Yesterday (Wednesday, 5/21), the 192 members of the World Health organization unanimously adopted what?s called the ?Framework Convention on Tobacco Control.? It?s a treaty aimed at reducing tobacco deaths and related diseases, which are rising rapidly in the developing world.

Dr. Derek Yach says many people don?t realize the impact smoking has in the developing world.

He says, "I think people would be shocked to know that deaths from tobacco dwarf those from AIDS, malaria and TB combined. In developing countries, chronic diseases are fast becoming the largest cause of death. And in five of WHO?s six regions, chronic diseases ? or cardiovascular disease, cancer, all fueled by tobacco and a few other risk factors far outweigh the impact of AIDS, malaria and tuberculosis."

However, the executive director of non-communicable diseases at the World Health Organization says he is not recommending a shift in resources.

He says, "That certainly doesn?t mean that we would want the war on AIDS, malaria and TB to slow down. In fact, it?s got to increase because those diseases affect the poorest of the poor in the countries of the world. But at a big level, if you?re going to have an impact on global mortality and global trends, tobacco is a superb way to start by reducing the impact of chronic diseases."

Health officials say tobacco kills about five million people each year. They say the death toll could reach 10-million by the year 2020 if the treaty is not enacted ? and that most of the deaths will be in developing countries.

He says, "Well, our experience both from developing and developed countries says the package of measures in the treaty including strong tax increases, bans or total restrictions of advertising, better access to quitting, smoke-free policy in public places and so on together will result in sustained declines if they?re implemented together and if they?re implemented with strong political will. In countries like Canada that kind of combination has reduced consumption by about two to three percent a year. In a country like South Africa, it?s actually resulted in even sharper declines of about five to six percent declines in consumption per year."

Shortly before the Framework on Tobacco Control was adopted, the United States had dropped attempts to insert a ?reservation clause? into the treaty. It would have allowed countries to ignore any provision they found objectionable. US representatives had said that parts of the treaty could be unconstitutional.

Dr. Yach says the announcement of support by Health and Human Services Secretary Tommy Thompson was welcome news.

He says, "All we can say at this point is that we are very pleased to see the way in which secretary Thompson, without any explanations or caveats, made it clear that the US will continue to be seriously engaged in the war against global tobacco problems. And we need to remind people that already the Centers for Disease Control, the National Institutes of Health, the Environmental protection Agency are the most serious global players in tobacco control."

Nevertheless, it?s unclear at this time whether the United States will sign and ratify the treaty. Forty countries must ratify the treaty for it to take affect ? a process supporters say could take six months to a year.