title: Whole-of-government approaches to NCDs: the case of the Philippines Interagency Committee-Tobacco.
abstract: To address the rise in non-communicable diseases (NCDs), governments are now being urged to 'put forward a multisectoral approach for health at all government levels, to address NCD risk factors and underlying determinants of health comprehensively and decisively' [UN, 2011. Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (No. A/66/L.1). New York, NY: United Nations]. There is a global consensus that whole-of-government approaches (WG) can be particularly effective in regulating products such as tobacco, pre-packaged foods and alcohol, which are or can be major risk factors for NCDs. Despite the overwhelming push towards interagency arrangements for health policymaking and implementation, including in contemporary efforts to prevent and control NCDs, there has been minimal investigation into how countries have pursued WG and which types of institutional designs and arrangements offer particular utility to achieve health objectives. This article examines these issues through a case study concerning the interagency mechanism that the Philippine government currently utilizes to govern tobacco control, the Interagency Committee-Tobacco (IAC-T). We conducted key informant interviews (n = 33) with government officials, and representatives from civil society organizations, health professional associations and intergovernmental organizations. We targeted informants who have been involved in the work of the IAC-T and/or tobacco control policy more broadly. We also analysed public documents to contribute to our analysis of the structure, functioning and legal status of the IAC-T. Our findings highlight two salient challenges that arose in the Philippines case: (1) the inclusion of industry representation on the IAC-T and (2) the attempt to consolidate the responsibilities of the different departments through a policy of 'balance' between health and commercial interests. We analyse how health proponents navigated this challenging institutional arrangement and the various barriers they faced in achieving the intended health objectives. We draw from this case to discuss the lessons that can inform broad calls for WG to NCDs.
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Hosmer House, 3654 prom Sir-William-Osler, Montréal, QC H3G 1Y5, Canada, raphael.lencucha@mcgill.ca.
authors.forename: Raphael
authors.initials: R
authors.lastname: Lencucha
authors.affiliation: Economic and Health Policy Research, American Cancer Society, 250 Williams Street NW, Atlanta, GA 30303, USA, Marquette University, Department of Political Science, 540 N 15th St, Milwaukee, WI 53233, United States and.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Drope
authors.affiliation: Action for Economic Reforms (AER), Unit 1403 West Trade Center, 132 West Avenue, Quezon City 1104, Philippines.
authors.forename: Jenina Joy
authors.initials: JJ
authors.lastname: Chavez
mesh_terms: D002908:Chronic Disease / Q000517:prevention & control; D006291:Health Policy; D006801:Humans; D010679:Philippines; D011050:Policy Making; D062789:Tobacco Products
keywords: Health in All Policies; Whole-of-government; health policy; intersectoral collaboration; non-communicable diseases; tobacco control