Making a human right to tobacco control: Expert and advocacy networks, framing and the right to health

Abstract

This article addresses the proliferation of human rights in international public health over the last 20 years by examining recent attempts at framing the global smoking epidemic as a human rights problem. Rather than advocating in favour or against human rights-based approaches, the article purports to understand how and why such approaches are being articulated and disseminated. First, it argues that the representation of the global smoking epidemic as a human rights issue has been the product of a small, international network of public health experts and lawyers: the human rights and tobacco control collective or community (HTC). The article describes in particular the HTC's membership, its style of thinking and its efforts to articulate and disseminate human rights-based approaches to tobacco control. Second, the article argues that the aim of the HTC when framing tobacco control as a human rights issue was not to generate public attention for and the political will to tackle the global smoking epidemic, as the literature on framing and human rights presupposes. Instead, as the article shows, the HTC framed tobacco control as a human rights problem to tap into the powerful, judicial monitoring and enforceability mechanisms that make up international human rights.

Framing global health: The governance challenge

“…We needed to identify a higher-level commonality in worldview that defined the frame as coherent although internal contestations could still be acknowledged. This is reflected in the brief introductions to the frames used later in this paper and in several of the papers in this collection, including those by Reubi (2012), by Williams (2012) and by Woodling et al (2012). A crucial move was to accept that the identification of specific frames as coherent was to some extent heuristic in that it simplified reality for analytical purposes, but in a nonetheless useful manner.…”

“…For them, the relationship between human rights and health is primarily about the right to health: the right to receive appropriate and affordable health care (see UNCESCR 2000, Hunt 2004, Hunt and Backman 2008. Unlike Mann's definition, this conception of human rights and health emphasised the importance of international legal norms like article 12 of the 1966 International Covenant on Economic, Social and Cultural Rights (IESCR), judicial enforcement mechanisms and human rights lawyers (Reubi 2012).…”

“…Over the past 20 years, there has been a marked resurgence in framing global public health issues in terms of human rights (see Reubi 2012). Perhaps the two most significant issues in this resurgence were HIV/AIDS and, later, access to medicines (Olesen 2006, Biehl et al 2009, Rushton, 2012.…”

Orders of worth and the moral conceptions of health in global politics

“…These five frames are evidence-based medicine, economics, development, security, and human rights (Reubi 2012;. The security frame in particular is an important addition to the Keiko et al study, taking account of the growing 'securitization' literature on global health (see below).…”

“…The order of fairness is grounded in the language of human rights, which is increasingly invoked in global health conflicts (Inoue and Drori 2006;Youde 2008;Reubi 2012). From the fairness point of view, the problem of health is not one of biological vulnerability to Nature, but a problem of distributional (in)justice and thus of health equity and non-discrimination.…”