Kelley Lee

London School of Hygiene & Tropical Medicine

In an email invitation to its “Health is Global, Partners Forum”, held on 22 November 2012, the UK Department of Health expressed pleasure that The Right Honourable Kenneth Clarke QC MP (Minister without portfolio and Trade Envoy) would speak on Trade for Better Health. The one-day meeting is an annual event bringing together key partners concerned with the UK’s Health is Global Strategy.

The DOH’s Global Health Team, however, could not have picked a more controversial British politician to headline its annual partners’ meeting. Clarke has been a Member of Parliament since 1970, serving as minister under the Thatcher, Major and now Cameron governments. His popularity has, in large part, been due to his personae as a somewhat jovial uncle. The controversy that has dogged his career, some argue preventing him from becoming Prime Minister, has been his close relationship with the tobacco industry.

After leaving office in 1998, Clarke became a director and deputy chairman of British American Tobacco (BAT), a position he occupied until 2007. The release of internal company documents led to allegations that he accepted hospitality from BAT while Chancellor of the Exchequer, in one case, thanking then BAT Chairman Patrick Sheehy for a “note and folder”, and promising to discuss it with the Treasury.

After joining the company, he played a leading role in expanding access to overseas markets such as Vietnam. When allegations broke of the company’s complicity in cigarette smuggling, Clarke defended BAT to the House of Commons Health Select Committee as “a company of integrity” and “an extremely good corporate citizen”. Evidence of smuggling has continued to accumulate including on Vietnam.

Upon returning to office as Justice Minister in 2010, and allegedly under pressure from business lobby groups, Clarke was accused of trying to delay and limit the jurisdiction of the Serious Fraud Office under the Bribery Act 2010.

All of this would suggest that Clarke is no friend to any strategy to promote “global health”. Yet the evident delight of the Global Health Team in inviting Clarke may reflect a shift in how the DOH is interpreting its mandate under this strategy. Launched with much fanfare by then Prime Minister Gordon Brown in 2008, development lay at the heart of the Labour government’s global health strategy. As described in The Lancet, “better health in poor countries is good for our own health, as well as being essential to improving wellbeing and tackling poverty globally.”

Under the present Coalition government, and during a period of economic austerity, global health has cosied up to trade policy.  Global health is a market opportunity, in other words, for UK plc to earn a few pounds.

This latest incarnation of Clarke, as a global health partner, is perhaps unsurprising. After all, Clarke is no stranger to irony. As health secretary from 1988-90 he remained infamous for his cigar smoking and less than healthy lifestyle. He was chancellor, responsible for ensuring that Customs and Excise were not cheated of its revenue, throughout the period when BAT is accused of smuggling billions of cigarettes worldwide. He was the company director who brokered the BAT-sponsored creation of the International Centre for Corporate Social Responsibility at Nottingham University. However, this didn’t stop the company maintaining operations in Burma and Uzbekistan.

He is now minister without a portfolio which, it would seem, gives him a free hand to have a jovial laugh at the expense of the DoH’s global health strategy.