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Tobacco control in Namibia: The importance of government capacity, media coverage, and industry interference
No full textBACKGROUND:
Namibia is typical of low-income and middle-income countries with growing tobacco use, but with limited capacity to impose comprehensive tobacco control legislation. Despite initiating dialogue on national tobacco control policy in 1991, the country took nearly 20 years to pass the Tobacco Products Control Act.
OBJECTIVE:
To use Namibia as a case study to illustrate challenges faced by low-income countries working to forward tobacco control legislation.
METHOD:
Face-to-face and telephonic interviews were conducted with 13 bureaucrats and advocates currently or previously engaged in tobacco-related work in Namibia. Tobacco-related news articles from national newspapers were examined.
RESULTS:
The constitutional obligation of the government to promote public health laid the foundation for Namibia's tobacco control policy. Staff capacity constraints greatly delayed the passing of tobacco control legislation. It is unclear what influence the tobacco industry's involvement as a stakeholder had on policy; however, in at least one instance, the tobacco industry actively misled government. Namibia's ratification of the Framework Convention on Tobacco Control was instrumental in passing legislation that meets most provisions of the international treaty. The media have generally played a supportive role in pushing the government to pass tobacco control legislation.
CONCLUSIONS:
The fact that Namibia was able to pass fairly comprehensive tobacco control legislation with such meagre resources is commendable. The government must now implement the regulations that make the legislation effective. Tobacco control progress in low-income and middle-income nations can be encouraged through use of the media and improved staff and legal capacity within health ministrie
How accurate are South African macroeconomic forecasts?
No full textThis paper considers the ex post accuracy of two published sets of macroeconomic forecasts: the Economist Intelligence Unit's (EIU's) Country Report and the "Economist of the Year" consensus forecast, sponsored by Media 24. Root weighted mean square errors (RWMSEs) of these two competing entities' forecasts are, on average, about 60% of the RWMSEs of adaptive naïve predictions for current-year forecasts and about 75% of the RWMSEs of adaptive naïve predictions for one-year-ahead forecasts. There is no substantial difference in the forecast accuracy of the two entities, despite large differences in forecasting methodology. Forecasts are revised on a monthly basis. Monthly revisions in Media 24's consensus forecast are substantially more likely to reduce forecast errors than the EIU's monthly forecast revisions. Revisions in the next-year forecasts for GDP growth and inflation are only marginally better than random, and thus such revisions have little credibility
Price and tax measures and illicit trade in the FCTC: what we know and what research is required
No full textINTRODUCTION:
Article 6 of the Framework Convention on Tobacco Control commits Parties to use tax and price policies to reduce tobacco use, whereas Article 15 commits Parties to implement measures to eliminate the illicit trade in tobacco products. This paper identifies research gaps/needs, especially in low- and middle-income countries, which, if adequately addressed, would help in implementing Articles 6 and 15.
METHODS:
Based on a recent comprehensive review on the impact of tax and price on tobacco consumption and a summary of reviews and narratives about the illicit tobacco market, research gaps are identified.
RESULTS:
Countries have highly diverse research needs, depending on the stage of the tobacco epidemic, previous research and data availability, and making a ranking of research needs infeasible. Broad issues for further research are the following: (1) monitoring tobacco consumption, prices, and taxes, (2) assessing the effectiveness of the tax structure in generating revenue and reducing tobacco use, (3) strengthening the tax administration system in order to reduce tax evasion and tax avoidance, (4) improving our understanding of the political economy of tobacco tax policy, and (5) employing a multidisciplinary approach to assessing the magnitude of illicit tobacco trade.
CONCLUSIONS:
At a technical level, the case for increasing excise taxes to improve public health and increase government revenue is easily made, but the political and policy environment is often not supportive. In order to effectively impact policy, the required approach would typically make use of rigorous economic techniques, and be cognizant of the political economy of raising excise taxes
New evidence on subjective wellbeing and the definition of unemployment in South Africa
No full textAccess to new nationally-representative, individual-level panel data from South Africa has allowed for the revalidation of Kingdon and Knight’s (2006) discussion on the definition of unemployment. This paper investigates subjective wellbeing as a measure of comparison between labour market statuses. It finds that on the grounds of subjective wellbeing the non-searching unemployed (or 'discouraged') are significantly worse-off than the not-economically-active. Moreover, evidence suggests that with regard to the relationship between life satisfaction and labour market status, the 'discouraged' have 'hit rock bottom'. This paper therefore advocates for the inclusion of the non-searching unemployed in the labour force and the use of a broad definition of unemployment, on the grounds that rational individuals would not self select into a lower state of wellbeing.Neil Lloyd acknowledges the fi nancial support of the National Research Foundation and the National
Income Dynamics Study.
