Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinbrugh, Edinburgh, UK.
Tob Control. 2022 Jun;31(Suppl 1):s5-s11. doi: 10.1136/tobaccocontrol-2021-056885. Epub 2022 Jan 31.
This paper explores implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control in Ethiopia. The analysis highlights how operationalising key requirements of Article 5.3, such as minimising policy engagement with the tobacco industry, has been mediated by path-dependent processes of stakeholder consultation and collaboration that have persisted following privatisation of Ethiopia's state-owned tobacco monopoly.
We conducted semistructured interviews with key officials (n=21) working in tobacco control policy, with high levels of access secured across ministries and agencies beyond health.
We found contrasting levels of awareness of Article 5.3 across government sectors, with extremely limited awareness in departments beyond health. The data also highlight competing ideas about conflict of interest, in which recognition of a fundamental conflict of interest with the tobacco industry is largely confined to health actors. Beyond limited cross-sectoral awareness and understanding of Article 5.3, gaps in implementation are exacerbated by assumptions and practices around stakeholder consultation, in which attempts to minimise policy interactions with the tobacco industry are mediated by institutionally embedded processes that presume active engagement. The results also highlight a continuation of the close relationship between the Ethiopian government and tobacco monopoly following its privatisation.
The Ethiopian government's recent achievements in tobacco control legislation require that policymakers are actively supported in reconciling perceived tensions and requirements for stakeholder consultation. Effective tobacco control governance would be further enhanced by enabling government agencies to more clearly identify which interactions with the tobacco industry are strictly necessary under Article 5.3 guideline recommendations.
本文探讨了《世界卫生组织烟草控制框架公约》第 5.3 条在埃塞俄比亚的实施情况。该分析强调了如何通过利益相关者咨询和合作的路径依赖过程来实施第 5.3 条的关键要求，这些过程在埃塞俄比亚国有烟草垄断私有化后仍然存在。
我们对参与烟草控制政策制定的主要官员（n=21）进行了半结构化访谈，在卫生部以外的各部委和机构获得了较高程度的准入。
我们发现政府各部门对第 5.3 条的认识程度存在明显差异，卫生部门以外的部门认识极为有限。数据还突出了利益冲突的不同观念，即与烟草业存在根本利益冲突的认识主要局限于卫生部门的行为者。除了对第 5.3 条的有限跨部门认识和理解之外，利益相关者咨询方面的差距因围绕利益相关者咨询的假设和做法而加剧，这些做法试图通过机构内部的过程来最小化与烟草业的政策互动，而这些过程假定积极参与。结果还突出了埃塞俄比亚政府与其烟草垄断企业私有化后的密切关系。
埃塞俄比亚政府在烟草控制立法方面的最新成就要求积极支持决策者协调感知到的紧张局势和利益相关者咨询的要求。通过使政府机构能够更清楚地确定哪些与烟草业的互动是根据第 5.3 条指导方针建议严格必要的，将进一步加强有效的烟草控制治理。
