In a brazen slap to both American science and American sovereignty, Dr. Reina Roa — Panama’s top health bureaucrat and the incoming head of the World Health Organization’s anti-tobacco treaty summit — is openly attacking the credibility of the U.S. Food and Drug Administration.
In an official July 8 communication, Roa dismissed the FDA’s evidence-based reviews of reduced-risk nicotine products such as e-cigarettes and pouches, arrogantly questioning the agency’s independence simply because its conclusions don’t align with the WHO’s ideological agenda.
If the global public health community truly wishes to reduce the burden of smoking, it must start by respecting the integrity of scientific bodies like the FDA.
This is not a harmless bureaucratic quibble. It is an extraordinary and unfounded rebuke of one of the world’s most respected regulatory institutions — and, by extension, an insult to the United States. Moreover, it’s a refusal to acknowledge an ever-growing body of scientific evidence demonstrating that non-combustible nicotine products are dramatically less harmful than smoking.
Roa’s claim that “there is no independent scientific consensus not affiliated with the tobacco industry confirming that these products pose a substantially lower risk” is demonstrably false. The global scientific consensus on this matter is overwhelming and spans continents, ideologies, and public health traditions.
Against science
The U.K.’s Royal College of Physicians stated in its landmark 2016 report “Nicotine without Smoke” that “the hazard to health arising from long-term vapour inhalation … is unlikely to exceed 5% of the harm from smoking tobacco.” Public Health England, now the Office for Health Improvement and Disparities, famously concluded that vaping is “at least 95% less harmful than smoking.”
In 2018, the U.S. National Academies of Sciences, Engineering, and Medicine found “substantial evidence that exposure to toxic substances from e-cigarettes is significantly lower compared with combustible tobacco cigarettes.” Cancer Research U.K. is clear that “e-cigarettes are far less harmful than smoking,” and Action on Smoking and Health in Britain echoes that “the evidence is increasingly clear that vaping is much less harmful than smoking.”
International bodies agree. New Zealand’s Ministry of Health, France’s National Academy of Medicine, Canada’s Centre on Substance Use and Addiction, and Australia’s National Centre for Epidemiology and Population Health have all publicly confirmed that vaping and other non-combustible nicotine products are significantly less harmful than smoking.
This is not outlier science. It is the core of responsible and evidence-based policymaking.
Willful ignorance or …?
Roa’s suggestion that these positions do not represent a true scientific consensus reflects either willful ignorance or a deliberate attempt to mislead. Worse, it insinuates that the FDA, a regulatory agency known for setting some of the toughest product standards globally, may be compromised or manipulated by the tobacco industry. This is an outrageous accusation bordering on outright defamation.
What a turnaround for the WHO. In its 2015 study group report, it recommended that “regulatory strategies developed by the U.S. Food and Drug Administration could be used as a basis for deciding on best practices.”
Yet now that the FDA has authorized vapes, heated tobacco, and nicotine pouches as “appropriate for the protection of public health,” Roa signals that the WHO has suddenly changed its mind — raising the question of whether her position has more to do with U.S. funding cuts for the WHO than with public health.
It would be troubling enough if this false rhetoric came from a fringe voice. But an official communique from the Ministry of Health of Panama and incoming president of the 11th Conference of the Parties, the key global gathering for setting tobacco policy under the WHO’s Framework Convention on Tobacco Control, should be held accountable.
The role should demand evidence-based leadership and the ability to unify countries around the shared goal of reducing smoking-related death and disease. Instead, Roa’s rejection of accepted fact signals a concerning unwillingness to engage with real-world data and a disregard for the urgent need to provide smokers — especially in developing nations — with accurate information.
Science demands better
Questioning the FDA’s independence is not only offensive to American regulators and public health professionals but also an error that weakens the credibility of the WHO. Tobacco harm reduction is not an American invention, nor is it industry propaganda. It is a public health strategy rooted in the principle of reducing risk for people who either can’t or won’t quit nicotine entirely. The WHO’s own Framework Convention on Tobacco Control treaty explicitly mentions harm reduction, yet it continues to sideline this approach in practice.
By downplaying the FDA’s role and dismissing the broad scientific consensus, Roa undermines the credibility of public health institutions worldwide and fuels mistrust in regulatory science. Ironically, in accusing others of lacking independence, she raises questions about her own objectivity in presiding over COP 11 — the most important international public health meeting of the year. Such a gathering should be conducted impartially, without an atmosphere that attempts to exclude the settled consensus about reduced-harm products.
Roa’s remarks betray the very mission of the WHO and the Framework Convention on Tobacco Control treaty. If the global public health community truly wishes to reduce the burden of smoking, it must start by respecting the integrity of scientific bodies like the FDA, embracing credible evidence wherever it originates, and recognizing that harm reduction is not a threat — it’s an opportunity.
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