Murray Leibbrandt acknowledges the Research Chairs Initiative of the Department of Science and
Technology and National Research Foundation for funding his work as the Research Chair in Poverty and
Inequalit
The impact of Chinese import penetration on the South African manufacturing sector
No full textThe rapid growth in imports from China over the past decade is seen as a key factor contributing towards the relatively slow growth in output and the decline in employment in South African manufacturing during this period. Yet the effects of Chinese trade may be complex and differentiated across sectors. To account for these differential effects, this analysis draws on a database of 44 manufacturing industries covering the period 1992-2010. Two approaches – a Chenery-type decomposition and econometric estimation – are used to evaluate the impact of Chinese trade on prices, production and employment in South African manufacturing. Chinese penetration of the South African market is shown to have increased rapidly over the past decade, in part due to displacement of imports from other countries, but more importantly at the expense of local production. Exports of manufactures to China did not add significantly to industrial growth in South Africa, whereas labour-intensive industries were particularly badly affected by Chinese imports implying that the negative impact on employment was more than proportional to the output displacement. However, we also find evidence that Chinese imports contributed towards lower producer price inflation in South Africa, which in turn will have moderated increases in consumer prices and helped to curtail production cost increases.This paper is based on research carried out for a project on “Chinese Competition and the Restructuring
of South African Manufacturing” funded by the UK Economic and Social Research Council, Grant No.
ES/1035125/1. The project was administered by the Southern African Labour and Development Research
Unit at the University of Cape Town in South Africa and the School of International Development at the
University of East Anglia in the United Kingdom. This paper benefi ted from extensive comments by
participants of a workshop organized by the Trade and Industrial Policy Strategies in Pretoria
Effects of Objective and Subjective Income Comparisons on Subjective Wellbeing
No full textWe present results from the Cape Area Panel Study dataset investigating how social comparisons with
regard to income affect subjective wellbeing of both young adults and parents. Objective and
subjective measures of relative income are used, assessing how individuals compare themselves to
others and to themselves over time. Strong evidence is found to suggest that social comparisons
affect subjective wellbeing, both relative to neighbours and relative to oneself in the past. Objective
measures of wellbeing also influence happiness, but this is more prevalent in interpersonal than
inter-temporal comparisons. It is possible that some adaptation does occur within individuals over
time.JEL Classification: DO1, D31, D60, H00, I31Brennan Hodkinson is a Environmental–Economics Policy Research Unit (EPRU) Research Associate
Financial support from the Swedish International Development Cooperation Agency (Sida), through the Environment for Development (EfD) initiative, is gratefully acknowledged. Martine Visser is Associate Professor within School of Economics at the University of Cape Town. She is on the Executive Committees of the Environmental–Economics Policy Research Unit (EPRU) and the Research Unit for Behavioral Economics and Neuroeconomics (RUBEN) and a research associate of the South African Labour and Development Research Unit (SALDRU). She is also on the Steering Committee for the African Climate Development Initiative (ACDI)
Evaluating the impact of health programmes on productivity
No full textThis article reviews some of the key methodological approaches available to researchers interested in identifying a causal relationship between health interventions and economic indicators of productivity. We then discuss some of the empirical work that has utilized these techniques in making the case for a causal relationship from health interventions to productivity. We conclude that while considerable progress has been made in addressing concerns over attribution, much work remains to be done in expanding our knowledge of why certain interventions work whilst others do not
What do people actually learn from public health education campaigns? Incorrect inferences about male circumcision and female HIV infection risk in a cluster randomized trial in Malawi
No full textObjective: To examine whether individuals who learn that voluntary medical male circumcision (VMMC) partially reduces female-to-male HIV transmission erroneously infer a reduction in male-to-female HIV transmission risk.
Design: Cluster randomised controlled trial. Methods: In 2008, information that VMMC reduces female-to-male HIV transmission risk was randomly disseminated to men in rural Malawi, with follow-up in 2009 (n=917). Data was collected on perceived male and female HIV-transmission risks. We assessed whether beliefs about male circumcision and female HIV-risk varied by receipt of VMMC information and by whether or not individuals believed that VMMC partially protects men from HIV-infection.
