We revisit the Tragedy of the Commons in an dynamic overlapping generations economy peopled of shepherds who decide how many sheepthey let graze on a common parcel of land, while relying on di fferent forms of rationality (Nash players, Pure or Impure Kantian players). Weexamine the dynamics of heterogeneity and land congestion when the prevalance of those di fferent forms of rationality evolves over time follow-ing a vertical/oblique socialization process a la Bisin and Verdier (2001).We study the impacts of a quota and of a tax on the congestion of land, and we show that introducing a quota may, in some cases, reduce theproportion of Kantians (Pure and Impure), and worsen the Tragedy of Commons with respect to the laissez-faire. Finally, we examine whethera government should promote either a Pure or an Impure Kantian morality, by comparing the relative fi tness of Pure/Impure Kantians, and theirinteractions with the congestion of land.
We revisit the Tragedy of the Commons in an dynamic overlapping generations economy peopled of shepherds who decide how many sheepthey let graze on a common parcel of land, while relying on di fferent forms of rationality (Nash players, Pure or Impure Kantian players). Weexamine the dynamics of heterogeneity and land congestion when the prevalance of those di fferent forms of rationality evolves over time follow-ing a vertical/oblique socialization process a la Bisin and Verdier (2001).We study the impacts of a quota and of a tax on the congestion of land, and we show that introducing a quota may, in some cases, reduce theproportion of Kantians (Pure and Impure), and worsen the Tragedy of Commons with respect to the laissez-faire. Finally, we examine whethera government should promote either a Pure or an Impure Kantian morality, by comparing the relative fi tness of Pure/Impure Kantians, and theirinteractions with the congestion of land.
We revisit the Tragedy of the Commons in an dynamic overlapping generations economy peopled of shepherds who decide how many sheepthey let graze on a common parcel of land, while relying on di fferent forms of rationality (Nash players, Pure or Impure Kantian players). Weexamine the dynamics of heterogeneity and land congestion when the prevalance of those di fferent forms of rationality evolves over time follow-ing a vertical/oblique socialization process a la Bisin and Verdier (2001).We study the impacts of a quota and of a tax on the congestion of land, and we show that introducing a quota may, in some cases, reduce theproportion of Kantians (Pure and Impure), and worsen the Tragedy of Commons with respect to the laissez-faire. Finally, we examine whethera government should promote either a Pure or an Impure Kantian morality, by comparing the relative fi tness of Pure/Impure Kantians, and theirinteractions with the congestion of land.
Im Beitrag wird eine ethnographische Studie präsentiert, deren Gegenstand die Teilnahme von Frauen an den Arbeitskämpfen im südafrikanischen Bergbau gewesen ist. Die Darstellung ist durch folgende theoretisch abgeleitete Fragen gerahmt: Wie erfolgt die Verwandlung der geschlechtsspezifischen Gestaltung des sozialen Raumes in kulturelle und alltagsbezogene Praktiken und wie erfolgt die Produktion und die Reproduktion sozialer Räume angesichts der Absonderung von frauenspezifischen Aufgaben im Rahmen des Arbeitskampfes? Den Schwerpunkt der Studie bilden die Muster der geschlechtsspezifischen Partizipation innerhalb der Interessenvertretungen der Bergarbeiter und ihre Bedeutung im Arbeitskampf. (ICB)
Together with reductions in indirect taxes on food imports, cash for work programs were one of the main responses implemented by African governments following the food, fuel, and financial crisis of recent years. The main objective of those programs was to help the poor cope with the various shocks by increasing their net earnings through community-level work paid for under the programs. Yet it is unclear whether these cash for work programs indeed reached their intended beneficiaries and to what degree they generated other, potentially long-term beneficial impacts. This paper explores these issues in the context of Liberia and the performance of the Cash for Work Temporary Employment Program (CfWTEP) funded by the World Bank through an emergency crisis facility in response to the 2007/2008 food crisis. Both quantitative and qualitative data are presented, focusing on the operational and policy experiences emerging from program implementation. This paper analyzes the context that led to the creation and implementation of the CfWTEP in Liberia, the nature and administrative arrangements for the program, and its operational performance. The objective is to share the lessons learned from evaluation findings so that they can be useful for implementing similar programs in the future in Liberia itself or in other countries. Findings from the analysis highlight the possibilities of implementing public works program in low capacity, post conflict setting and the scope for using the program as a springboard towards a broader and more comprehensive social safety net.
