Examination of witness (Questions 259
- 279)
THURSDAY 9 DECEMBER 1999
DR DEREK
YACH
Chairman
259. Good morning. Can I welcome you to this
session of the Committee. Can I particularly welcome Dr Yach and
thank you on behalf of the Committee firstly for your written
evidence and for your willingness to come rather a long way to
meet us this morning, we do appreciate that. I wonder if you would
like to briefly introduce yourself and say a little bit about
the WHO in the context of work on tobacco and your own role within
the work of that organisation?
(Dr Yach) Thank you. We also appreciate the opportunity
to participate in this. My name is Derek Yach. I am from the World
Health Organisation where I am the Programme Manager for what
is called the Tobacco Free Initiative. This is one of the two
new Cabinet projects that Dr Brundtland initiated when she took
office as Director General of the WHO in July last year. The prime
focus of it is to try to increase advocacy and action for tobacco
control on a global basis. The decision to do that was based upon
the extraordinary evidence of human health impacts around the
world. My past activities have been for three years in the World
Health Organisation as leading an international consultative process
on policy development, that is all policy development not just
in relation to tobacco, and previous to that I have been involved
in a range of community based community health research and epidemiological
activities in South Africa.
260. Thank you. I wonder if I could immediately
focus on to an area which has obyiously become one of the most
important areas of our investigation. That relates to the tobacco
industry's internal documents. You refer to these internal documents
in your evidence to us. If I can just quote from your evidence.
You say: "Only one of the tobacco companies in the UK, the
BAT Group, has been subject to significant document disclosure
requirements (through US litigation and through the US Congress).
In addition, even with respect to the BAT Group, the disclosures
are in need of supplementation; for example, most of the document
disclosures from BAT Group were subject to a 1994 cutoff date
and should be supplemented with more recent documents." I
wonder if you could say a little bit about your views of the significance
of these documents and the point about supplementation post-1994.
How do you believe that this Committee can be of assistance in
addressing the contents and implications of these documents?
(Dr Yach) I think that for many years we have felt
in tobacco policy that we have had to work in the dark. The tobacco
industry documents provide us for the first time, in the words
of our policy adviser, Judith MacKay, to really walk through the
minds of the tobacco industry. The equivalent for us in tobacco,
the problem we face, can be seen if you think of malaria. There
is no possibility of advancing malaria research and policy if
you do not understand the mosquito, its structure, its function,
how it works. We now have that opportunity for our programme,
which is the tobacco industry. Since the documents started becoming
available in the early 1990s and particularly over the last few
years it has helped us understand the science of addiction, it
has helped us to understand the way in which international, WHO
and NGO policy has been thwarted, the way the research direction
has been undermined. It has put in the eyes of the public the
truth about a range of facts that previously we only had suspicions
about. What it is basically doing is it is making the potential
for an international dialogue on the true policy very transparent.
We believe that will help the policy debate at a global level.
Many governments around the world are now looking at the tobacco
industry documents from their perspective to find out in their
country how has it been that they have had such difficulties in
the past in introducing advertising bans or restrictions, trying
to move the excise tax process forward. We have found through
many of the documents very detailed strategies developed by the
tobacco industry over many years to try to thwart that policy
process. So we believe that this is an incredibly important resource
equivalent to the epidemiological data which actually put the
health case out in the first place. Whereas many of the documents
in the US and that have been based in the US are now in the Minnesota
Depository and have been put on-line and are available both by
the tobacco industries based in the US as well as by the Government,
the US Department for Justice, the Centres for Disease Control,
they have all provided support to scan all the documents, the
same has not occurred with regard to those that are based in the
UK. The first limitation is public access. The intention of the
US court case was to make it fully accessible. There is a physical
reality in the case of BAT Co`s UK depository limited space,
limited time, complex searching ability. Making the material available
through the Internet we believe is the best and simplest solution.
It would mean that everybody would have equal access. It would
mean that you would have a fully transparent system. We believe
that BAT may have has already scanned all of its documents and
this may be something that you would want to ask them about so
that you would save the costs of having to scan them yourselves.
In addition, the deadline of 1994 was set by the US court cases.
This inquiry is happening at the end of 1999. We believe that
it needs to be supplemented with information from all the tobacco
companies that are selling products in the UK until the point
at which the inquiry completes its deliberations.
