Raphael Lencucha
Datos Biográficos
| ID | 1733029 |
|---|---|
| NOMBRE | Raphael Lencucha |
| NOMBRES | Raphael |
| APELLIDO | Lencucha |
| FIRMA | LENCUCHA R |
| AFILIACIONES | McGill University |
| ORCID | 0000-0002-9273-2027 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 51 |
| TOTAL DE CITAS | 33 |
| TOTAL COMO AUTOR | 51 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2010 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 3 |
The end of the garden path? Analyzing smallholder tobacco farming income and decision-making in Mozambique
Many government sectors view tobacco growing to hold significant economic value for smallholder farmers, a narrative driving policy and practice. Corresponding to this narrative, there has been a marked increase in land allocated to leaf production and cigarette manufacturing. We tested this narrative in Mozambique by quantifying the economic net income of smallholder tobacco growers (n = 1 315 households) in four major tobacco growing districts …
Understanding the climate vulnerability and resilience of people with disabilities
This article examines how people with disabilities in the state of Kerala, India experience and respond to the impacts of climate change, drawing on 72 semi-structured interviews with disabled individuals, caregivers, and key stakeholders. Although Kerala has comparatively strong social development indicators and has taken steps toward disability-inclusive climate and disaster planning, our findings reveal persistent social, economic, and institu…
From positionality statements to reflexive statements of principle-informed process
box Positionality statements that accompany journal articles or other presentations of research outputs are important contributions to equity and justice in global health research
The political economy of tobacco of Zimbabwe
Tobacco continues to be viewed as a path to economic development by some governments, including Zimbabwe, despite widespread knowledge of tobacco’s negative consequences for users, farmers and the environment. Zimbabwe is one of the top five tobacco producers in the world and the largest tobacco producer in the African region. Zimbabwe’s focus on tobacco production creates difficulties for the implementation of the World Health Organization Frame…
Vision, relationships, patience … and power
Political economy of tobacco tax in Bangladesh
Our findings illustrate a complex interplay of political economy factors that challenge the design and implementation of tobacco taxes in Bangladesh. Creating opportunities for consultation and collaboration between the Ministries of Finance and Health regarding the formulation of tobacco taxes will be very important. National action plans with multi-stakeholder involvement are essential to achieving tobacco control goals through actionable steps
Contextual factors impacting WHO Framework Convention on Tobacco Control implementation in Africa—a scoping review
According to the World Health Organization (WHO), tobacco use causes over 8 million deaths annually including 1.3 million due to second-hand exposure. Furthermore, data from the Tobacco Atlas show that the tobacco industry continues to target new markets in the WHO African region, one of two regions where absolute numbers of smokers continue to increase. Understanding context contributes to policy formulation and implementation ensuring relevance…
Transforming global health
The field of global health is at a pivotal moment of transformation. Decoloniality has emerged as a critical framework to assess and transform the pathologies that mark the field. These pathologies include the inequitable sharing of resources, the power hierarchies that entrench decision-making in institutions largely based in North America and Europe and the general predisposition towards paternalistic and exploitative interactions and exchange …
“We have to look deeper into why”
Eliminating gender inequality and promoting population health are stand-alone goals in the Sustainable Development Goals (SDGs). It is crucial to understand goal setting and policy making processes aimed at promoting gender and health equality given the entrenched and structural natures of these inequalities. Our research examines the process of problem and solution representation, priority setting, and factors that shape the policymaking process…
Tobacco policy (in)coherence in Mozambique
Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique’s political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignm…
Competing (ac)counts of disability
Research is a critical starting point for public policy. For disability policy, the calculation of prevalence – the percentage of persons with disabilities in a population – has attracted significant attention. Multiple disability prevalence studies have been conducted in Zambia. We used data from semi-structured interviews about research and the policy process with twelve Zambian disability policy stakeholders to explore perspectives about disab…
Multiple Locations of Alcohol Use in the Narratives of the Peruvian Andean Highland and Population with Problem Drinking
The present qualitative study explores local meanings and modes of interpretation of alcohol use among people with problem drinking in the Peruvian Andean highlands. We conducted individual interviews with 19 people in two districts of Ayacucho region identified as having engaged in problem drinking, using McGill Illness Narrative Interview Schedule. Participants articulated multi-layered associations between alcohol and the body, emotions, socia…
Framing policy objectives in the sustainable development goals
Society continues to be confronted with the deep inadequacies of the current global order. Rampant income inequality between and within countries, dramatic disparities in access to resources, as seen during the COVID pandemic, persistent degradation of the environment, and numerous other problems are tied to existing systems of economy and government. Current global economic systems are implicated in perpetuating these problems. The Sustainable D…
