Constructing tobacco control as a human rights issue: smoking, lawyers and the judicialization of the right to health

Abstract

Over the last 20 years, there have been an increasing number of initiatives and efforts to use the language, institutions and practices of human rights in the field of global health (Reubi 2011). HIV/AIDS was one of the first global health issues in relation to which human rights approaches were articulated, generally to protect those with HIV/AIDS from stigma and discrimination. The establishment, by Jonathan Mann, of a Human Rights Office within the WHO’s Global Programme on AIDS is a typical illustration of such efforts (Fee and Parry 2008; Rushton 2010, forthcoming). Global health activists have also employed the human rights rhetoric in relation to access to medicines. Indeed, from the celebrated South African HIV/AIDS medicines access campaign led by large, international NGOs such as Oxfam and Medecins Sans Frontieres to efforts by Brazilian patient groups to obtain free drug treatment for rare genetic diseases, all have explicitly appealed to the values and norms of international human rights (Olesen 2006; Petryna 2009). More recently, public health advocates have sought to frame maternal and child health as a human right issue with the hope of generating public interest and political action (Yamin and Maine 2005; Shiffman and Smith 2007). The present chapter addresses this proliferation of human rights discourses ininternational public health 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 like much of the literature on human rights and global health has done (e.g. Gruskin et al. 2005; Ferraz 2009; Schrecker et al. 2010; Reubi 2011), this chapter purports to understand how and why such approaches are being articulated and disseminated. Drawing on the literature on ‘thought collectives’, ‘epistemic communities’ and ‘advocacy networks’ (e.g. Fleck 1979; Hass 1992; Keck and Sikkink 1998; Mirowski and Plehwe 2009), the chapter first argues that the identification and description of the global smoking epidemic as a human rights issue have been the product of a small, international network of public health experts and lawyers that I term the human rights and tobacco control collective or community (HTC). The chapter 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 over the last 10 years.