261. You would presumably argue that we have
so far only slightly lifted the curtain on what is available.
What do you think the significance would be of completely drawing
back the curtain in relation to the moving of policy, not just
in this country but globally on tobacco policy?
(Dr Yach) The people who we speak to involved with
tobacco products regulation have fairly sound reason to believe
that the science of addiction, the science of tobacco product
modification, has been considerably advanced within the tobacco
industry and much of that has not seen the light of day. We would
save enormous public resources by having that information now
and not having to repeat a lot of research that may be required.
262. Can I just interrupt. To simplify what
you are saying, you are implying that the tobacco companies could
have produced a much safer product a long, long time ago but chose
not to. Or have I misunderstood what you are implying?
(Dr Yach) Yes, that is correct. We have good reason
to believe, again going back for many years, tobacco companies
agreed not to compete in the area of safety and improved health
consequences. There were no economic incentives then for any individual
company to do that.
263. So there was a cross-industry agreement
on this issue?
(Dr Yach) We believe that there was. I think the documents
that we already have at our disposal show that has occurred in
many areas of research, that denial of the evidence has been done
jointly by many of the companies, the way in which the direction
of research in their own areas has occurred, the way many of the
animal experiments, the mouse house in Germany and others were
closed down. That was all when lines of research were leading
into areas where they did not want it to proceed. I need to explain
where WHO is in the question of product modification. We must
admit that we have come to realise relatively late the critical
importance of this as an additional component of comprehensive
control. Dr Brundtland announced to the international regulatory
authorities in Berlin this year that she would be convening a
scientific meeting to look at what do we know about the basis
for setting stronger product modification rules. That meeting
will be held in Norway in February. Many of your own scientists
will be present at that meeting. Part of the problem we have is
that not all of the evidence will be on the table because some
of it is still being held within the vaults of the tobacco industry.
264. You have referred to the Guildford documents.
(Dr Yach) Yes.
265. Have you accessed those documents? What
problems do you perceive in respect of public access? What assistance
might this Committee offer in terms of not just accessing the
Guildford depository but also the other archives that you have
obviously referred to in respect of other companies?
(Dr Yach) First of all, with regard to the US based
companies, I think that access has improved considerably. Philip
Morris, for example, provided updated information until late 1998/1999
under the terms of the settlement. Much of the material is on-line.
We have sent some of our staff to Guildford and in the initial
searches, really being able to go through only a few thousand
documents, we have found some of the most important information
showing the way in which the tobacco industry worked globally
compared to the US where probably a lot more of the science is
based. So from an international perspective we would regard what
is really contained in Guildford as being crucial for many of
our developing countries, particularly those, of course, where
BAT has historically played an important role. The same probably
occurred elsewhere. Step one must be to see whether the documents
have already been scanned and, if they have, to make them available
on the Internet. Step two would be if they have not been scanned
to ensure that we find the public resources to scan them. We believe
the costs would be minimal compared to the enormous public benefit.
We also believe that a range of research institutions, public
and private, should be encouraged to work together with the British
Government to actually make that a high priority to occur very
fast. We are currently involved in developing the first international
treaty WHO has ever been involved in. That will focus on tobacco
control. We need that evidence as the treaty making process starts
moving ahead. We would also hope that UK institutions, your Medical
Research Council and others, for example, would see this as a
legitimate area for public funds to be used to do research on
the benefits of using the tobacco industry documents to advance
public policy. The National Cancer Institute for the National
Institute of Health has invested reasonable funds in making this
an important research topic in the US. So this is now regarded
as the appropriate line of research to advance cancer control
as well.
266. Over and above pursuing the research issue,
clearly in the States the action that has been taken arising from
the Minnesota action has resulted in a significant amount of money
accruing to individual states from the settlement. Some of the
states have used this money to invest in anti-smoking policies
in quite a detailed and radical way. Do you see the access to
records issue possibly leading on to similar litigation elsewhere
outside the States, possibly in this country and other countries
that globally would be concerned with the tobacco issue?