Gendering the Political Economy of Smallholder Agriculture
Gender plays a prominent role in shaping the practices and experiences of smallholding farming households. This scoping review seeks to chart and analyze how gender is used in the existing literature on the political economy of smallholder agriculture. The aim of this review is to first identify the extent to which gender is addressed as a unit of analysis in this body of literature, and second, to identify when and how gender is incorporated in …
Children with Disabilities in Canada during the Covid-19 Pandemic
Children with disabilities were especially vulnerable during the COVID-19 pandemic, and policies designed to mitigate its effects were limited in addressing their needs. We analyzed Canadian policies related to children with disabilities and their families during the COVID-19 pandemic to identify the extent to which these policies aligned with the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) and responded to thei…
Foregrounding women and household dynamics to inform Article 17
Women hold agency within tobacco-growing households and participate in decision-making processes regarding tobacco agriculture. Women should be included in future tobacco control policies and programmes pertaining to Article 17
The use, misuse and overuse of the ‘low-income and middle-income countries’ category
Exploring the political economy nexus of tobacco production and control
Control, power, and responsibility
BACKGROUND: Alcohol control has emerged as an important global health challenge due to the expanding influence of alcohol companies and limited control measures imposed by governments. In the Peruvian Andean highland, the ritual function of collective drinking is reported to have been weakened in response to the increased availability of alcohol and the experience of political violence. This study seeks to merge the broader political economy with…
Trust, risk, and the challenge of information sharing during a health emergency
Information sharing is a critical element of an effective response to infectious disease outbreaks. The international system of coordination established through the World Health Organization via the International Health Regulations largely relies on governments to communicate timely and accurate information about health risk during an outbreak. This information supports WHO’s decision making process for declaring a public health emergency of inte…
An Overview of the Policy and Market Landscape of Tobacco Production and Control in Mozambique
Background: Tobacco growing has been considered a mainstay of Mozambique's economy, but there is a dearth of analysis of the tobacco policy landscape in the country. Methods: Review of government and non-government documents and academic papers addressing Mozambique's tobacco-growing history, the changes in the political economy of tobacco, and health policies addressing tobacco use and prevention of noncommunicable diseases. Results: Despite its…
Disability Focal Point Persons and Policy Implementation Across Sectors
Background: Zambia has created new disability policies and updated existing policies to be consistent with the United Nations Convention on the Rights of Persons with Disabilities. These initiatives require the widespread engagement of ministries and departments to achieve effective policy development and implementation. To pursue widespread engagement, the Government of Zambia developed a structure of disability focal point persons (FPPs). The Z…
Intersectoral policy on industries that produce unhealthy commodities
Tobacco, alcohol and unhealthy foods are key contributors to non-communicable diseases globally. Public health advocates have been proactive in recent years, developing systems to monitor and mitigate both health harms and influence by these industries. However, establishing and implementating strong government regulation of these unhealthy product-producing industries remains challenging. The relevant regulatory instruments lie not only with min…
Engaging culture and context in mhGAP implementation
In 2002, WHO launched the Mental Health Gap Action Programme (mhGAP) as a strategy to help member states scale up services to address the growing burden of mental, neurological and substance use disorders globally, especially in countries with limited resources. Since then, the mhGAP program has been widely implemented but also criticised for insufficient attention to cultural and social context and ethical issues. To address this issue and help …
Government policy and agricultural production
Unhealthy foods and tobacco remain the leading causes of non-communicable disease (NCDs). These are key agricultural commodities for many countries, and NCD prevention policy needs to consider how to influence production towards healthier options. There has been little scholarship to bridge the agriculture with the public health literature that seeks to address the supply of healthy commodities. This scoping review synthesizes the literature on g…
Rhetoric and the law, or the law of rhetoric
Whole-of-government approaches to NCDs
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 Nation…
Global tobacco control and economic norms
Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments …
The political economy of foreign direct investment—Evidence from the Philippines
Much of the conventional wisdom about the political economy of foreign direct investment suggests that many developing country governments lower regulatory and/or legislative standards in order to woo potential investors. Using the case of the tobacco industry's efforts to influence excise tax policy reforms in the Philippines, we find a much more complex reality. Over a period of more than 15 years of concerted efforts and significant financial …
Being Global in Public Health Practice and Research
Extending collaborations for knowledge translation
