Concerns about foreign influence in health policymaking are growing as India prepares for the COP11 of the WHO Framework Convention on Tobacco Control (FCTC). The FCTC process is causing growing concern, with many believing that it is increasingly shaped not by science but by a few powerful international NGOs, often funded by private philanthropy. While India has consistently asserted its right to localise global frameworks across sectors, the issue becomes especially acute in the context of tobacco regulation. India has one of the world’s most severe tobacco burdens, with over 300 million users and more than 1.35 million annual deaths from tobacco-related illnesses. The urgency to act is obvious, as is the need for regulation that takes into account Indian consumption patterns, socioeconomic realities, and public health infrastructure.

Jeffrey Smith, Resident Senior Fellow at Integrated Harm Reduction, said, “The only known fact is that current tobacco policies fall far short of meeting the goal of cessation. Without innovative policies that allow those who use tobacco products to switch, India is unlikely to reduce the health consequences of tobacco use at the population level”.

Instead, global policy frameworks have frequently advocated for blanket prohibitionist measures, including emerging alternatives that help combat the negative effects of smoking or chewing tobacco, while failing to address more harmful forms of tobacco, such as bidis and smokeless tobacco. As a result, the regulatory approach appears to be inconsistent with risk profiles and ground realities. Countries all over the world are reevaluating such frameworks. Sweden, Indonesia, Malaysia, and the UAE, among others, are looking into more flexible regulatory models aimed at reducing harm through innovation, consumer awareness, and improved enforcement.

Priyanka Dutta