The factors enabling and hindering evidence use

What types of use do we see?

In this book we have characterised uses of evidence as instrumental, conceptual, process and symbolic (see Chapter 2). We do see instrumental use, in that the form of the directive was largely drafted as part of the action-research process. The specific proposal from the simulations of the tax rates to use was also adopted in the directive.

Underlying instrumental use was significant conceptual use. As a result of the process, stakeholders had a much better understanding of the challenges arising from tobacco consumption, the limited benefits to the economy compared to the costs to the state, and possible modalities of taxation. This understanding led to the approval of the directive and tax rates. As taxation is a regional issue, each country realised that regional tax harmonisation was the only way to control consumption and reduce illicit trade, and that a regional strategy would have more impact. Another form of conceptual use that emerged is that local evidence on tobacco use is now produced and disseminated widely which makes it possible to talk about real statistics from the region. In terms of research, we can see a flowering of documents that use the statistics produced by CRES. Countries have also used their greater understanding to inform their participation in international meetings such as the Conference of the Parties to the FCTC (Civil society respondent).

The process also greatly raised the profile of the dangers of tobacco consumption in the region, which helped to counteract the lobbying from the tobacco industry. This is an example of positive symbolic use.

In terms of process use, the establishment of research units in each country led to countries acknowledging the importance of the evidence process.

How evidence use was promoted

A variety of interventions promoted the use of evidence (see Table 12.1), but there were four main levers. An important first lever was the process facilitation role played by CRES, along with key champions in CRES and ECOWAS. The CRES director used his contacts to bring together all the key players in the fight against tobacco. He understood the multidisciplinary aspects of tobacco control, the need to produce relevant rigorous evidence and the need to master political decisionmaking mechanisms. He involved his academic colleagues specialising in law and sociology for the draft law in Senegal and the smoking ban inTouba. He used his relationship with the ECOWAS representative to work on tariffs in ECOWAS. The collaboration between CRES and ECOWAS helped them to understand the steps to be taken for a change of directive. The director of CRES also seized on the opportunity of a meeting with the then president of the Republic of Senegal to raise the presidents awareness of the need for a new law to control tobacco use.

CRES obtained funding for the action research and immediately started to address the main shortcomings highlighted in the prior situational analysis, namely the lack of synergy in tobacco control between researchers and other stakeholders like civil society, ministries of health, fiscal and customs administrations, and members of Parliament at the national and regional levels. CRES had an understanding of how this synergy could be built that could lead to a new tobacco directive. This process began with the involvement of all stakeholders from the beginning through a methodological workshop to upgrade their knowledge in terms of tobacco use and especially tobacco taxation. This enabled all stakeholders to discuss the subject and to understand actual practice in the region. A key champion in ECOWAS, the chairman of the Customs Commission, indicated.

I had no knowledge of this issue. I started to get a better idea of the tobacco issue at the first methodological workshop. It was with the country profiles

Table 12.1 Use interventions and their influence

(Continued)

Table 12.1 (Continued)

Note: Change mechanisms are highlighted in italics.

that I learned about the harmful effects of tobacco, especially on young people and vulnerable people.

This process facilitation involved a second lever, the inclusion of key people in the process as the intention was that the Council of Ministers would change the tobacco taxation directive on the basis of evidence. In order to achieve this, it was important that the technical staff who had to convince the ministers of the need for this change were involved throughout. Hence, officials from the ministries responsible for the application of taxation had to be involved in the steering committees, be part of the research generation process, participate in key events and so forth.

The integration of the technical experts from the administrative bodies who would analyse the proposals to be made to the ministers was facilitated by their inclusion in multidisciplinary national research teams that were expected to produce most of the evidence.

