Investment incentives and the implementation of the Framework Convention on Tobacco Control: evidence from Zambia

Abstract

Purpose Policy misalignment across different sectors of government serves as one of the pivotal barriers to WHO Framework convention on Tobacco Control (FCTC) implementation. This paper examines the logic used by government officials to justify providing investment incentives to increase tobacco processing and manufacturing in the context of FCTC implementation in Zambia. Methods We conducted qualitative semi-structured interviews with key informants from government, civil society and intergovernmental economic organizations (n=23). We supplemented the interview data with an analysis of public documents pertaining to economic development policy in Zambia. Results We found gross misalignments between the policies of the economic sector and efforts to implement the provisions of the FCTC. Our interviews uncovered the rationale used by officials in the economic sector to justify providing economic incentives to bolster tobacco processing and manufacturing in Zambia: 1) tobacco is not consumed by Zambians/tobacco is an export commodity, 2) economic benefits outweigh health costs, and 3) tobacco consumption is a personal choice. Conclusions Much of the struggle Zambia has experienced implementing the FCTC can be attributed to misalignments between the economic and health sectors. Zambia’s development agenda seeks to bolster agricultural processing and manufacturing. Tobacco control proponents must understand and work within this context of economic development in order to foster productive strategies with those working on tobacco supply issues. These findings are broadly applicable to the global analysis on the barriers and facilitators of FCTC implementation. It is important that the Ministry of Health monitors the tobacco policy of other sectors and engages with these sectors to find ways of harmonizing FCTC implementation across sectors.

Government policy and agricultural production: a scoping review to inform research and policy on healthy agricultural commodities

“…The result of this has been the over-privileging of the role of the private sector either at the expense of government participation in the market or perhaps more commonly reorienting government resources to serve these private interests often at the expense of smallholder farmers [93,94]. For example, in Zambia the push for value-addition along the agricultural supply chain, in the absence of a government policy to reduce the tobacco supply, led to government support for tobacco processing and manufacturing [80,95]. This economic decision will likely lead to increased consumption of tobacco leaf in Zambia, contrary to public health objectives.…”

Is trade liberalisation a vector for the spread of sugar-sweetened beverages? A cross-national longitudinal analysis of 44 low- and middle-income countries

“…Given growing evidence of public health concerns associated with trade and investment liberalisation (Baker et al., 2016, Lencucha et al., 2016, McNamara, 2015, Schram et al., 2015; A. M. Thow et al., 2015a, Thow et al., 2015b; Anne Marie Thow et al., 2015a, Thow et al., 2015b; A. M. T. Thow et al., 2015c), concerns borne out by the results in this study, advocacy groups should demand that public health should be prioritised in drafting of trade agreements. These results indicate that tariffs can have a role in counteracting the entrance of harmful products in emerging markets of LMICs and therefore could be an effective policy tool to regulate food environments by discouraging the availability and affordability of unhealthy products.…”

Rhetoric and the law, or the law of rhetoric: How countries oppose novel tobacco control measures at the World Trade Organization

“…The lack of supply chains for alternative agricultural products is not simply a matter of for market, but also warrants the attention of governments to support these alternatives through investment incentives or other policy instruments. In contrast, countries continue to incentivize investment in the tobacco sector (Lencucha, Drope, Labonte, Zulu, & Goma, 2015). …”