The purpose of this paper is to expand the current focus on researcher–decision maker knowledge translation (KT) partnerships to include community partners. Lessons were drawn from the community-based participatory research literature. An inductive thematic analysis was conducted, using 42 eligible articles, and resulted in the identification of four themes (principles, structure, process and relationships) and associated factors that could contr…
Shifting from tobacco growing to alternatives in Malawi? A qualitative analysis of policy and perspectives
Tobacco is the primary export commodity in Malawi and an important contributor to foreign earnings. The entrenchment of tobacco interests within government has partly explained why Malawi has lagged in its efforts to address the health consequences of tobacco and has been a vocal opponent of global tobacco control. Despite the extensive historical and entrenched relationship between the economy of Malawi and tobacco production, there have been im…
The role of non-governmental organizations in global health diplomacy
The Framework Convention on Tobacco Control (FCTC) is an exemplar result of global health diplomacy, based on its global reach (binding on all World Health Organization member nations) and its negotiation process. The FCTC negotiations are one of the first examples of various states and non-state entities coming together to create a legally binding tool to govern global health. They have demonstrated that diplomacy, once consigned to interactions…
Navigating institutional complexity in the health sector
INTRODUCTION: This research examines the institutional dynamics of tobacco control following the establishment of Kenya's 2007 landmark tobacco control legislation. Our analysis focuses specifically on coordination challenges within the health sector. METHODS: We conducted semi-structured interviews with key informants (n = 17) involved in tobacco regulation and control in Kenya. We recruited participants from different offices and sectors of gov…
Extending collaborations for knowledge translation
The purpose of this paper is to expand the current focus on researcher–decision maker knowledge translation (KT) partnerships to include community partners. Lessons were drawn from the community-based participatory research literature. An inductive thematic analysis was conducted, using 42 eligible articles, and resulted in the identification of four themes (principles, structure, process and relationships) and associated factors that could contr…
Framing international trade and chronic disease
There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global …
The role of non-governmental organizations in global health diplomacy
The Framework Convention on Tobacco Control (FCTC) is an exemplar result of global health diplomacy, based on its global reach (binding on all World Health Organization member nations) and its negotiation process. The FCTC negotiations are one of the first examples of various states and non-state entities coming together to create a legally binding tool to govern global health. They have demonstrated that diplomacy, once consigned to interactions…
Being Global in Public Health Practice and Research
Cosmopolitanism and foreign policy for health
BACKGROUND: Foreign policy holds great potential to improve the health of a global citizenship. Our contemporary political order is, in part, characterized by sovereign states acting either in opposition or cooperation with other sovereign states. This order is also characterized by transnational efforts to address transnational issues such as those featured so prominently in the area of global health, such as the spread of infectious disease, he…
The political economy of foreign direct investment—Evidence from the Philippines
Much of the conventional wisdom about the political economy of foreign direct investment suggests that many developing country governments lower regulatory and/or legislative standards in order to woo potential investors. Using the case of the tobacco industry's efforts to influence excise tax policy reforms in the Philippines, we find a much more complex reality. Over a period of more than 15 years of concerted efforts and significant financial …
Plain packaging
This paper highlights two salient challenges at the intersection of tobacco control and macroeconomic policy-making: (i) the use of trade and investment disputes to undermine and/or stall tobacco control legislation and (ii) the inconsistency, and thus unpredictability, of country positions across the two spheres. In the interest of improving international policy coherence, the authors suggest possible solutions to these two challenges at the nat…
Investment incentives and the implementation of the Framework Convention on Tobacco Control
Much of the struggle Zambia has experienced in implementing the FCTC can be attributed to misalignments between the economic and health sectors. Zambia's development agenda seeks to bolster agricultural processing and manufacturing. Tobacco control proponents must recognise and work within this context in order to foster productive strategies with those working on tobacco supply issues. These findings are broadly applicable to the global context.…
Whole-of-government approaches to NCDs
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 Nation…
Costs, revenues and profits
The tobacco industry narrative that tobacco farming is a lucrative economic endeavour for smallholder farmers is demonstrably inaccurate in the context of Malawi. From the perspective of these farmers, tobacco farming is an economically challenging livelihood for most
Global health diplomacy
Navigating institutional complexity in the health sector
INTRODUCTION: This research examines the institutional dynamics of tobacco control following the establishment of Kenya's 2007 landmark tobacco control legislation. Our analysis focuses specifically on coordination challenges within the health sector. METHODS: We conducted semi-structured interviews with key informants (n = 17) involved in tobacco regulation and control in Kenya. We recruited participants from different offices and sectors of gov…
