In the past five years, the market for flavored tobacco and nicotine products has become increasingly global, while policies have fragmented along national lines. Flavors attract new consumers, keep existing consumers addicted, and can worsen the negative health effects of smoking. Many of these concerns apply to newer products such as e-cigarettes, but with the added complexity for policymakers of differential risks for certain groups within the population. We conduct a comparative policy mapping of flavored cigarette and e-cigarette regulations in 200 national jurisdictions to build an original dataset of global flavor policy. We classify the policy combinations into four distinct approaches and generate several hypotheses to explain global policy variation. By comparing flavor restrictions across a large number of jurisdictions, we show that countries fall into four distinct groups. 41 countries restrict flavors in neither product, 16 restrict both, 40 restrict flavored e-cigarettes more than cigarettes, and 39 restrict flavored cigarettes more than e-cigarettes. In exploring several potential explanations for policy variation, we find that countries’ political systems, state capacity, and the role of states in the global tobacco economy correlate with different policies on flavor restrictions in cigarettes and e-cigarettes. Despite global calls to ban flavored tobacco and nicotine products, policymakers, tobacco control advocates, tobacco industry representatives and other relevant actors are divided as to how to regulate them, resulting in a patchwork of national policies. Comparing how countries regulate flavored cigarettes and flavored e-cigarettes highlights the barriers to adopting a global approach to a globalizing market: government capacity, governance type, and a country’s place within the global economy all contribute to countries taking different policy approaches despite a globalized product market and shared body of current scientific evidence.
Non-communicable diseases (NCD) are the leading causes of death in Latin American countries, yet the burden of NCD attributable to lifestyle risk factors in the region remains poorly understood. In this study, we aimed to estimate the proportion and number of NCD deaths attributable to lifestyle risk factors in five Latin American countries. We used data from national surveys conducted in five Latin American countries (Argentina, Brazil, Chile, Colombia, and El Salvador), comprising 259,327 participants. Self-reported data on fruit and vegetable consumption, physical activity, alcohol use, and tobacco smoking were stratified by sex and age group. The Preventable Risk Integrated Model (PRIME) was applied to compare baseline distributions of lifestyle risk factors with a counterfactual scenario based on World Health Organization (WHO) recommendations, estimating changes in annual NCD deaths due to cardiovascular disease (CVD), diabetes, and chronic obstructive pulmonary disease in 2021. We estimated that 184,111 NCD deaths could have been prevented or delayed across the five countries by adhering to WHO lifestyle recommendations. Brazil (46.1
Non-pharmaceutical interventions (NPIs) and COVID-19-related border controls might have influenced global dengue transmission dynamics. Taking the imposition of travel restrictions during the pandemic as a natural experiment, this study aimed to explore potential associations between border restrictions and dengue prevalence in selected non-endemic and endemic Asia-Pacific countries during the pandemic using a retrospective prediction approach. Generalized Additive Models (GAMs) were employed to model dengue case trends from 2009 to 2019, characterizing transmission periodicity and incidence patterns during the pandemic. Correlation analyses were conducted to examine possible associations between air passenger arrivals and reported dengue cases across four countries in 2020, using passenger volume data. SARIMA models were used to estimate counterfactual dengue incidence in the absence of COVID-19-related NPIs, and predicted cases were compared with observed cases to assess deviations potentially attributable to control measures. Compared with the 2009–2019 epidemic seasons, dengue activity in China and Australia remained below historical levels in 2020, while Thailand’s activity was slightly lower than its historical peak, with cases fluctuating within the moderate-to-high range. Singapore’s dengue activity remained consistently above historical maximum levels. Correlation analyses suggested a positive linear association between international air passenger arrivals and dengue cases in non-endemic countries, with Pearson correlation coefficients exceeding 0.75; however, such associations were not apparent in countries with endemic (Thailand and Singapore). Retrospective predictions indicated that COVID-19-related border restrictions might be associated with lower dengue case counts in China and Australia (96.97
Over the last century, philanthropic foundations have become prominent global health actors increasingly involved in shaping the global health agenda. Concurrently, media organisations have become increasingly reliant on philanthropic funding as media consumption patterns have changed. Philanthropic foundations, such as the Gates Foundation, are positioned to offer financial support to media organisations while being provided with a strategic avenue to draw attention to particular issues and garner support. However, positive media narratives of the Gates Foundation and their focus on market-oriented vertical solutions to global health may divert attention and efforts away from other important horizontal approaches. While these critiques exist, no systematic analyses of the Foundation and their portrayal in the media has been conducted to date. This study aimed to analyse media portrayals of the Gates Foundation across the United States, United Kingdom, and Australia between 2013 and 2023, and to examine whether the Foundation’s grant funding of media organisations influences these portrayals. Utilising a mixed-methods approach, this empirical study uncovered that media portrayals predominantly frame the Gates Foundation positively and favour coverage of vertical, disease-specific approaches to global health, particularly infectious diseases, while giving limited coverage to broader horizontal approaches. We found the Foundation donated 291 million USD in grants to media organisations across the United States, United Kingdom, and Australia between 2013 and 2023. However, we found insufficient evidence of an association between this grant funding and positive portrayals (p = > 0.05, OR = 0.5). Limitations associated with sourcing comprehensive funding data, and the complexities of intermediary funding raise important questions about transparency and media independence that requires further exploration. Media coverage of global health philanthropic organisations and the influence of media funding on this coverage has had limited scholarly attention to date. The predominance of positive portrayals and coverage of vertical interventions, despite insufficient evidence of an association with grant funding, highlights the value of independent reporting that critically examines prominent philanthropic actors and adequately addresses the full spectrum of global health challenges and solutions. Not applicable.
