The Politics of Smoke-Free Policies in Developing Countries: Lessons from Africa

The public health rewards of smoke-free policies are well documented. But in their enthusiasm to achieve such policies, public health advocates and policymakers frequently underestimate the political complexity of passing laws, and then implementing and enforcing them. Using 12 African countries as the focus of discussion, this research examines the basic political process for and the barriers to achieving smoke-free policies. Moreover, in addition to the obstacles, it examines why some countries have been experiencing comparatively more success in the smoke-free policy area. The findings of the research suggest strongly that the presence of a vigorous tobacco control civil society movement, some will on the part of government institutions, and active research support contribute significantly to successful smoke-free policies. It is also apparent that the emerging battle fronts in smoke-free policies are in the areas of implementation and enforcement, and while similar variables that affect the passing of new laws also condition these outcomes, there are the added distinct challenges of policy fatigue and additional resource constraints

The Puzzle of Heterogeneity in Support for Free Trade

Over time and across countries, researchers have noted frequent and mostly unexplained gender differences in the levels of support for policies of free or freer trade: according to aggregate results from many surveys, women tend to be less favorable toward policies of liberalizing trade than men. Positing an economic security explanation based largely on a mobile factors approach, we ask if it is women generally who are more negative toward trade or rather women who are more economically vulnerable – i.e., women from the scarce labor factor. We utilize data from two recent surveys on individuals’ attitudes toward different facets of trade and its effects to examine this hypothesis empirically. Rejecting a monolithic definition of “women,” we find that disaggregating by education level illuminates to some extent what underlying characteristics might be helping to drive some of these findings. Lower-skilled women in the US are much less likely to support free trade compared to higher-skilled women and this may largely explain previous negative findings. The low versus high-skill dynamic is, however, much less clear in the findings using survey data from a small sample of developing countries

(WP 2013-08) Economic (In)Security and Gender Differences in Trade Policy Attitudes

Over time and across countries, researchers have noted frequent and mostly unexplained gender differences in the levels of support for policies of free or freer trade: women tend to be less favorable toward policies of liberalizing trade than men. Yet, no well substantiated theoretical or empirical account of the gender component of trade attitudes has emerged. Using an economic security explanation based principally on a mobile factors approach, we find that it is not women generally who are more negative toward trade but particularly economically vulnerable women – i.e. women from the scarce labor factor. We utilize recent survey data on individuals’ attitudes toward different facets of trade and its effects across three disparate regions to examine this phenomenon empirically. An economic security approach helps to explain the marked differences in attitudes toward trade among lower- and higher-skilled females in developing and developed countries

Short-Interval Cortical Inhibition and Rhetoric and the Law, Or the Law of Rhetoric: How Countries Oppose Novel Tobacco Control Measures at The World Trade Organization

The tobacco industry has developed an extensive array of strategies and arguments to prevent or weaken government regulation. These strategies and arguments are well documented at the domestic level. However, there remains a need to examine how these arguments are reflected in the challenges waged by governments within the World Trade Organization (WTO). Decisions made at the WTO have the potential to shape how countries govern. Our analysis was conducted on two novel tobacco control measures: tobacco additives bans (Canada, United States and Brazil) and plain, standardized packaging of tobacco products (Australia, New Zealand, Ireland, EU and UK). We analyzed WTO documents (i.e. meeting minutes and submissions) (n = 62) in order to identify patterns of argumentation and compare these patterns with well-documented industry arguments. The pattern of these arguments reveal that despite the unique institutional structure of the WTO, country representatives opposing novel tobacco control measures use the same non-technical arguments as those that the tobacco industry continues to use to oppose these measures at the domestic level

A pedagogical experiment on liberal democracy in South Asia

In the spring of 2006, a junior-level political science class focusing on democracy at the University of Miami and the Nepal Study Center at the University of New Mexico collaborated on a pedagogical experiment that sought to enhance learning opportunities about liberal democracy by promoting intellectual exchange between two nations, Nepal and the U.S. This abstract will introduce the program, note several key themes of the students’ proposals to address issues of democratization, and highlight directions for future related activities

Whole-Of-Government Approaches to NCDs: The Case of the Philippines Interagency Committee—Tobacco

