Background FCTC 2030 Programme (2017-2021) was launched to accelerate WHO Framework Convention on Tobacco Control (FCTC) implementation in 15 low- and middle-income countries (LMICs). We evaluated the Programme in six domains: Governance; Smoke-Free Policies; Taxation; Packaging and Health Warnings; Tobacco Advertising, Promotion and Sponsorship (TAPS) bans; International and Regional Cooperation. Methods Following a mixed-methods design, we surveyed (Jun-Sept 2020) FCTC focal persons in 14 of the 15 countries, to understand the Programme’s financial and technical inputs and progress made in each of the six domains. The data were coded in terms of inputs (financial=1, technical=1, or both=2) and progress (none=1, some=2, partial=3, or strong=4) and a correlation was computed between the inputs and progress scores for each domain. We conducted semi-structured interviews with key stakeholders in five countries. We triangulated between the survey and interview findings. Results FCTC 2030 offered substantial financial and technical inputs, responsive to country-needs, across all six domains. There was a high positive correlation between technical inputs and progress in five of the six domains, ranging from r=0.61 for Taxation (p<0.05) to r=0.91 for Smoke-Free Policies (p<0.001). The interviews indicated that the Programme provided timely and relevant evidence and created opportunities for influencing tobacco control debates. Conclusions The FCTC 2030 Programme might have led to variable but significant progress in advancing FCTC implementation in the 15 countries. As expected, much of the progress was in augmenting existing structures and resources for FCTC implementation. The resulting advances are likely to lead to further progress in FCTC policy implementation. IMPLICATIONS What this study adds: In many low- and middle-income countries (LMICs), WHO Framework Convention for Tobacco Control (WHO FCTC) policies are not in place; and even when enshrined in law, they are poorly enforced. It is not clear how financial and technical assistance to high tobacco-burden LMICs can most effectively accelerate the implementation of WHO FCTC policies and offer value for money. Bespoke and responsive assistance, both financial and technical, to LMICs aimed at accelerating the implementation of WHO FCTC policies is likely to lead to progress in tobacco control.

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INTRODUCTION About 21.4% of India's population uses smokeless tobacco products (SLT), yet limited data are available on their microbial contamination. To understand the potential microbiological risks associated with SLT use, the present study aims to investigate bacterial contamination of tobacco and the types of microbes that could be cultured from SLT products. METHODS Twenty-two brands of SLT products, including paan masala, khaini, gutka and tobacco-containing dentifrices were examined and cultured by using appropriate selective and differential media including MacConkey agar and CLED agar. This was followed by a sequence of further identification by biochemical tests. RESULTS All 22 types of SLT products showed growth of aerobic bacteria. The most common bacteria isolated were Pseudomonas aeruginosa followed by Streptococcus faecalis. Other bacteria that were isolated from products, in traces, included Klebsiella spp., E. coli, and Bacillus subtilus. CONCLUSIONS This study raises and addresses the issue of bacterial contamination of packaged SLT products. SLT users might be subjected to a significant health hazard, especially those who are immunocompromised.

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Background: Pneumonia is one of the leading causes of death in under-5 children in India. This led the Ministry of Health & Family Welfare (MoHFW) in India to decide for the nationwide roll-out of the Pneumococcal Conjugate Vaccine (PCV). However, the introduction of PCV became more complex in the face of unprecedented challenges set forth by the COVID-19 pandemic. The study aims to assess enablers and barriers to the introduction of PCV in India during the pandemic. Methodology: Qualitative research approach involving key-informant interviews from John Snow India (JSI), the lead technical agency that supported MoHFW in the PCV expansion was employed to delineate the enablers and barriers. Principle of saturation was employed to derive the sample size. Thematic analysis using inductive approach was based on the modified World Health Organization (WHO) framework for new vaccine introduction impact on the Immunization and Health Systems, using NVIVO 12 qualitative data analysis software. Results: A total of 11 key informants (4 national-level program managers and 7 state technical officers) were telephonically interviewed. The study found social acceptance, lower cost of the vaccine, and intensive communication activities as potential enablers. Other enablers for PCV introduction included a robust vaccine supply-chain system, ample cold-chain space availability, and strong political commitment, despite the ongoing second wave. Further, the identified barriers included poor physical access, insufficient social mobilization, and limited advocacy along with a stretched workforce. Conclusion: The study delineated several enablers and barriers to introducing PCV in the country during the pandemic. The existing barriers in the PCV roll-out prompted the need to address these gaps, making key program-based recommendations to improve future new vaccine introductions during the pandemic.