학위논문 (석사) -- 서울대학교 대학원 : 사범대학 협동과정 글로벌교육협력전공, 2020. 8. 김종섭. ; The importance of promoting higher education through global development efforts and foreign aid is growing. Bolstered by efforts of higher education institutions to internationalize, the volume of foreign aid for the purpose of developing the world's higher education institutions is increasing. Such phenomenon especially gives importance to aid modalities of international scholarships and subsistence support to international students. Even when commitments are made to aid types that are not scholarships, the frequency of institution-level involvement by both donor and recipient institutions in bilateral aid programs for higher education is increasing (Varghese, 2010). However, not many studies have been conducted about the determinants and effectiveness of bilateral aid to higher education. Therefore, this study aims to contribute to the literature of higher education aid by analyzing the determinants of bilateral higher education aid of DAC donors based on empirical bilateral ODA data provided by OECD from 2000 to 2017. For the analysis of collective and individual determinants, this study has utilized explanatory variables that have been selected based on the donor-interest and recipient-needs (DI-RN model) to examine the impact of a recipient's economic, humanitarian and educational needs, as well as a donor's political and economic needs on the amount of higher education aid a country receives. In addition, explanatory variables that represent the ease of cross-border information flows have also been used in order to estimate the impact of a recipient's conditions that facilitate international information flows on higher education aid. A key finding is that even with the regional development cooperation priorities of donors considered, the amount of higher education aid that a country may receive in general is determined by various factors. The empirical analysis result of DAC donors as a group indicated that several factors of recipient needs, donor interest, and the recipient's social knowledge infrastructure were all considered in the allocation of higher education aid. While aid to higher education followed the basic principle of aid, wherein it is conceptualized by many that aid should be given to larger countries with low GDP, it was also revealed in the results that insufficiencies in a country's labor force as well as gross tertiary enrolment rate were relevant to the amount of higher education aid. At the same time, it was estimated that countries with high levels of information infrastructure and more global ties were more likely to receive larger amounts of higher education development support. Second, in addition to an assessment of the composition of aid types committed for the purpose of higher education, it was revealed that different variables were significant to different donors as determinants for providing higher education aid. For instance, France, Germany and Austria would both allocate more higher education aid to encourage international student mobility through scholarships and student benefits to politically global yet poorer countries. However, ceteris paribus, it was estimated that France will most likely be preferential to francophone countries with good information infrastructure and higher needs in secondary education whereas Germany would more likely be open to accepting international students from countries with a reasonably capable higher education institution. Similar to France, it can be assumed that Austria will also provide more aid to countries with better information infrastructure. However, Austria showed a tendency to provide such aid to countries with higher youth unemployment and lower primary education capacity. Furthermore, it was estimated that the U.S will commit more aid to countries lacking in social infrastructure and a weaker labor market, while Japan's will most likely support higher education development in countries with low upper-secondary education achievement. In summary, the empirical analysis conducted in this study revealed that different needs and interests were considered by donors in allocating higher education aid. The allocation