Role of the tobacco industry in implementation of the WHO Framework Convention on Tobacco Control in the WHO African region

Background: The WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2003 to address global tobacco epidemic. Of 41 (out of 47) countries in the WHO African region that have ratified the FCTC, 28 have enacted legislation to implement various provisions. This study aims to evaluate progression of FCTC implementation in the WHO African region and investigate activities of the tobacco industry in the process.

Methods: Using a mixed-methods approach, three FCTC Parties in three phases of implementation: No legislation, no implementation (Zambia); Legislation, but no implementation (Tanzania); and Legislation plus implementation (Ghana) were selected. NVivo 10 was used to compare the FCTC implementation reports and delineate the levels of implementation of the FCTC Articles. Additionally, triangulation of interviews with key informants and archival documents was used to identify key characteristics that led to differences in implementation processes.

Results: The FCTC has put tobacco control on the policy agenda of these countries. The key factors differentiating level of implementation are the strength of the tobacco industry, political will, the strength of the health department, the capacity to support tobacco control, the presence and strength of tobacco control advocacy networks, and the degree of international support.

Conclusion: Non-communicable diseases (NCDs) have become the leading cause of death in the WHO African region. With tobacco use being the major risk factor of NCDs, although resources are needed to undertake tobacco control, it is important for policymakers to have the political will to implement the FCTC and enforce the specific policies.