WHO framework convention on tobacco control: a global "good" for public health

Although the application of legal instruments to international health issues - relative to other areas of international concern - is still at a rudimentary stage of development, the transnational health impacts of globalization provide a rationale for the codification and implementation of global norms to deal with shared problems. The experience of promulgating international agreements in other areas closely related to international health - the environment, for example - demonstrates how evidence-based international agreements can effectively address a range of problems that cross national boundaries. The framework convention-protocol approach is a legally binding, incremental approach to international law-making that has frequently been employed to deal with environmental threats, and is now being adapted to serve purely public health ends. Experience with the recently initiated WHO Framework Convention on Tobacco Control provides a case study of how transnational public health problems can be addressed by an international legal approach. Scientific evidence in public health and economics has provided the foundation for the elaboration of this evidence-based strategy. The present tobacco epidemic poses a range of transnational challenges that are best addressed through coordinated action. In this article, it is argued that the proposed Convention has the potential to be a global "good" for public health - i.e. it has the potential to yield important global public health benefits - and that it represents a test case for more active involvement of the public health community in international law-making.