Negotiating Change: Ideas, Institutions, and Political Actors in Tobacco Control Policy Making in Mauritius

Abstract

Context: This article explains the policy process that occasioned the development of comprehensive tobacco control policies in Mauritius from 1980 to 2019. It does so by drawing theoretical insights from John Kingdon's streams framework, historical institutionalism, and ideational perspectives to explicate how tobacco control rose to the status of government policy agenda. Methods: The main sources of data are government documents, media reports, archival studies, grey literature, and published books and articles. These sources were supplemented by key informant interviews with government officials, civil society groups, and other vested interest groups. Findings: This article finds that the prevalence of noncommunicable diseases in the late 1980s, the political commitment of Mauritius's Labour government to comprehensive tobacco control, the institutional legacies of Mauritius's Public Health Act of 1925, and the administrative capacity of Mauritius's Ministry of Health and Quality of Life are the primary factors that drove tobacco control policies in Mauritius. Conclusion: The findings from this study will enrich our understanding of policy change and the politics of tobacco control in the global south. Future research should investigate why some countries in Africa have failed to adopt comprehensive tobacco control policies despite ratifying the Framework Convention on Tobacco Control.

What facilitates policy audacity in tobacco control? An analysis of approaches and supportive factors for innovation in seven countries

“…The documentation available ranged from comprehensive, authoritative historical timelines and analyses of the policy context in which audacity occurred, published in peer-reviewed literature (Mauritius,22 23 Aotearoa/New Zealand,24 25 Australia,26 27 to academic blogs (Aotearoa/New Zealand,28 detailed online presentations,29 media reports30 31 and in-depth interviews32 with key policy makers, as well as ordinance study sessions33 (Beverly Hills), webinars34 35 and blog articles36 by civil society organisations (Netherlands), PowerPoint presentations by key policy makers,37 media reports,38 blogs39 40 and short case studies41 (Balanga City). Cases are presented below in the order in which they were announced.…”

“…From 2001, a new antitobacco NGO, ViSa (now VISA), was formed. It received limited funding support from government23 and provided support to policy-makers, as well as fulfilling a role of monitoring and exposing tobacco industry activities, and using data to lobby government for revisions and tightening of tobacco control regulations (p. 455) 22. It also included staff who had previously been senior bureaucrats at the MOH&QL, and cooperated with other domestic NGOs and a number of international NGOs 22.…”

“…22 It also included staff who had previously been senior bureaucrats at the MOH&QL, and cooperated with other domestic NGOs and a number of international NGOs. 22 VISA was keen to cultivate a harmonious working relationship with MOH&QL, where power for tobacco control policy making is highly centralised, 22 and which was instrumental in advancing the tobacco control policy agenda and increasing its influence with decision-makers.…”

“…For example, each year when tobacco industry-funded undergraduate scholarships to the University of Mauritius were announced, VISA would write to the university, student recipients, the media, government and others to bring attention to the fact that these scholarships were being provided by a killer industry. 22 Making clear the extent to which tobacco industry CSR was undermining the advertising ban made banning CSR an obvious next step when the 2008 regulations were developed. The 2008 amendment was also made possible by the appointment in 2005 of another Health Minister, Dr Rajeshwar Jeetah, who was highly committed to tobacco control and influential within the government.…”

“…He saw political opportunity for Mauritius to be a tobacco control leader as one of the early FCTC signatories (p. 449). 22 Other supportive factors were muted influence and opposition from non-health ministries such as agriculture or finance because of the limited domestic tobacco industry (pp. 449-450) and using the existing Public Health Act to create amendments based on the FCTC to avoid tobacco industry interference to slow the legislative process (pp.…”