Advancing whole-of-government approaches to tobacco control: Article 5.3 and the challenge of policy coordination in Bangladesh, Ethiopia, India and Uganda

Rachel Barry; SM Abdullah; Aastha Chugh; Selamawit Hirpa; Praveen Kumar; Denis Male; Rob  Ralston; Tracey Wagner-Rizvi; Jeff Collin

doi:10.1136/tobaccocontrol-2021-057154

Advancing whole-of-government approaches to tobacco control: Article 5.3 and the challenge of policy coordination in Bangladesh, Ethiopia, India and Uganda

Rachel Barry, SM Abdullah, Aastha Chugh, Selamawit Hirpa, Praveen Kumar, Denis Male, Rob Ralston, Tracey Wagner-Rizvi, Jeff Collin

Research output: Contribution to journal › Article › peer-review

11 Citations (SciVal)

Abstract

Introduction: Despite an extensive evidence base on the diverse economic, environmental and social benefits of tobacco control, difficulties in establishing coordinated national approaches remain a defining challenge for Framework Convention on Tobacco Control (FCTC) implementation. Minimising tobacco industry interference is seen as key to effective coordination, and this paper analyses implementation of Article 5.3 guidelines, exploring implications for whole-of-government approaches to tobacco control in Bangladesh, Ethiopia, India and Uganda.
Methods: Based on 131 semistructured interviews with government officials and other key stakeholders, we explore barriers and facilitators for promoting: (1) horizontal coordination across health and other policy spheres, and (2) vertical coordination across national and subnational governments on Article 5.3 implementation.
Results: Our analysis identifies common barriers to coordination across diverse geographical contexts and varying approaches to implementation. They highlight broadly shared experiences of limited understanding and engagement beyond health agencies; restricted responsibility and uncertainty amid conflicting mandates; tensions with wider governance practices and norms; limited capacity and authority of coordination mechanisms; and obstacles to vertical coordination across local, state and national governments. Interview data also indicate important opportunities to advance coordination across sectors and government levels, with Article 5.3 measures capable of informing changes in practices, building support in other sectors, allowing for ‘bottom-up’ innovation and being shaped by engagement with civil society.
Conclusion: Supporting effective implementation of Article 5.3 is key to advancing multisectoral approaches to FCTC implementation and tobacco control’s contributions to global health and sustainable development.

Original language	English
Article number	057154
Pages (from-to)	s46-s52
Journal	Tobacco Control
Volume	31
Issue number	1
Early online date	11 Feb 2022
DOIs	https://doi.org/10.1136/tobaccocontrol-2021-057154
Publication status	Published - 1 Jun 2022

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

Funding

This research was undertaken within the Tobacco Control Capacity Programme, an international consortium funded by the UK Global Challenges Research Fund (GCRF). The wider project sought to develop new studies focused on tobacco control through a process of co-creation of research topics. It was through this process that Article 5.3 was identified by local research teams and via stakeholder events as a key research and policy priority across four countries—Bangladesh, Ethiopia, India and Uganda. Alongside a core focus on national implementation, research conducted by two project teams in India (Delhi and Manipal, Karnataka) allowed for examination of dynamics across multilevel governance (with the Delhi team exploring national and state-level efforts and the Manipal team focused on districts).

Funders	Funder number
UK Research and Innovation	MR/S037519/1, MR/P027946/2

Keywords

tobacco control
Article 5.3
WHO Framework Convention on Tobacco Control
multilevel governance
comparative analysis
multisectoral coordination

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/tobaccocontrol-2021-057154Licence: CC BY

Cite this

Barry, R., Abdullah, SM., Chugh, A., Hirpa, S., Kumar, P., Male, D., Ralston, R., Wagner-Rizvi, T., & Collin, J. (2022). Advancing whole-of-government approaches to tobacco control: Article 5.3 and the challenge of policy coordination in Bangladesh, Ethiopia, India and Uganda. Tobacco Control, 31(1), s46-s52. Article 057154. https://doi.org/10.1136/tobaccocontrol-2021-057154

Barry, R, Abdullah, SM, Chugh, A, Hirpa, S, Kumar, P, Male, D, Ralston, R, Wagner-Rizvi, T & Collin, J 2022, 'Advancing whole-of-government approaches to tobacco control: Article 5.3 and the challenge of policy coordination in Bangladesh, Ethiopia, India and Uganda', Tobacco Control, vol. 31, no. 1, 057154, pp. s46-s52. https://doi.org/10.1136/tobaccocontrol-2021-057154

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Advancing whole-of-government approaches to tobacco control: Article 5.3 and the challenge of policy coordination in Bangladesh, Ethiopia, India and Uganda

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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