Billionaires vs. Big Tobacco in the Global South

Last year, we reported on the creation of the Anti-Tobacco Trade Litigation Fund with financing from the Gates Foundation and Bloomberg Philanthropies to help low- and middle-income countries' governments defend against international trade suits brought by tobacco companies. These suits have been a key way for big tobacco to keep open growing markets in poorer countries amid new efforts to impose controls on tobacco use. Such efforts, strongly backed by Bloomberg and Gates, have the potential to save innumerable lives—with tobacco use the leading cause of preventable death in the world, claiming 6 million lives annually—but pose a deep threat to corporate profits. Since its inception, the Anti-Tobacco Trade Litigation Fund has already helped win at least one major victory in Uruguay.

Welcome to the most intriguing global health battle now underway—one that pits an aggressive U.S. industry against two of the richest men in the world.

In the U.S., tobacco use has been on the decline since the mid-1960s. The decrease can be attributed to a number of undertakings, including effective anti-smoking campaigns, steep increases in tobacco taxes and changes in social norms. As a result, the tobacco industry saw some serious declines in revenue. But that wouldn't last long as the industry began moving into poor country markets.

And business is booming.

The top six tobacco companies—all located in developed countries—own 80 percent of the world's tobacco production. In 2013, big tobacco profits were equal to those of Coca-Cola, Walt Disney, General Mills, FedEx, AT&T, Google, McDonald's and Starbucks combined. Big tobacco seems unstoppable.

But the anti-smoking movement has some pretty powerful allies in its corner, with Mike Bloomberg leading the charge. Tapping a fortune that now stands at $41 billion, Bloomberg has already given $600 million since 2007 to curb tobacco use in poorer countries, and recently, Bloomberg Philanthropies announced that it would be committing an additional $360 million to these efforts.

The Gates Foundation, meanwhile, has sunk over $200 million into its anti-tobacco work since 2008. We're surprised that this number isn't higher, since saving lives by curbing smoking is low-hanging fruit compared to other challenges that Gates is pursuing. Bending the mortality curve on this issue doesn't hinge on big breakthroughs on vaccines or anything like that. Rather, it requires taking a bunch of common sense public health steps that worked so well in advanced countries. (The same is true for saving lives through improved road safety, another Bloomberg priority area that this funder has nearly to itself.)

Maybe Gates hasn't invested more on tobacco because Bloomberg is on the case. Certainly, Mike's foundation shows no signs of backing off on this front.

The new $360 million will go toward the support of "evidence-based policies" to slow tobacco use, and will continue backing campaigns to increase public awareness of the dangers of tobacco in low- and middle-income countries (LIMICs). This latest round of funding builds on a decade of Bloomberg's work.

In 2006, he invested $125 million in support of global anti-smoking campaigns. In 2008, Bloomberg Philanthropies and the Gates Foundation launched the Initiative to Reduce Tobacco Use. Focusing on LIMCs, the initiative aims to reduce global tobacco use through a "comprehensive, proven approach that combines policy change with increased public awareness." Also in 2008, Bloomberg Philanthropies made a four-year, $250 million commitment to the WHO Framework Convention on Tobacco Control, collectively referred to as MPOWER.

Outlined by Bloomberg and WHO director Margaret Chan, the framework will monitor tobacco use, protect people from tobacco smoke, offer to help people quit, warn people of the dangers of tobacco, enforce media and sponsorship bans, and raise tobacco taxes. Funds from Bloomberg's latest give will also be used to expand MPOWER's policy strategies and campaigns to hold the tobacco industry responsible for the damaging health effects of its products.

Incidentally, MPOWER previously garnered a five-year, $125 million commitment from the Bill and Melinda Gates Foundation.

Gates and Bloomberg linked up again in 2015 with a combined $4 million investment in the Anti-Tobacco Trade Litigation Fund.

For those keeping track at home, the new Bloomberg pledge brings his total anti-smoking financial commitment to just under $1 billion. Throwing big money at a big problem with clear solutions is a trademark of Bloomberg's philanthropy, which is why we've twice named him as America's most "effective philanthropist."

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