When delegates gather in Geneva on November 17 for the 11th Conference of the Parties (COP11) to the World Health Organization’s Framework Convention on Tobacco Control (FCTC), few will ask the obvious question: who pays for the room where it happens?

The FCTC is the world’s only binding treaty on tobacco control. It now shapes national law far beyond its original remit, guiding taxation, packaging, advertising, and—indirectly—the regulation of new nicotine products. Yet the decisions that ripple out from Geneva are made within an ecosystem financed not by member-state dues but by a tight web of foundations, governments, and advocacy groups whose interests align with one another—and with parts of the pharmaceutical industry.

The Philanthropic Powerhouses

Since 2007, Bloomberg Philanthropies has poured more than $1.6 billion into global tobacco control. Through its Bloomberg Initiative to Reduce Tobacco Use, it funds Vital Strategies, the Campaign for Tobacco-Free Kids (CTFK), The Union, and the University of Bath’s Tobacco Control Research Group. These organizations run the STOP consortium, a mainstay of FCTC side events and briefings.

The Bill & Melinda Gates Foundation plays a complementary role, notably bankrolling the Knowledge Hub on Tobacco Taxation at the University of Cape Town, co-funded by Cancer Research UK. And donor governments—particularly the UK, Norway, Australia, and the European Commission—finance the FCTC 2030 program, which underwrites participation by poorer countries.

Between them, these actors pay for the travel grants, research networks, and technical papers that shape what becomes official orthodoxy. Their combined effect is to make global tobacco policy a donor-driven enterprise rather than a genuinely multilateral one.

The Quiet Pharmaceutical Presence

Article 5.3 of the FCTC excludes tobacco-industry involvement, but it says nothing about pharmaceutical companies. That leaves the door ajar for firms whose products—nicotine-replacement therapies, prescription cessation drugs—benefit directly from restrictive tobacco and vaping policy.

The connection is not theoretical. Pfizer and GlaxoSmithKline, makers of Chantix and Nicorette, sponsored major WHO-endorsed conferences such as the 2006 and 2009 World Conferences on Tobacco or Health. Professional societies tied to the WHO, including the European Respiratory Society, routinely accept pharmaceutical sponsorship for congresses and fellowships while collaborating on cessation guidelines. The International Pharmaceutical Federation, an observer accredited to the FCTC, promotes pharmacist-led cessation within COP sessions.

Meanwhile, commercial NRT brands sustain visibility through sports and “quit-smoking” campaigns that echo WHO messaging. Each new guideline or subsidy for cessation pharmacotherapy expands its potential market. It is a tidy symmetry: what the FCTC defines as a public-health obligation also functions as product promotion for the companies supplying the sanctioned cure.

The Absent (and Excluded) Industry

By contrast, tobacco and vaping manufacturers are nowhere near the COP’s official agenda. The Secretariat’s donor lists include no industry money; Article 5.3 is interpreted to mean zero contact. When firms seek a hearing, they do so outside the tent—through events like the Global Tobacco and Nicotine Forum or the “counter-conferences” that coincided with COP10 in Panama. Delegates are advised to stay away.

Whatever one’s view of the industry, this asymmetry matters. It ensures that only one side of the nicotine-policy spectrum has institutional access, and that side is heavily financed by donors and industries whose interests are presented as moral rather than commercial.

The Bootleggers, the Baptists—and Their Modern Merger

The economist Bruce Yandle first coined the phrase “Bootleggers and Baptists” in 1983 to describe how moral campaigners and profit-seekers can support the same regulation: Baptists give it virtue; Bootleggers reap the gains.

Four decades later, Chris Snowdon of the Institute of Economic Affairs argues that in modern Britain the two have largely merged into a single class of “Bootlegging Baptists”—activists who believe in their causes yet whose livelihoods depend on the expansion of the regulatory state. The moral and the material have become indistinguishable.

That insight travels neatly to Geneva. The global tobacco-control establishment is no longer a coalition of idealists and opportunists but an integrated network. Philanthropic foundations supply the cash and the moral narrative; advocacy NGOs provide the policy muscle; academic centers add legitimacy; and the pharmaceutical industry profits quietly as demand for its cessation products grows.

This alignment has produced what might be called institutional moral certainty: a conviction that restricting nicotine in every form is self-evidently virtuous, even when evidence of harm reduction challenges that premise. Swedish data showing minimal smoking and record-low cancer rates, thanks to snus and nicotine pouches, barely register in FCTC documents. Such products threaten the consensus, both ideologically and financially.

The Cost of Consensus

The practical outcome of this fusion is policy rigidity. Once advocacy and industry are financially interdependent, neither has reason to question the other’s assumptions. Funding circulates between the same actors; criticism is treated as heresy; and innovation that arises outside the sanctioned ecosystem is dismissed as industry propaganda.

By insulating itself from the tobacco and vaping sectors, the FCTC has not eliminated conflicts of interest; it has simply chosen a different set of them. Philanthropic and pharmaceutical influence is treated as benign because it aligns with WHO orthodoxy. Yet that influence shapes global markets just as surely as tobacco lobbying once did—only now in the name of health rather than commerce.

The risk is not corruption in the crude sense but epistemic capture: a situation where funding and ideology reinforce one another until dissenting evidence—especially about harm-reduction—cannot gain entry. That dynamic explains why countries that have successfully reduced smoking through safer nicotine products, such as Sweden and Norway, are rarely cited as models. Their experience sits outside the moral framework that underpins the treaty.

What Reform Would Look Like

If the WHO and its member states wish to restore confidence in the FCTC, they must extend their conflict-of-interest principles beyond the tobacco industry. Every entity—commercial, philanthropic, or academic—that has a material stake in nicotine policy should disclose its funding. Observer status should be conditional on full transparency about donors, contracts, and consultancies.

Equally important, the COP process must open itself to scientific evidence from harm-reduction research, even when it originates from disfavored quarters. Consumers who have quit smoking through vaping or nicotine pouches deserve representation in the conversation that governs their lives. Public-health treaties should not become guild monopolies for those already inside the funding circle.

The View from Geneva

As COP11 opens, the banners will again proclaim unity against Big Tobacco. But the real story is about Big Philanthropy and Big Pharma—about the quiet forces that pay for the hotels, commission the studies, and write the talking points. None of this funding is secret; it is simply unexamined.

The FCTC’s defenders will say this is how global health works: private donors fill gaps left by states. Perhaps so. But when those donors’ priorities shape what counts as legitimate science or moral virtue, the result is not a neutral technocracy—it is a global policy cartel. The Bootlegging Baptists are in charge now, and they mean well. That may be the most dangerous thing about them.