The third lever to promote use of the evidence was the organisation of workshops and conferences that brought together the 15 ECOWAS member countries led by CRES. All 15 ECOWAS countries were represented by a delegation of at least two people from the tax and customs administrations and the country’s ministry of health.The host city for these events was rotated, with workshops and conferences held in Ouagadougou, Dakar and Abidjan. Each of these events was opened

Using evidence for tobacco control 219 by eminent people from the host country in the presence of high-level representatives from community institutions. For example, the two advocacy workshops, the first bringing together tax, customs and health administrations and the second the parliamentarians, held in Abidjan, were attended by the chief of staff of the Minister of African Integration, a vice president of the National Assembly of Côte d’Ivoire, a vice president of the Ivorian Senate, the chairman of the ECOWAS Customs Commission and the representative of the WAEMU Commission.

The fourth lever was the presentation of the results in the form of easy to read policy notes to better disseminate the results. Each country profile was the subject of a policy note in a brief, four-page format focusing on policy recommendations. The policy notes were written in both English and French.

Facilitators and barriers to the use of evidence

The three key facilitators of the use of evidence

RATIFICATION OFTHEWHO FRAMEWORK CONVENTION ONTOBACCO CONTROLAT REGIONAL LEVEL

When the action-research project on tobacco taxation in West Africa began, all ECOWAS countries had ratified the WHO FCTC which identified taxation as the most effective way to reduce consumption. Thus, there was a strong commitment by each country to fight the consumption of tobacco products. The need to fulfil this commitment provided an environment conducive to the adoption of a new directive on the taxation of tobacco products and contributed to the active participation of governments.

PARTICIPATION IN INTERNATIONAL MEETINGS

Since ratification of the FCTC, tobacco control stakeholders have participated in international meetings such as the Conference of the Parties to the FCTC and the World Tobacco Conference. These meetings raised awareness of the need for strong commitment against tobacco, and demonstrated that the international community' has decided to take action. According to the civil society respondent, the discussions at these conferences provided an opportunity to hear about the strength of taxation as a means of tobacco control.

THE ROLE OF CHAMPIONS

Two main champions were the driving force behind the new tobacco tax directive — the director of CRES and the chairman of the ECOWAS Customs Commission. The director of CRES designed the action-research project to create synergy between research, advocacy and political decision making. CRES’s role in process facilitation, led by the director, is described earlier. Second, agreement of a new directive on the taxation of tobacco would not have been possible without the political will of the chairman of the ECOWAS Customs Commission.

At the outset he had no knowledge of the issue, but he was committed to providing ECOWAS countries with an effective tool to control tobacco. He mobilised ECOWAS delegations for the meetings and ensured the preparation of technical notes for the discussions. Once the directive was ready for adoption, despite the considerable delays caused by the Ebola virus crisis in the ECOWAS region, he continued to work towards the final adoption of the process.

The three key barriers to the use of evidence

THE EBOLA CRISIS

After analysis and validation of the draft directive in 2014, the Ebola virus crisis hit West Africa. As some ECOWAS countries had Ebola cases, ECOWAS was forced to suspend all inter-state gatherings to prevent the spread of the disease.This situation slowed down the process of adopting the directive, which delayed the process for about three years. However, as the two key champions were still in their positions in ECOWAS and in CRES, it was relatively easy to pick up the process again.

INTERFERENCE FROM THE TOBACCO INDUSTRY

The tobacco industry took advantage of the Ebola crisis to try to discredit the process. Letters were sent to a few ministers to discourage them from adopting the draft regional directive. The lobbyists denounced the role played by CRES, arguing that it had replaced the administrations as the driver of the process. CRES and civil society shared these letters and helped government to respond to these letters, and the tobacco industry did not manage to derail the process.

THE EXISTENCE OFTWO PARALLEL DIRECTIVES

Both ECOWAS and WAEMU developed directives. The WAEMU directive does not have a specific tax, just an ad valorem figure. Countries belonging to both regional bodies can apply the directives of both. However, this does not make the application of the same directive in the 15 ECOWAS countries any easier. WAEMU, being an economic and monetary union, has more opportunities to meet, because it deals with more economic issues and is more closely integrated. The issues around these multiple tax jurisdictions are discussed in Blecher and Drope (2014).