Results: Men informed about VMMC were more likely to believe that sex with a circumcised male would confer lower transmission risk for women vis-à-vis sex with an uncircumcised male (38% versus 50%, p<0.01). Multivariate regression analyses showed that incorrect inferences were most likely to be made by those who believed that circumcised men were partially protected from contracting HIV. Consistent with this, instrumental variable analyses indicated that those individuals who received information about VMMC, and consequently believed it, were 82 percentage points more likely to believe that male circumcision also protects women (p<0.01). The inferred reduction in direct HIV infection risk for women due to male circumcision was approximately 50%.
Conclusions: Our results suggest the need for VMMC campaigns to make explicit that male circumcision does not directly protect women from HIV-infection. It is also important to assess whether incorrect inferences lead to updated self-perceived HIV-risk and the adoption of riskier sexual behaviours.Brendan Maughan-Brown is grateful for funding from the National Research Foundation (NRF) Research Chair in Poverty and Inequality Research for his Postdoctoral Research Fellowship. Atheendar S. Venkataramani is grateful to the Massachusetts General Hospital Global Primary Care Program for travel and research support. Opinions expressed and conclusions arrived at, are those of the authors and are not necessarily to be attributed to the NRF.
Sources of Funding: Funding for this study was provided by Michigan Center for Demography of Aging (MiCDA), OVPR and Rackham at the University of Michigan as well as the Institute for Research on Women and Gender. Godlonton and Thornton gratefully acknowledge use of the services and facilities of the Population Studies Center at the University of Michigan, funded by NICHD Center Grant R24 HD041028. The funders had no role in the collection, analysis, and interpretation of data, manuscript preparation, and in the decision to submit the article for publication
The effects of different dimensions of HIV-related stigma on HIV testing uptake among young men and women in Cape Town, South Africa
No full textAlthough HIV-related stigma is known, in general, to deter HIV-testing, the extent to which different dimensions of stigma independently influence testing behaviour is poorly understood. We used data on young black men (n=553) and women (n=674) from the 2009 Cape Area Panel Study to examine the independent effects of stigmatising attitudes, perceived stigma and observed-enacted stigma on HIV-testing. Multivariate logistic regression models showed that stigma had a strong relationship with HIV-testing among women, but not men. Women who held stigmatising attitudes were more likely to have been tested (OR 3, p<0.01), while perceived stigma (OR 0.61, p<0.1) and observed-enacted stigma (OR 0.42, p<0.01) reduced the odds significantly of women having had an HIV test. Our findings highlight that different dimensions of stigma may have opposite effects on HIV testing, and point towards the need for interventions that limit the impact of enacted and perceived stigma on HIV-testing among women.We would like to thank Muthoni Ngatia, Atheendar Venkataramani, David Maughan-Brown and Rebecca
Maughan-Brown for helpful comments and suggestions. Brendan Maughan-Brown is grateful for funding
from the National Research Foundation (NRF) Research Chair in Poverty and Inequality Research for his
Postdoctoral Research Fellowship. Opinions expressed and conclusions arrived at, are those of the authors and are not necessarily to be attributed to the NRF
Effects of household shocks and poverty on the timing of traditional male circumcision and HIV risk in South Africa
No full textPoverty may influence HIV risk by increasing vulnerability to economic shocks and thereby preventing key health investments. We explored this by examining the relationship between household shocks and the timing of traditional male circumcision, a practice associated with considerable expense and whose HIV‐prevention benefits are larger when done earlier, even within young adulthood. Using unique data on a sample of Xhosa men, a group that almost universally practice traditional circumcision, we found that respondents in the poorest households delayed circumcision by two years if a household member experienced loss of income or death and/or illness. The impact of these shocks declined with increasing household income. Our findings suggest that interventions that work to mitigate the impact of shocks among the poor may be useful in HIV prevention efforts. More generally, they illustrate that the relationship between HIV and wealth may be more nuanced than assumed in previous work.Sources of Support: The Cape Area Panel Study was supported by the United States National Institute for Child Health and Human Development, the Andrew W. Mellon Foundation, the National Institute on Aging, the Health Economics & HIV/AIDS Research Division (HEARD) at the University of KwaZulu-Natal, and the European Union.
Acknowledgements
We would like to thank Cally Ardington, Murray Leibbrandt, Nicoli Nattrass, Vimal Ranchhod, Jeremy
Seekings, and seminar participants at the Center for Social Science Research in Cape Town, South Africa for useful comments and suggestions on an earlier version of this work. Brendan Maughan-Brown is grateful for funding from the NRF Research Chair in Poverty and Inequality Research for his Postdoctoral Research Fellowship. Atheendar Venkataramani is grateful for the Massachusetts General Hospital Department of Medicine Global Primary Care and Center for Global Health for supporting research and travel to South Africa. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All errors are our own