The decision-making process in Brazil's ratification of the World Health Organization Framework Convention on Tobacco Control

Cad Saude Publica. 2017 Sep 21;33Suppl 3(Suppl 3):e00126115. doi: 10.1590/0102-311X00126115.
[Article in Portuguese, English]

Abstract

Tobacco consumption is a leading cause of various types of cancer and other tobacco-related diseases. In 2003, the World Health Assembly adopted the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), which aims to protect citizens from the health, social, environmental, and economic consequences of tobacco consumption and exposure to tobacco smoke. The Convention was to be ratified by the Member States of the WHO; in Brazil's case, ratification involved the National Congress, which held public hearings in the country's leading tobacco growing communities (municipalities). The current study analyzes this decision-making process according to the different interests, positions, and stakeholders. In methodological terms, this is a qualitative study based on document research, drawing primarily on the shorthand notes from the public hearings. We analyze the interests and arguments for and against ratification. The article shows that although preceded by intense debates, the final decision in favor of ratification was made by a limited group of government stakeholders, characterizing a decision-making process similar to a funnel.

MeSH terms

  • Brazil
  • Decision Making
  • Government Regulation
  • Health Policy
  • Humans
  • National Health Programs
  • Public Health
  • Smoking / legislation & jurisprudence*
  • Smoking Cessation
  • Tobacco Industry / legislation & jurisprudence
  • Tobacco Use Disorder / prevention & control*
  • World Health Organization