How do interests, ideas, and institutions affect multisectoral governance? The case of tobacco governance in two Pacific small island developing states

Abstract

Multisectoral governance has been recognized to be vital to regulate harmful commodity industries, yet countries struggle with reaching policy coherence due to government agencies' conflicting mandates and industry interference. Limited empirical evidence is available on how interests, ideas, and institutions intersect and influence multisectoral governance in low‐ and middle‐income countries, particularly in Pacific small island developing states (PSIDS), often exploited by vested industry interests and whose non‐communicable disease crisis commands urgent action to regulate harmful commodities. This study assessed the ways interests, ideas, and institutions intersect and shape multisectoral tobacco governance in PSIDS. Interviewee data collected in Fiji and Vanuatu show that the idea of individual responsibility, the limited recognition of commercial determinants of health, the centralization of authority, and the vulnerabilities of small island developing states, (including small population, land, economy, geographic isolation, and status as a developing economy), prevent these states from achieving policy coherence in multisectoral tobacco governance.

Challenges of conflict of interest, coordination and collaboration in small island contexts: towards effective tobacco control governance in UK Overseas Territories

“…Supporting small islands is a priority for FCTC implementation, given they constitute one-fifth of all parties to the convention. Our findings add to the few existing studies highlighting the difficulties of minimising tobacco industry interference22 23 28 alongside the wider challenges posed by ‘islandness’ to effective tobacco control 20 21. Such evidence underlines the need to support officials in promoting good health governance and managing conflicts of interest in such contexts 28.…”

“…SIDS and small non-state jurisdictions share governance challenges relevant to tobacco control, including geographical isolation, small and highly connected societies, a narrow economic base, distinctive political and cultural sensitivities and limited governmental capacity and human resources 13–19. A small literature on Pacific Island countries further illustrates the significance of ‘islandness’ to effective tobacco control,20 21 including in managing conflicts of interest and preventing tobacco industry interference 22–24…”

Governing ultra‐processed food and alcohol industries: the presence and role of non‐government organisations in Australia

“…9 Furthermore, disagreements between the organisations that make up a coalition can weaken their collective advocacy efforts; 9,29 these could further weaken NGOs whose capacity constraints inhibit them to engage in monitoring and accountability activities. 9,45,46…”

“…However, receipt of such funds must not be conditional and so limit NGOs' capacity to advocate. 9,11,46 In addition, government measures to increase the transparency of HCI activities by requiring regular and consistent disclosure would help NGOs to hold industry actors to account. 55,56 Fourth, government agencies in Australia should not only recognise NGOs as surrogate regulators of HCIs but actively create an enabling environment for them to engage in formulating and implementing public policies.…”

Authority in tobacco control in Pacific Small Island Developing States: a qualitative study of multisectoral tobacco governance in Fiji and Vanuatu

“…In doing so, it aims to expand the evidence on the barriers to multisectoral engagement in tobacco control, in accordance with Articles 5.1, 5.2a and 5.3. This paper presents part of a larger project exploring how interests, ideas and institutions shape multisectoral collaboration on tobacco control in Pacific Small Island Developing States (PSIDS) 17…”