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Elliott LM, Dalglish SL, Topp SM. Health Taxes on Tobacco, Alcohol, Food and Drinks in Low- and Middle-Income Countries: A Scoping Review of Policy Content, Actors, Process and Context. Int J Health Policy Manag 2022; 11:414-428. [PMID: 32945639 PMCID: PMC9309941 DOI: 10.34172/ijhpm.2020.170] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 08/25/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Taxation of tobacco, food, alcohol and other beverages has gained renewed attention in responding to non-communicable diseases (NCDs). While largely built on evidence from high-income countries (HICs), the projected economic and health benefits of these measures have increased calls for their use in price-sensitive low- and middle-income countries (LMICs). However, uptake has been sporadic and there remains little research on why and how LMICs utilise fiscal measures in response to NCDs. METHODS This scoping review analyses factors influencing the design and implementation of health-related fiscal measures in LMICs. Utilising Arksey and O'Malley's scoping review methodology and Walt and Gilson's policy triangle, we considered the contextual, procedural, content and stakeholder-related factors that influenced measures. RESULTS We identified 75 papers focussing on health-related fiscal measures, with 47 (63%) focused on tobacco, 5 on alcohol, 6 on soft drink and 4 studies on food-related fiscal regulation. Thirteen papers analysed multiple measures and most papers (n = 66, 88%) were less than a decade old. Key factors enabling the design and implementation of measures included localised health and economic evidence, policy championing, inter-ministerial support, and global or regional momentum. Impeding factors encompassed negative framing and retaliation by industry, vested interests and governmental policy disjuncture. Aligning with theoretic insights from the policy triangle, findings consistently demonstrated that the interplay between factors - rather than the presence or absence of particular factors - has the most profound impact on policy implementation. CONCLUSION Given the growing urgency to address NCDs in LMICs, this review highlights the need for recognition and rigorous exploration of political economy factors influencing the design and implementation of fiscal measures. Broader LMIC-specific empirical research is needed to overcome an implication noted in much of the literature: that mechanisms used to enact tobacco taxation are universally applicable to measures targeting foods, alcohol and other beverages.
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Affiliation(s)
- Lana M. Elliott
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sarah L. Dalglish
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Institute for Global Health, University College London, London, UK
| | - Stephanie M. Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
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Kostova DA, Moolenaar RL, Van Vliet G, Lasu A, Mahar M, Richter P. Strengthening Pandemic Preparedness Through Noncommunicable Disease Strategies. Prev Chronic Dis 2021; 18:E93. [PMID: 34672923 PMCID: PMC8588872 DOI: 10.5888/pcd18.210237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Deliana A Kostova
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30322.
| | - Ronald L Moolenaar
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
| | | | - Ally Lasu
- RTI International, Research Triangle Park, North Carolina
| | - Michael Mahar
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
| | - Patricia Richter
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
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Kostova D, Richter P, Van Vliet G, Mahar M, Moolenaar RL. The Role of Noncommunicable Diseases in the Pursuit of Global Health Security. Health Secur 2021; 19:288-301. [PMID: 33961498 PMCID: PMC8217593 DOI: 10.1089/hs.2020.0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Noncommunicable diseases and their risk factors are important for all aspects of outbreak preparedness and response, affecting a range of factors including host susceptibility, pathogen virulence, and health system capacity. This conceptual analysis has 2 objectives. First, we use the Haddon matrix paradigm to formulate a framework for assessing the relevance of noncommunicable diseases to health security efforts throughout all phases of the disaster life cycle: before, during, and after an event. Second, we build upon this framework to identify 6 technical action areas in global health security programs that are opportune integration points for global health security and noncommunicable disease objectives: surveillance, workforce development, laboratory systems, immunization, risk communication, and sustainable financing. We discuss approaches to integration with the goal of maximizing the reach of global health security where infectious disease threats and chronic disease burdens overlap.
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Affiliation(s)
- Deliana Kostova
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Patricia Richter
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Gretchen Van Vliet
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Michael Mahar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Ronald L Moolenaar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
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