The year 1998 was a monumental one in the history of public health.
The Master Settlement Agreement, the largest civil litigation settlement in U.S. history, forced the tobacco industry to face the damage it had caused to the lives of millions of people. The four largest tobacco companies were ordered to pay billions of dollars to states, and the sale and marketing of cigarettes in the U.S. was restricted.
That same year, Sylviane Ratte, then a French chef-turned-graduate-student in politics at Edinburgh University in Scotland, moved to London to work for the Health Education Authority, a quasi-governmental organization with a multidisciplinary approach, similar to Vital Strategies.
“It’s tiring to want to change the world, and everyone has their own way to think about how the world can be changed, but we are really spoiled and lucky. We are in a really exceptional place.”
Sylviane’s organization provided evidence to the British parliamentary inquiry into the behavior of the tobacco industry. As part of the Master Settlement and legal decisions in the U.S., major tobacco companies had to put their archives in the public domain. At the headquarters of British American Tobacco in Guilford, England, the U.K. depository for tobacco industry archives, Sylviane was able to search industry records and read deeply disturbing documents.
“The experience was mind shattering. I had already been working on young people and tobacco and was aware of industry behavior but this was something else!”
She found three things most shocking.
“One was the completely cynical, criminal, wasteful and malevolent nature of these companies, using all possible means, including illegal means, to expand the sales of a product they knew would create many diseases and kill one out of two of their consumers,” she said. “Another thing was their capacity to brainwash millions of people around the world by manipulating and corrupting the media and decision-makers by producing what we would now call fake science and fake news, and paying doctors to lie just for profit. Lastly, and very important was the strategy of destruction they had put in place to attack, to denigrate and silence the then very few tobacco control advocates around the world, including portraying them as health fascists, against freedom.”
Sylviane found her own name in one document, which she said marked the end of any naiveté she had. The tobacco epidemic, she said, “was a completely avoidable and manmade disaster.” The industry had to be brought to justice.
Sylviane’s drive for equity and justice began in Cannes in the south of France, where she was born to parents with modest means and basic educations.
“We were living in the wealthiest place on earth where a lot of money and very little money lived side by side,” she said of Cannes. “I always had my sense of justice, trying to rectify that gap between rich and poor.”
While Sylviane began working as a chef for the Sheraton Hotels in Scotland, she always volunteered or worked to help people on the side. She ran a child care program for refugees from Chile, assisted a theater group for people with mental health disorders, and taught French to those with little education.
About two years after her experience combing through tobacco industry documents in London, Sylviane returned to France, where she has lived ever since.
She ran a network of “smoke-free hospitals” and then developed and worked for the French Cancer League. In 2005, Sylviane joined the French government, an opportunity that has defined her career.
At the French Cancer League, she and others had helped push then-President Jacques Chirac to make cancer and tobacco control a priority of his administration, and he created the National Cancer Institute. Sylviane was brought on to manage the tobacco control unit, and during her time there, despite much resistance, the National Cancer Institute helped increase tobacco taxes in France and pass smoke-free laws, first in businesses in 2007 and in hotels, restaurants and cafes in 2008.
Sylviane also helped create, with colleagues from European Respiratory Society and Cancer UK, the Smoke-free Partnership in Europe, an advocacy group to counter the tobacco industry lobby at the European level in Brussels.
Sylviane was entrusted at the cancer institute with the responsibility to follow the negotiations of the World Health Organization’s Framework Convention on Tobacco Control, the first legally binding public health treaty developed under WHO, which has set global policy on tobacco control ever since.
“France contributed quite a lot to push some of the good treaty articles on advertising bans, for example, fending off the tobacco industry challenges, notably with Germany at the time. The contribution was really important, and I really enjoyed my time and the progress we made,” she said. “On tobacco control, a handful of passionate and clever people around the world who figured out how to start cornering the industry moved a huge field. It was very exhilarating, and a big learning curve.”
In 2007, Sylviane began work at the International Union Against Tuberculosis and Lung Disease, on Bloomberg Philanthropies tobacco control program in Indonesia and Turkey, and eventually in Africa. After eight years, she welcomed an opportunity to shift her career.
“I was seeing the same people 20 years in tobacco control. The community was quite closed. I decided quite early on that as soon as France had plain packaging, I would leave tobacco control and apply what I had learned to other fields.”
France adopted plain packaging, which eliminates attractive marketing from cigarette packs, in 2015. That same year, Sylviane began to work on Vital Strategies’ new road safety program as part of the Bloomberg Philanthropies Initiative for Global Road Safety.
She is proud of the Initiative’s considerable achievement reducing crashes in its 15 cities, from Mumbai to Fortaleza to Accra. Road safety has been institutionalized into city planning, for example, roads are now being designed and inspected from a safety perspective from an early stage.
Sylviane has further been charged with developing Vital Strategies’ office in Paris across the organization’s focus areas. She would like to use that platform to, among other things, do more for francophone countries in Africa and she is currently developing links with the International Association of Francophone Mayors.
In her 30-year career, Sylviane says that Vital Strategies is the best place she has ever worked.
“We are so spoiled to have an alignment of people who have the skill sets and the funds. When you’ve had the experience of struggling to find funds, as I have, to have these planets aligned is incredible,” she said. “It’s tiring to want to change the world, and everyone has their own way to think about how the world can be changed, but we are really spoiled and lucky. We are in a really exceptional place.”