Overcoming the corporate playbook in international treaty negotiations: Insights from the Framework Convention on Tobacco Control.

International health-related treaty negotiations are often subject to outsized influence from transnational corporations and states that protect economic interests at the expense of developing and implementing strong, health-promoting obligations. In the early 2000s, proponents of global tobacco control faced these conditions when negotiating the Framework Convention on Tobacco Control. Indeed, the tobacco industry and major states, including the United States and China, exerted continual pressured to abandon or weaken the Convention. Even more challenging, World Health Organization officials and health ministry representatives on state delegations were inexperienced with treatymaking. Despite these circumstances, the Convention contains a markedly strong set of obligations. Existing theories centered on major state power and domestic politics cannot explain this outcome. Drawing on a document analysis, this paper argues that the Convention's unexpected strength is explained by the distribution and uses of institutional, principled, and expert authority by a diverse coalition of state and non-state actors that shared a vision, evidence basis, and moral claims for the treaty. As international health-related treaties can help advance progress on pressing transnational health issues, and contemporary negotiations face resistance from industry opponents, this work offers important insight on how multistakeholder coalitions can negotiate strong obligations under the most challenging conditions.