Kenya, Tanzania, and Uganda founded a Customs Union in 2004 and apply a Common External Tariff (CET) on imports to the region. However, the CET has been increasingly destabilized by countries using unilateral exemptions on a wide range of strongly traded goods. This instability undermines progress in regional integration and creates an uneven playing field for business. The article discusses evidence for the influence of interest groups on the observed instability. This study takes a political economy perspective and tracks lobbying behavior from the domestic to the regional level. It looks at the influence of business membership organizations and other interest groups on CET negotiations. The article applies an exploratory, qualitative approach predominantly drawing on data gathered by the author in 25 interviews with experts in Kenya, Tanzania, and Uganda in January 2016.

Understanding firm-and field-level change toward sustainable development: insights from the pharmaceutical industry and access to medicine, 1960-2020

Background In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development. Methods We developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents. Results The Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action. Conclusion The application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.

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