at the internal debate and dissent that member nations are bringing to the table. TPA has long questioned the WHO’s integrity, and for good reason. The opaque decision-making process and lack of transparency are concerning, especially when these WHO decisions will directly impact consumers and business owners worldwide. The lack of accountability within the WHO risks decisions being made without public input and hinders effective public health responses. And because the WHO reserves the right to restrict information “which may adversely affect WHO’s relations with a Member State or other intergovernmental organization,” even simple (yet illuminating) disagreements between delegations at WHO conferences will never see the light of day.

Due to these legitimate concerns regarding the WHO’s dubious practices, TPA simultaneously hosted the Conference of the People (COP), aka “Good COP 2.0,” to counter the WHO’s “Bad COP.” Good COP 2.0 also took place in Geneva, Switzerland, and included 39 experts from 22 different countries. Unlike the WHO’s COP11, TPA’s Good COP 2.0 welcomed a wide array of viewpoints and was livestreamed on TPA’s YouTube page for those who wanted to attend virtually and participate in the conference or watch it later.

TPA has long supported adult access to tobacco harm reduction (THR) products like e-cigarettes, heated tobacco, nicotine pouches, and smokeless products. THR strategies improve health outcomes for adult smokers and have proven to be effective tools in helping millions of adults kick the deadly habit of combustible tobacco. If improving public health is the objective, then THR strategies must be prioritized, not shunned. Silencing those with differing opinions harms consumers seeking alternatives to quit, and the WHO should be ashamed for not sharing the full discussions held at COP11 with the public. If the WHO has nothing to fear, they should have nothing to hide.

The public deserves to see the full lengths that countries like Serbia, North Macedonia, and Mozambique went through to advocate for THR. These delegations were filled with Profiles in Courage, and they deserve a hero’s applause in the light of day.