Background In Latin America, total sales of sugar-sweetened beverages (SSBs) continue to rise at an alarming rate. Consumption of added sugar is a leading cause of diet-related non-communicable diseases (NCDs). Coalitions of stakeholders have formed in several countries in the region to address this public health challenge including participation of civil society organizations and transnational corporations. Little is currently known about these coalitions – what interests they represent, what goals they pursue and how they operate. Ensuring the primacy of public health goals is a particular governance challenge. This paper comparatively analyses governance challenges involved in the adoption of taxation of sugar-sweetened beverages in Mexico, Chile and Colombia. The three countries have similar political and economic systems, institutional arrangements and regulatory instruments but differing policy outcomes. Methods We analysed the political economy of SSB taxation based on a qualitative synthesis of existing empirical evidence. We identify the key stakeholders involved in the policy process, identified their interests, and assess how they influenced adoption and implementation of the tax. Results Coalitions for and against the SSB taxation formed the basis of policy debates in all three countries. Intergovernmental support was critical to framing the SSB tax aims, benefits and implementation; and for countries to adopt it. A major constraint to implementation was the strong influence of transnational corporations (TNCs) in the policy process. A lack of transparency during agenda setting was notably enhanced by the powerful presence of TNCs. Conclusion NCDs prevention policies need to be supported across government, alongside grassroots organizations, policy champions and civil society groups to enhance their success. However, governance arrangements involving coalitions between public and private sector actors need to recognize power asymmetries among different actors and mitigate their potentially negative consequences. Such arrangements should include clear mechanisms to ensure transparency and accountability of all partners, and prevent undue influence by industry interests associated with unhealthy products.
Background: In Latin America, diet-related non-communicable diseases and sales of sugar-sweetened beverages continue to rise at an alarming rate. Calls for action suggest "multi-sector" and "multi-stakeholder" approaches involving civil society and the private sector, including transnational corporations. While the focus has often been on forming “partnerships” of public and private sectors, ensuring the primacy of public health goals remains a significant governance challenge. This paper analyses this governance challenge using the experiences of Chile, Mexico and Colombia in the adoption of taxation of sugar-sweetened beverages. The three countries offer useful comparisons given their similar political and economic systems, institutional arrangements and regulatory instruments. We conducted a qualitative synthesis of the existing empirical evidence applying a political economy analysis to identify successes and failures during the policy process to adopt and implement the tax.Results: The findings suggest that a major constraint was the political influence of transnational corporations in the policy process and on stakeholders. Intergovernmental support was critical to frame the sugary drinks beverages (SSBs) tax aims, mechanisms and its benefits, and for countries to adopt the measures. Coalitions for and against the tax were critical for the policy debates, and a lack of transparency throughout the agenda setting was diluted by powerful TNCs presences in the countries studied.Conclusion: Governance arrangements involving partnerships with private sector actors should recognize the asymmetry of power among them and address it. Such arrangements should adopt clear mechanisms to ensure transparency and accountability of all partners, and avoid the undue influence of unhealthy commodity industries. Support of several governmental entities simultaneously, grassroots groups, and civil society groups in NCD prevention policies is also needed.
Background: In Latin America, total sales of sugar-sweetened beverages continue to rise at an alarming rate. Consumption of added sugar is a leading cause of diet-related non-communicable diseases. Coalitions of stakeholders have formed in several countries in the region to address this public health challenge including participation of civil society organizations and transnational corporations. Little is currently known about these coalitions – what interests they represent, what goals they pursue and how they operate. Ensuring the primacy of public health goals is a particular governance challenge. This paper comparatively analyses governance challenges involved in the adoption of taxation of sugar-sweetened beverages in Chile, Mexico and Colombia. The three countries have similar political and economic systems, institutional arrangements and regulatory instruments but differing policy outcomes..Methods: We analyse the political economy of SSB taxation based on a qualitative synthesis of existing empirical evidence. We identify the key stakeholders involved in the policy process, identify their interests, and assess how they influenced adoption and implementation of the tax.Results: Coalitions for and against the SSB taxation formed the basis of policy debates in all three countries. Intergovernmental support was critical to framing the SBB tax aims, benefits and instrumentation; and for countries to adopt it. A major constraint to implementation was the strong influence of transnational corporations (TNCs) in the policy process. A lack of transparency during agenda setting was notably enhanced by the powerful presence of TNCs.Conclusion: NCD prevention policies need to be supported across government, alongside grassroots organizations, policy champions and civil society groups to enhance their success. However, governance arrangements involving coalitions between public and private sector actors need to recognize power asymmetries among different actors and mitigate their potentially negative consequences. Such arrangements should include clear mechanisms to ensure transparency and accountability of all partners, and prevent undue influence by industry interests associated with unhealthy products.
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