Rhetoric and the law, or the law of rhetoric
Disentangling regional trade agreements, trade flows and tobacco affordability in sub-Saharan Africa
BACKGROUND: In principle, trade and investment agreements are meant to boost economic growth. However, the removal of trade barriers and the provision of investment incentives to attract foreign direct investments may facilitate increased trade in and/or more efficient production of commodities considered harmful to health such as tobacco. We analyze existing evidence on trade and investment liberalization and its relationship to tobacco trade in…
The context and quality of evidence used by tobacco interests to oppose Anvisa’s 2012 regulations in Brazil
Evidence is an important resource for policy makers. Alongside its practical utility, evidence is a persuasive strategic and rhetorical tool. This study scrutinises the information used by tobacco interests in opposition to Brazil's National Health Surveillance Agency's (ANVISA) 2012 regulations. We analysed one prominent document widely cited in the policy discourse, produced by Fundação Getulio Vargas (FGV) in 2010 when ANVISA initiated public …
A conceituação das ameaças ao controle do tabaco provenientes de acordos econômicos internacionais
Com base nos resultados de dezenas de entrevistas com atores-chave envolvidos na formulação de políticas de controle do tabaco, examinamos as percepções desses atores em relação a ameaças ao controle do tabaco provenientes de políticas econômicas internacionais (comerciais e de investimento). Adotando uma perspectiva jurídica, avaliamos também as ameaças existentes e desafios potenciais que as políticas econômicas podem apresentar para os esforço…
As instituições e a implementação do controle do tabaco no Brasil
Esta pesquisa examina as características institucionais da Comissão Nacional para a Implementação da Convenção-Quadro sobre Controle do Tabaco (CONICQ) e como essas características institucionais facilitaram e impediram sua capacidade de promover o controle intersetorial do tabagismo. Os autores avaliam particularmente as características da CONICQ enquanto um dos principais fatores de mudanças e melhorias nas primeiras políticas de controle do ta…
The institutional context of tobacco production in Zambia
BACKGROUND: Tobacco production is said to be an important contributor to Zambia's economy in terms of labour and revenue generation. In light of Zambia's obligations under the WHO Framework Convention of Tobacco Control (FCTC) we examined the institutional actors in Zambia's tobacco sector to better understand their roles and determine the institutional context that supports tobacco production in Zambia. METHODS: Findings from 26 qualitative, sem…
The financial sustainability of the World Health Organization and the political economy of global health governance
The World Health Organization (WHO) continues to experience immense financial stress. The precarious financial situation of the WHO has given rise to extensive dialogue and debate. This dialogue has generated diverse technical proposals to remedy the financial woes of the WHO and is intimately tied to existential questions about the future of the WHO in global health governance. In this paper, we review, categorize, and synthesize the proposals f…
Opening windows and closing gaps
NGOs remain a critical factor in efforts to strengthen tobacco control policy. These organizations were able to mobilize support for the tobacco flavouring ban adopted at the Federal level in Canada, and although the initial Bill had major limitations to achieving the health objectives, the persistence of these NGOs resulted in amendments to close these loopholes
Costs, contracts and the narrative of prosperity
Tobacco farming households enter into contract with tobacco companies to realise perceived economic benefits. The narrative that tobacco farming is a lucrative economic undertaking for smallholder farmers, however, is inaccurate in the context of Kenya
Global tobacco control and economic norms
Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments …
Disability Focal Point Persons and Policy Implementation Across Sectors
Background: Zambia has created new disability policies and updated existing policies to be consistent with the United Nations Convention on the Rights of Persons with Disabilities. These initiatives require the widespread engagement of ministries and departments to achieve effective policy development and implementation. To pursue widespread engagement, the Government of Zambia developed a structure of disability focal point persons (FPPs). The Z…
Intersectoral policy on industries that produce unhealthy commodities
Tobacco, alcohol and unhealthy foods are key contributors to non-communicable diseases globally. Public health advocates have been proactive in recent years, developing systems to monitor and mitigate both health harms and influence by these industries. However, establishing and implementating strong government regulation of these unhealthy product-producing industries remains challenging. The relevant regulatory instruments lie not only with min…
Engaging culture and context in mhGAP implementation
In 2002, WHO launched the Mental Health Gap Action Programme (mhGAP) as a strategy to help member states scale up services to address the growing burden of mental, neurological and substance use disorders globally, especially in countries with limited resources. Since then, the mhGAP program has been widely implemented but also criticised for insufficient attention to cultural and social context and ethical issues. To address this issue and help …
Political science (43 obras) · Economics (32 obras) · Medicine (29 obras) · Public health (28 obras) · Global Public Health Policies and Epidemiology (27 obras) · Business (24 obras) · Economic growth (24 obras) · Geography (22 obras) · Tobacco control (19 obras) · Tobacco industry (19 obras)