Sohil Sud, MD


My interest in policy, politics, and global health stems from the belief that we are all impacted by the actions‚ intended or not‚ of policymakers and the systems they create. My family’s own trajectory has been directly influenced by the forces of British colonialism, Malaysian nationalism, and corporatized globalization‚ and that’s only going back three generations.  Moreover, I know I am not alone with such history; similar correlations between policy, migration, socioeconomics, and health could be made for every single being on this planet.  I aspire to bend the systems that so profoundly govern our existence in a manner that promotes equity, justice, and humanity.

Additionally, I am primarily a clinician (pediatric hospitalist), a job that is equal parts rewarding and frustrating.  It is a tremendous honor to be able to treat a teenage victim of gang-related violence, but I’d much rather he have a safe space to play.  It is a privilege to be able to stabilize a child suffering from severe asthma, but I’d prefer she instead not grow up in a household with individuals addicted to tobacco.  There’s only so much I can do with a white coat and stethoscope, and my work in policy arenas can feel at times more impactful and cathartic.

In that context, when I read that tobacco companies were exploiting trade rules to block policies designed to curb youth smoking, this felt like such a blatant affront to all of the values I espouse.  What systems allowed this usurpation of democracy, reinforcement of imperialism, prevention of prevention, and exportation of disease?  Why should a child in Uruguay or Vietnam remain vulnerable to deceptive marketing practices of tobacco companies that we’ve worked to outlaw in the United States?  I studied international relations, politics, and economics in both undergraduate and graduate schools and never came across the chapter that explained how a company can sue a country, over vital public health measures no less.  I sought to find out.


Our strategy was multi-pronged. On a personal level, I strove to become a subject matter-expert. Not surprisingly, there are not many pediatricians-turned-global-trade-experts, so I saw an opportunity to become someone able to speak to both the adverse health outcomes of youth exposure to tobacco and the perverse policies that perpetuate them.

I connected with Ellen R Schaffer, PhD and Joseph Brenner, MA of the San Francisco-based Center for Policy Analysis on Trade and Health (CPATH).  I am forever indebted to the efforts that these two remarkable and passionate individuals took to mentor and inspire me.  Together, we accomplished the following:

  • Became experts: researching and publishing a peer-reviewed article on this topic in major pediatric journal
  • Preached to the choir: presenting our findings via posters and presentations at gatherings of the American Public Health Association, Pediatric Academic Societies, Physicians for Human Rights, Academic Pediatric Association, UCSF Pediatric Grand Rounds, and UCSF Pathways Symposium
  • Organized and educated a base: hosted a meeting of stakeholders and advocates, including representation from the American Academy of Pediatrics, California Department of Public Health, Center for Tobacco-Free Kids, UCSF Center for Tobacco Control Research and Education, and UC Tobacco-Related Disease Research Program, among others
  • Media outreach: contributing to articles published in the press and writing letters-to-the-editor
  • Legislative outreach: submitting written testimony to appropriate congressional committees and representatives within the Federal Government
  • Coalition-building: working within a large, international group of tobacco, health, and trade experts


The aforementioned efforts were undertaken across a four-year time from 2011 to 2014, after which I phased out my involvement to pursue other endeavors.  I was supported by the Pediatric Leadership for the Underserved (PLUS) residency training program at UCSF.  There are many others continuing to produce great research on this topic, and I am happy to facilitate contact for those interested.


Our work, along with that of countless others, was impactful on multiple levels. We successfully raised awareness and ire about ongoing litigation between Philip Morris and a few countries, including Uruguay and Australia. These legal challenges were eventually decided against Philip Morris and kept in place the will of the people and public health protections enacted by these governments.

We also made some headway in preventing future loopholes from being created. Our work influenced the eventual treaty language of the Trans Pacific Partnership, a major trade deal between eleven countries spanning three continents, in which tobacco was acknowledged as a unique product undeserving of the protections other goods received in this deal.

Of course, these successes come with limitations. First, the United States withdrew from negotiations and did not become party to this trade agreement, rendering tobacco companies based in the United States unaffected by these updated rules. Second, the regulations themselves are weaker than what might be needed to truly protect public health legislation. Third, what gains were made in tobacco-control efforts might be offset by its exceptionalism; other health measures remain subject to the same rules exploited by tobacco companies to sue foreign governments.