GENEVA — In a major shift in position, the United States indicated Sunday that it would back a global anti-tobacco treaty due to be adopted at the World Health Organization's annual assembly.

Adoption of the accord after four years of negotiations is one of the highlights of the 192-country health assembly, which will also be dominated by the SARS virus and WHO's efforts to change global health regulations to cope with new infectious diseases and the threat of bioterrorism. "Much to the surprise of many around the world, I am going to be supporting the tobacco treaty," said U.S. Health and Human Services Secretary Tommy Thompson on the eve of the ministerial meeting. However, he stressed that U.S. President George W. Bush would decide "if and when he signs it." He didn't make any predictions on whether U.S. Congress would agree to ratify it. Anti-smoking activists and developing countries have persistently accused the United States of trying to undermine the tobacco accord, which envisages total bans or restrictions on advertising and marketing, new labelling controls and a clampdown on smuggling and second-hand smoke. The language of the treaty was agreed in March over U.S. objections that it did not allow countries to opt out of individual clauses, a procedure known as taking reservations - and thus meet the needs of the U.S. constitution. The United States subsequently wrote to the other 191 countries in WHO, saying that its ability to sign and ratify the convention was undermined by the ban on reservations and asking for support to reopen the negotiations and delete the ban. However, virtually no other country was willing to renegotiate the text. Sen. Tom Daschle of South Dakota and Rep. Nancy Pelosi of California, the Democratic leaders in the Senate and House respectively, asked Bush in a letter not to reopen the tobacco negotiations. Rep. Henry Waxman of California, was also highly critical of U.S. behaviour. "I'm not going to make any changes, no reservations," Thompson told a small group of journalists. "Our delegation here, headed by me, is in support of the tobacco treaty." Until Sunday, most observers had feared that the United States would tell the assembly it wouldn't be able to support the treaty. "Wow. That's astonishing," said Kathryn Mulvey, director of the campaign group Infact, when told of Thompson's declaration. "That's a complete break from the past and it's great news for the rest of the world," she said. The European Union agreed Thursday to ratify the anti-tobacco treaty, but said that Germany, which has a strong cigarette lobby, would be allowed to exempt itself from a clause providing for a ban or restrictions on advertising. The so-called Framework Convention on Tobacco Control is meant to stem the toll in tobacco-related disease, which currently stands at nearly five million people per year and is expected to climb to 10 million per year over the next two decades. There are an estimated 1.2 billion smokers in the world and WHO surveys show that smoking rates among 13-15 year-old children are about 20 per cent. The anti-tobacco convention was one of the top priorities of WHO Director General Gro Harlem Brundtland, who is standing down after five years in office. South Korea's Jong-wook Lee, head of WHO's Stop TB Program, is due to be approved as her successor at the assembly. Lee takes over just as the UN health agency is held in higher regard than for many years. Its high-profile action in tackling the SARS virus by issuing travel restrictions and advising affected countries on the course of action has won widespread praise. WHO says the spread of the virus has emphasized the need to reform the international health regulations to cope with new infectious diseases like Ebola and the risk of bioterrorism. WHO has also hit the headlines with its recent report on diet and health, recommending for the first time that sugar consumption be limited to 10 per cent of calorie intake. A reception to mark a meeting of Commonwealth health ministers on the eve of the assembly thus caused consternation in WHO circles because it was jointly sponsored by the Commonwealth Dental Association and Coca Cola. Brundtland did not accept the invitation.

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