Many health problems require international action, but getting governments to agree on strategies for prevention or treatment is difficult. By making use of scientific evidence on the effects of tobacco, the member states of WHO have negotiated their first global health treaty. If the treaty can be implemented effectively, it could act as a possible model for tackling other health issues

When Dr Gro Harlem Brundtland became director general of the World Health Organization in 1998, she clearly stated that the tobacco epidemic should be tackled by an international collective action and that WHO should take a leadership role.1 In 1999, WHO started work on the WHO Framework Convention on Tobacco Control, which was endorsed by member states on 21 May 2003. It is the first time WHO has used its constitutional authority in global public health to develop a legal instrument aimed at improving population health. The initiation and negotiation of the framework convention was based strongly on the accumulation of scientific evidence.2 We review the development and scientific basis of the convention and discuss its implications and the potential of international collective action against threats to global public health.