RT Journal Article
SR Electronic
T1 ‘That is a Ministry of Health thing’: Article 5.3 implementation in Uganda and the challenge of whole-of-government accountability
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP s12
OP s17
DO 10.1136/tobaccocontrol-2021-057049
VO 31
IS Suppl 1
A1 Male, Denis
A1 Ralston, Rob
A1 Nyamurungi, Kellen
A1 Collin, Jeff
YR 2022
UL http://tobaccocontrol.bmj.com/content/31/Suppl_1/s12.abstract
AB Introduction While Uganda has made legislative progress towards implementing Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC), ongoing challenges in minimising tobacco industry interference have not been adequately explored. This analysis focuses on understanding difficulties in managing industry engagement across government ministries and in developing effective whole-of-government accountability for tobacco control.Methods Interviews with Uganda government officials within the health sector and beyond, including in Ministries of Trade, Agriculture and Revenue.Results The findings indicate substantial variations in awareness of Article 5.3, its norm and practices across government sectors. The data suggest ambiguity and uncertainty about accountability for Article 5.3 implementation, with policy makers in departments beyond health often uncertain about obligations under the FCTC. Second, we highlight how responsibility for Article 5.3 implementation and the obligations incurred are widely seen as restricted to the Ministry of Health. Third, competing mandates and perceived difficulties in reconciling health goals with economic growth are shown to impact on accountability for tobacco control. Yet, importantly, the data also demonstrate enthusiasm in some unexpected parts of government for actively engaging with Article 5.3 and for promoting greater intersectoral coordination.Conclusion This paper demonstrates the intrinsic challenges of developing whole-of-government approaches, highlighting considerable uncertainty and ambiguity among decision makers in Uganda about tobacco control governance. The analysis points to the potential for Uganda’s national coordinating mechanism to help reconcile competing expectations and demonstrate the importance of Article 5.3 beyond health actors.No data are available. Not applicable.