International tobacco control should repudiate Jekyll and Hyde health philanthropy

The founder of the Salvation Army, William Booth, famously said, “Take the Devil’s money, wash it in the Blood of the Lamb, and use it to save a dying world”. Booth thus opened the door for people of goodwill to take money for noble works from assorted devils. Today it is commonplace, for example, for religious charities to accept money from gambling taxes. The gratitude of the poor, the sick and the needy can quietly usher aside impertinent considerations about where the money came from. When the sums offered are modest, the high moral ground of principled refusal is more easily climbed. But the devil can have all the best tunes when it comes to Faustian temptations.

So what should global tobacco-control workers make of the world’s richest man,1 Mexican billionaire Carlos Slim Helú, pouring rivers of money into health, education and poverty charities in Latin America? Slim announced this year that he will expand the endowment of his foundations, such as the Carso Foundation, to US$10 billion over the next four years, up from US$4 billion, and will dedicate himself more to philanthropy. Slim set up the Carso Health Institute, initially endowed with US$500 million, and nominated Dr Julio Frenk (former minister of health in Mexico and former candidate for WHO’s director-general position) for the institute’s executive-director position.2

Although most known for his telecommunications business, Group Carso, which he controls, Slim owns many other businesses, including until recently a majority ownership of Cigatam, Mexico’s largest tobacco company. Cigarros la Tabacalera Mexicana (Cigatam) was majority owned by the Carso Group (Philip Morris Mexico owns the other 49.9 percent). In July 2007 Philip Morris International announced an agreement to buy an additional 30 percent of shares from the joint venture with Group Carso (which would keep 20 percent of shares). The acquisition is valued at US$1.1 billion. PMI’s press release on the deal quoted Miroslaw Zielinski, president for the PMI Latin America and Canada region: “Our relationship with Grupo Carso and its founder, Carlos Slim Helú, has proven to be extremely successful and we look forward to further growth of our business in Mexico.” The release continued: “Carlos Slim Helú will continue to serve as an advisor to Philip Morris Mexico, S.A. de C.V. and will remain an active partner in our Mexican tobacco business.”3

“Extremely successful” business for a tobacco company is none-too-subtle code for maintaining and increasing smoking in populations. It means seeing new generations of young smokers commence smoking, slowing cessation and maximising the retention of smoking opportunities by opposing smoke-free policies. Unavoidably, it means that your core business causes unparalleled numbers of preventable, often early and hideously wretched deaths, increasingly among smokers who are the least educated and most economically disadvantaged in the population. It means publicly posturing about informing smokers about health risk and addiction while “maintaining in a litigation setting its former position that it cannot be proved that smoking causes disease or is addictive”.4 It means embracing tokenistic and ineffectual tobacco control programs5 while opposing effective tobacco control policies known to seriously harm tobacco sales. In summary, it means having all the ethics of a cash register.6

Slim’s efforts to improve the health of Latin Americans while continuing to profit from tobacco sales is nothing but the latest episode in Jekyll and Hyde duplicity. His continuing “active partnership” with Philip Morris invites consideration of what advice he might be giving them. What will he suggest about compensating the families of tens of thousands of Mexican smokers who died early from smoking Cigatam products? What will he advise that they do with their earnings from underage smokers each year? Will he urge that Mexico move all retailed tobacco under the counter as happens in Thailand, significantly raise tobacco tax and be the first nation to introduce plain packaging? Will he fund mass reach, effective graphic campaigns known to reduce sales or support PM’s tepid, feel-good and ineffectual youth smoking prevention campaigns?

There is now a conga line of health and poverty-relief agencies and researchers applauding Slim’s philanthropy and hoping to get in on the action. Business philanthropy is to be applauded, but when a philanthropist’s day job is a major contributor to the death and disease that his generosity in part seeks to redress, it is time for all self-respecting agencies to make a stand and refuse to have anything to do with it.