(Dr Yach) A number of countries have approached us
for support with regard to finding out whether litigation is a
sensible option. Our advice is very simple: we support those activities
that advance public health goals. The primary focus of litigation
should not necessarily be to regain fund money per se,
but to ensure that healthy public policies are put in place. The
truth and the information coming out of the documents in itself,
independent of the funding, we believe is a means of advancing
that policy debate. The answer is absolutely clear that many countries
are seriously considering litigation in different forms. There
are already a number of court cases under way. The Indian Supreme
Court is one of those examples. We suspect that over time they
will recognise that fundamental to any court case is the ability
to have information about the behaviour of the tobacco industry
and certainly in the case of many of the multinationals that would
be very important, as with other UK companies.
Dr Brand
267. A quickie on this. You said that the cost
would be minimal compared to something. Would you speculate and
put a figure to putting the Guildford documents on-line?
(Dr Yach) Sure.
268. Because clearly that is the raw material
from which further research can then be done. That is for the
scientific bodies. The actual getting the stuff in the public
domain, how much would that cost?
(Dr Yach) We would estimate, based upon roughly how
many pages of documents there are and how much the scanning costs
are, we are probably talking about $2 million to $4 million as
a single cost for scanning the material and making it available
on the Internet. The comparison would be against the hundreds
and hundreds of millions of dollars going into all forms of treatment
and other research activities and tobacco control which are run
either by the Medical Research Council or the Wellcome Trust or
others.
Mr Burns
269. Earlier in one of your answers you were
talking about your belief that the companies at some point had
joined together to stop progressing any further research in certain
areas. Do you have any actual concrete evidence of this or is
it more anecdotal?
(Dr Yach) No, it is not anecdotal. I think one of
the earliest documents goes back to 1980 when a document prepared
by the tobacco industry stressed the role of ICOSI, which stands
for the International Commission on Smoking Initiatives and was
formed by the tobacco companies in the 1980s. One of the goals
stated by them—we will leave the document numbers with you—was
"the first initiative on a worldwide scale to counter the
actions of anti-smoking groups". That was their professed
aim. Under it they then went on to disclose what specific steps
they should take. These were then elaborated further in a range
of documents, including one of those held in a conference in Boca
Raton in 1988 sponsored by Philip Morris but joined by many of
the other companies where Geoffrey Bible, who was then the President
of Philip Morris International and now is the Chief Operating
Officer of Philip Morris, talking about WHO stated "this
organisation has an extraordinary influence on government and
consumers and we must find a way to defuse this and reorientate
the activities to their prescribed mandate. In addition, we need
to think through how we can use our food companies' size, technology
and capability with governments by helping them with their food
problems and giving us a more balanced profile with the government
than we now have against WHO's powerful influence". They
went on in the document to talk about the International Labour
Organisation. The aim of their plan was to inhibit corporation
of ILO into WHO's anti-smoking programmes and to take urgent steps
to contact worker and employer leaders of these groups in the
ILO governing bodies. One last comment: also in the same period
the Boca Raton plan discussed "countermeasures designed to
contain, neutralise, reorientate the World Health Organisation"
and stated "the necessary resources should be allocated to
stop WHO in their tracks". Because of this Dr Brundtland
felt this was such a serious influence on WHO historically that
it hampered us being able to move ahead with great enough clarity
and in October she called for an inquiry into the way in which
WHO and the UN systems have had their policies thwarted by the
industry and appointed a member of our executive board, Dr Zeltner,
who is Head of the Federal Swiss Health Department, to head the
inquiry which will be getting under way very soon. This is unprecedented.
I need to say that the World Bank has also joined the inquiry
and has nominated a top anti-corruption expert to join the inquiry.
Chairman
270. Would that inquiry have any bearing on
the way in which individual governments, such as our own, may
have had their efforts thwarted by the tobacco companies over
the years?
(Dr Yach) The terms of reference are mainly to focus
on the international domain. Dr Brundtland made it clear in her
statement that we would hope that individual governments would
carry out their own separate inquiries. I think this is an excellent
example of one which would be able to contribute to what WHO is
doing and, similarly, I think our insights at the global level
will also help to put in perspective the importance of this national
initiative as having global relevance.
271. So you would be urging us to press the
British Government to establish a similar inquiry, but we had
ministers in this place in 1954 actually talking about the connection
between smoking and ill health. It has taken so long for any meaningful
initiatives to be brought in. You would see that as very relevant?
