Analyzing commitments under the WHO framework convention on tobacco control using the TAPIC governance framework

摘要

Background: The TAPIC governance framework (Transparency, Accountability, Participation, Integrity, Capacity) was recently developed by a team of researchers on behalf of WHO Europe and the European Observatory on Health Systems and Policies as a tool for assessing and improving health governance in WHO member states. TAPIC draws on several decades of research on governance across many policy areas, placing insights from these studies in health contexts. This presentation applies TAPIC to commitments made by parties to the Framework Convention on Tobacco Control (FCTC) and its related guidelines. How well do commitments made under the FCTC align with good governance principles as outlined in the TAPIC framework? To what extent does the FCTC promote good governance, and can we do better? Methods: Beginning with primary documentation (FCTC text, guidelines, reporting by Parties) and considering recent research literature, the main structures of the FCTC were examined to assess their alignment with the TAPIC framework and identify areas of opportunity. Results: To the extent that it requires increased transparency from Parties, supports integrity within the policymaking process and promotes policymaking capacity, the FCTC is broadly likely to improve tobacco control governance in most countries. The FCTC itself could also be modified to further improve the governance strategies it contains. Further gains could be made by incorporating greater peer review, requiring Parties to codify rules around access to tobacco control policymaking and by identifying additional measures that capture governance procedures in additional to outcome variables. Conclusions: Using the TAPIC framework to evaluate FCTC Commitments highlights ways in which the agreement can promote better governance and ultimately could increase the effectiveness of international efforts to combat tobacco.