The U.S. Withdrawal from WHO: A Turning Point for FCTC Reform in the Global South?

The U.S. government’s recent decision to withdraw from the World Health Organization (WHO) has sparked intense global debate, with many countries engaging to assess its far-reaching implications. While the immediate focus has been on global health governance and funding, the domino effect of this move could be particularly pronounced in the Global South.

The U.S. has historically been one of the largest contributors to WHO’s budget, supporting various global health initiatives, including tobacco control. Its withdrawal raises concerns over funding shortfalls that will disproportionately affect developing nations reliant on WHO assistance. However, beyond financial implications, the move signals a broader shift in global health governance—one that presents both challenges and opportunities for countries in the Global South.

Among the critical issues now under scrutiny is the Framework Convention on Tobacco Control (FCTC), a treaty developed by WHO to curb tobacco use worldwide. The U.S. withdrawal has created an opportunity to reassess whether the FCTC is fit for purpose—especially for low- and middle-income countries. For many in the Global South, this moment is a milestone to shape the debate around the urgent need for FCTC reform.

Many governments in Europe like UK, Italy and Hungary are now reconsidering their relationship with the WHO and questioning its transparence and whether its regulatory frameworks align with their national priorities. In the global South, some independent voices are similarly starting to be raised in Argentina, Indonesia and Philippines. This reassessment is particularly relevant in the case of the FCTC, which has long been criticized for imposing a rigid, one-size-fits-all approach to tobacco regulation without considering local economic and social realities.

The FCTC, adopted in 2003, was designed to reduce tobacco consumption through measures such as advertising bans, taxation, and strict regulations on production and sales. While its intent was to promote public health, its implementation has often neglected the economic and regulatory challenges faced by countries where tobacco plays a significant role in livelihoods and government revenues.

Tobacco farming and manufacturing provide employment for millions in Southern Africa, Latin America, and Asia. In countries such as Malawi and Zimbabwe, tobacco exports are a major source of income. The FCTC’s aggressive push for reduced tobacco production can lead to job losses and economic instability, with few viable alternatives provided for affected communities.

Rather than imposing unrealistic transition plans, a reformed FCTC should support a more balanced approach that allows these economies to adapt gradually, ensuring that livelihoods are protected while public health goals are achieved.

One of the FCTC’s biggest shortcomings is its failure to recognize harm reduction strategies. Scientific advancements in tobacco and nicotine alternatives—such as heated tobacco products and e-cigarettes—have shown potential in reducing smoking-related harm. Yet, under WHO’s current approach, many of these alternatives face the same restrictive policies as traditional cigarettes.

For the Global South, where healthcare systems are often underfunded, harm reduction presents a practical solution to lowering smoking-related disease burdens without the need for costly public health interventions. A reformed FCTC must adopt a more science-based approach that allows smokers access to less harmful alternatives.

FCTC policymaking has largely excluded key stakeholders from discussions, including governments of tobacco-producing nations, industry players, and even harm reduction advocates. Many countries in the Global South have had little say in shaping policies that directly impact their economies.

Moving forward, reform must ensure that all affected parties are included in decision-making processes. Transparency and inclusivity will lead to more effective and sustainable tobacco control policies that reflect the diverse realities of different regions.

The U.S. withdrawal from WHO has disrupted the status quo, providing an unprecedented opportunity for countries in the Global South to challenge outdated policies and advocate for reform. As the future of global health governance is being debated, now is the time to push for a revised FCTC that better aligns with economic, social, and scientific realities.

Reforming the FCTC is not about undermining tobacco control—it is about ensuring that policies are fair, practical, and effective. If the Global South fails to seize this moment, millions will continue to suffer from policies that do not reflect their realities. It is time to reshape the conversation, ensuring that future tobacco regulations work for all, not just a select few.

Follow and Subscribe Nyasa TV :