(Dr Yach) Very relevant. I think we have to realise
the global relevance of the work done by Sir Richard Doll and
colleagues afterwards, that is regarded as ground breaking globally
important research right from the 1940s and early 1950s. We have
looked to the UK epidemiologists to provide the lead on tobacco,
and have received it, and increasingly they have played an international
role as well.
272. You used the word "corrupted"
in terms of how your organisation had been prevented from being
effective on this issue. Do you believe that other governments
and parliaments have been corrupted by the influence of the tobacco
companies?
(Dr Yach) We believe certainly the policy process
has been thwarted and certainly we would be able to show that
there have been severe efforts to stop policies being put in place
that are regarded as simply sensible public policies by WHO, the
World Bank and its member states. There would be many, many examples
of that.[2]
273. Have you any examples in respect of where
the British parliamentary system and the British Government system
has been thwarted by the kind of influence that you are talking
about?
(Dr Yach) No.
274. That is what we are looking at here.
(Dr Yach) No, I do not have any of that. I can assure
you that probably many of the people who will give evidence here
would have a better insight from an individual national perspective.
Audrey Wise
275. I just want to refer to the practicalities
of these documents at Guildford because it has been made very
clear to us, and you are reinforcing it, that the current arrangements
are hopelessly inadequate with very limited time and very limited
space for researchers to go in. There are a lot of documents.
I think I understand that you are saying very clearly that it
would be money well spent to have the whole lot put on the Internet.
(Dr Yach) Yes.
276. Now, I have taken serious note of that
and I am sure the Committee has. We have also heard informally
and while we have been in the US this question has come up a great
deal, as you can imagine, and we have wondered whether there is
anything short of that that would be useful. Suppose we made an
attempt to be more selective about what we asked for, would there
be anybody who could guide us as to how we would select the most
important documents? Or is it really very important to have the
whole lot?
(Dr Yach) I think, given the dramatic advances in
information technology and the electronic searching capability,
our advice would be to get the whole lot because you can never
be entirely sure of setting the right questions and the right
search parameters. I think we have found great difficulty even
using the available searching ability to find things and often
they crop up under different categories that you do not suspect.
I do not think that there will be a cost saving, there may in
fact be extra costs in being more selective, whereas at least
getting the material on to the Internet and then applying our
minds using the best of library science to search better, as well
as to have access to the indexes used by the tobacco companies
themselves, would save an enormous amount of time and effort.
There are, of course, many experts we could put you in touch with
who would be able to either verify this or give further detailed
information on the problems they have faced in searching through
documents for many years, those involved in the court cases in
the US for example and in Canada.
Audrey Wise: I think that would be very useful.
Mr Austin
277. In answer to the Chairman's question you
actually used the phrase that the research direction had been
"undermined". Was this merely as a result of the non-disclosure
of the information that was available to the tobacco companies
or by some other means?
(Dr Yach) I think we know in the case of environmental
tobacco smoke, for example, that the research process has been
affected in many ways: the setting up of many bogus or front groups
involved in research paid by the tobacco company to try to ensure
that no association was found. This has happened in the US, in
Japan, in Germany, and I am sure in the UK. The funding of enormous
amounts of symposia to try to continue to ensure that the passive
effects of tobacco on human health were not actually brought to
the public domain. The fact that when large scale European research
studies were carried out by our own sister agency, the International
Agency for Research on Cancer, there were fairly sustained efforts
to try to find out who were the researchers, could they influence
them, could they thwart the direction? There are many documents,
not one or two but tens of documents, that have shown how they
were particularly concerned with the European study showing that
the impact of environmental tobacco smoke in Europeans was much
the same as it is elsewhere, because of the consequences for smoking
in public policies moving faster in Europe. In the other areas
of research there were examples of animal research which was stopped
in its tracks because they realised reading through the documents
that these would not look very good if they were ever made public.
278. You are actually saying that it is not
just the withholding of the information but they set out deliberately
to create false facts on the ground.
(Dr Yach) Yes.
279. To mislead.
(Dr Yach) This is described particularly in the Minnesota
court case and the documents coming out of the Minnesota court
case and others.
2 Note by witness: I did not use the word "corrupted". Back
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