To address the rise in non-communicable diseases (NCDs), governments are now being urged to ‘put forward a multisectoral approach for health at all government levels, to address NCD risk factors and underlying determinants of health comprehensively and decisively’ [UN, 2011. Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (No. A/66/L.1). New York, NY: United Nations]. There is a global consensus that whole-of-government approaches (WG) can be particularly effective in regulating products such as tobacco, pre-packaged foods and alcohol, which are or can be major risk factors for NCDs. Despite the overwhelming push towards interagency arrangements for health policymaking and implementation, including in contemporary efforts to prevent and control NCDs, there has been minimal investigation into how countries have pursued WG and which types of institutional designs and arrangements offer particular utility to achieve health objectives. This article examines these issues through a case study concerning the interagency mechanism that the Philippine government currently utilizes to govern tobacco control, the Interagency Committee—Tobacco (IAC-T). We conducted key informant interviews (n = 33) with government officials, and representatives from civil society organizations, health professional associations and intergovernmental organizations. We targeted informants who have been involved in the work of the IAC-T and/or tobacco control policy more broadly. We also analysed public documents to contribute to our analysis of the structure, functioning and legal status of the IAC-T. Our findings highlight two salient challenges that arose in the Philippines case: (1) the inclusion of industry representation on the IAC-T and (2) the attempt to consolidate the responsibilities of the different departments through a policy of ‘balance’ between health and commercial interests. We analyse how health proponents navigated this challenging institutional arrangement and the various barriers they faced in achieving the intended health objectives. We draw from this case to discuss the lessons that can inform broad calls for WG to NCDs

Economic (In)Security and Gender Differences in Trade Policy Attitudes

Over time and across countries, researchers have noted frequent and mostly unexplained gender differences in the levels of support for policies of free or freer trade: women tend to be less favorable toward policies of liberalizing trade than men. Using an economic security explanation based principally on a mobile factors approach, we find that it is not women generally who are more negative toward trade but particularly economically vulnerable women – i.e. women from the scarce labor factor. We utilize recent survey data on individuals’ attitudes toward different facets of trade and its effects across three disparate regions to examine this phenomenon empirically. An economic security approach helps to explain the marked differences in attitudes toward trade among lower- and higher-skilled females in developing and developed countries.http://deepblue.lib.umich.edu/bitstream/2027.42/133087/1/wp1067.pd

Investment Incentives and The Implementation of the Framework Convention On Tobacco Control: Evidence from Zambia

Purpose: Policy misalignment across different sectors of government serves as one of the pivotal barriers to WHO Framework convention on Tobacco Control (FCTC) implementation. This paper examines the logic used by government officials to justify providing investment incentives to increase tobacco processing and manufacturing in the context of FCTC implementation in Zambia. Methods: We conducted qualitative semi-structured interviews with key informants from government, civil society and intergovernmental economic organizations (n=23). We supplemented the interview data with an analysis of public documents pertaining to economic development policy in Zambia. Results: We found gross misalignments between the policies of the economic sector and efforts to implement the provisions of the FCTC. Our interviews uncovered the rationale used by officials in the economic sector to justify providing economic incentives to bolster tobacco processing and manufacturing in Zambia: 1) tobacco is not consumed by Zambians/tobacco is an export commodity, 2) economic benefits outweigh health costs, and 3) tobacco consumption is a personal choice. Conclusions: Much of the struggle Zambia has experienced implementing the FCTC can be attributed to misalignments between the economic and health sectors. Zambia’s development agenda seeks to bolster agricultural processing and manufacturing. Tobacco control proponents must understand and work within this context of economic development in order to foster productive strategies with those working on tobacco supply issues. These findings are broadly applicable to the global analysis on the barriers and facilitators of FCTC implementation. It is important that the Ministry of Health monitors the tobacco policy of other sectors and engages with these sectors to find ways of harmonizing FCTC implementation across sectors

Navigating Institutional Complexity in The Health Sector: Lessons from Tobacco Control in Kenya

Introduction  This research examines the institutional dynamics of tobacco control following the establishment of Kenya’s 2007 landmark tobacco control legislation. Our analysis focuses specifically on coordination challenges within the health sector. Methods  We conducted semi-structured interviews with key informants ( n  = 17) involved in tobacco regulation and control in Kenya. We recruited participants from different offices and sectors of government and non-governmental organizations. Results  We find that the main challenges toward successful implementation of tobacco control are a lack of coordination and clarity of mandate of the principal institutions involved in tobacco control efforts. In a related development, the passage of a new constitution in 2010 created structural changes that have affected the successful implementation of the country’s tobacco control legislation. Discussion  We discuss how proponents of tobacco control navigated these two overarching institutional challenges. These findings point to the institutional factors that influence policy implementation extending beyond the traditional focus on the dynamic between government and the tobacco industry. These findings specifically point to the intragovernmental challenges that bear on policy implementation. The findings suggest that for effective implementation of tobacco control legislation and regulation, there is need for increased cooperation among institutions charged with tobacco control, particularly within or involving the Ministry of Health. Decisive leadership was also widely presented as a component of successful institutional reform. Conclusion  This study points to the importance of coordinating policy development and implementation across levels of government and the need for leadership and clear mandates to guide cooperation within the health sector. The Kenyan experience offers useful lessons in the pitfalls of institutional incoherence, but more importantly, the value of investing in and then promoting well-functioning institutions

Full Proceedings

Papers, abstracts and proceedings of the Seventh Annual Himalayan Policy Research Conference, Thursday, October 11, 2012, Madison Concourse Hotel and Governors\u27 Club, Preconference Venue of the 41st South Asian Conference at the University of Wisconsin-Madiso