of aid to the subsector on a collective level was examined to be affected by normative determinants that include humanitarian, economic, and educational needs as well as political interests and the recipient's infrastructural readiness to support the development of institutional development of higher education. However, individual donors showed differences in the type of specific need or interest that impacts the allocation of aid to higher education. Regardless, normative needs such as low GDP and different educational needs were identified to be key considerations for donors in allocating aid to higher education. The significance of this study lies in the identification of such differences in the determinants existent within and across different needs and interests as well as infrastructural conditions extraneous to the DI-RN model. However, such findings further require us to conduct studies that are more contingent to individual donors in order to provide a comprehensive understanding of the political and strategic drive of DAC donors within the higher education subsector. Additionally, studies about higher education aid allocation based on the recipient's perspective, such as the evaluation of specific outcomes of the different types of aid provided by different donors, is also expected to significantly contribute to the literature of higher education aid effectiveness. ; 국제 개발협력의 관점에서 원조를 통한 개발도상국의 고등교육기관 발전에 대한 중요성은 증가하고 있다. 나아가, 세계 각국에서 시행되고 있는 고등교육 국제화 노력과 더불어 고등교육의 발전을 위한 원조량은 꾸준히 증가하는 추세이다. 이 같은 원조는 고등교육의 특성상 국제 장학금과 국제 학생을 위한 자금 지원의 형태를 중심으로 이루어지게 되며, 양자원조 프로그램의 경우 공여국과 수원국의 고등교육기관들이 직접적으로 사업에 참가하는 양상이 증가하고 있다 (Varghese, 2010). 다시 말해 고등교육 발전을 목표로 하는 원조는 수많은 학생이 혜택을 받게 되고, 다양한 대학기관들이 직접 참여를 하게 되는 반면, 아직까지 고등교육 원조의 결정 요인과 효과성에 대한 경험적 연구는 충분히 이루어지지 않고 있다. 따라서 본 연구는 지난 2000년부터 2017년까지 OECD DAC의 공여국들의 고등교육 원조 결정요인을 분석함으로써 고등교육 원조의 담론에 기여하고자 한다. 우선 DAC 전체와 개별적인 공여국의 고등교육 양자 원조 결정요인을 분석하기 위해 본 연구는 고등교육을 목적으로 하는 양자 원조 약정액을 종속변수로 선택하고, Donor Interest-Recipient Needs (공여국의 이익-수원국의 필요) 모델을 바탕으로 독립변수를 선정하여 수원국의 경제적, 인도적, 교육적 요구와 수원국에 대한 공여국의 정치, 경제적 요인들을 분석하였다. 또한, 국가 간 정보 흐름의 용이함을 나타내는 독립변수를 추가함으로써 정보의 흐름에 따른 약정액의 차이도 분석이 가능하도록 하였다. 위와 같은 분석에 따라 두 가지 주요 결과를 도출하였다. 첫째, DAC에 속한 다양한 공여국들의 중점 협력국과 지역들이 존재한다는 것을 감안하더라도 각각의 수원국에 약정되는 고등교육 양자 원조 금액은 고등교육의 특성과 관련된 여러 가지 요인들에 의해 결정된다는 것이다. DAC 전체의 분석 결과에 따르면 수원국의 요구, 공여국의 이익, 그리고 수원국의 사회적 정보 체계의 다양한 요인들이 고등교육 원조에 영향을 미치는 것으로 나타났다. 또한, 고등교육에 대한 원조는 수원국의 GDP와 반비례하며 인구수와 비례하는 등 전체적인 원조의 결정요인을 대체적으로 따르는 것으로 나타났지만, 특히 수원국의 노동력 및 3차 교육 취학률과 반비례하는 것으로 나타났다. 반면, 수원국의 정보 기반 시설의 수준이 높거나 수원국의 정부가 국제사회에서 활발하게 활동을 할수록 고등교육 발전을 위한 지원을 더욱 많이 받는 것으로 나타났다. 둘째, 공여국들의 개별적인 분석 결과 각각의 공여국마다 고등교육 발전을 위한 양자 원조 약정액의 결정요인이 다른 것으로 나타났다. 예로, 프랑스, 독일, 오스트리아의 경우 자국으로 국제학생의 유학을 장려하기 위해 장학금과 학생 지원금 형태의 원조에 투자를 많이 한다는 공통점을 가지고 있으나, 1) 프랑스는 높은 정보 기반 시설을 가지고 있으나 중등교육 취학률이 낮은 구(舊) 식민지권 국가들과 프랑스어권 국가들에 대한 원조에 집중하는 것으로 나타났고, 2) 독일은 비교적 역량이 있는 고등교육기관을 갖춘 수원국을 대상으로 고등교육 원조를 선호하며, 3) 오스트리아는 청년실업률이 높고 기초교육기관이 제대로 작동하지 않는 국가들에게 고등교육 원조를 집중하는 것으로 나타났다. 결론적으로, 위와 같은 경험적 분석을 통해 DAC 전체적으로는 고등교육을 위한 양자 원조가 인도적, 경제적, 교육적 필요성과 관심, 그리고 수원국 정보 체계의 활성화 정도에 따라 규범적으로 시행되고 있는 것처럼 보이지만, 실질적으로는 다양한 공여국들이 각기 다른 요인을 바탕으로 고등교육 양자 원조를 집행하는 것이 확인되었다. 따라서 본 연구의 중요성은 공적개발원조(ODA)와 개도국의 고등교육 발전과 관련된 공여국과 수원국의 여러 가지 관점들이 고등교육 양자원조에 영향을 미치는 것을 DI-RN 모델을 바탕으로 확인한 데 있다. 반면, 본 연구에서는 DI-RN을 바탕으로 한 분석틀로는 확인이 되지 않는 고등교육 양자 원조 결정요인들을 더욱 포괄적으로 분석하기가 어려웠고, DAC에 속한 공여국들의 특유한 사회정치적 맥락이 깊이 있게 고려되지 않은 점이 제한점이다. 추가로, 향후 수원국의 관점에서 공여국들이 시행한 고등교육 양자 원조의 효과성을 분석하는 후속 연구가 진행된다면 고등교육 ODA 및 원조효과성 담론의 발전에 이바지할 것이다. ; Chapter 1. Introduction 1 Chapter 2. Literature review 7 Chapter 3 . Patterns of aid to higher education 21 Chapter 4. Research Method 49 Chapter 5. Findings 64 Chapter 6. Conclusion 80 Bibliography 89 Data Appendix 98 ; Master
Sosialistisessa T ekkoslovakiassa yksilöiden ammatilliset ja henkilökohtaiset selviytymisstrategiat olivat monipuolisempia kuin on yleensä ajateltu. Toimintamallit ja vaikutuskeinot eivät aina noudata stereotyypistä jakoa kommunisteihin ja ei-kommunisteihin. Tutkimus analysoi tunnettujen t ekkoslovakialaisten luonnontieteilijöiden toimintaa kylmän sodan aikana. Luonnontieteet on tutkimuksessa esimerkki rautaesiripun lävistäneestä yhteistyöstä. Yksilötason tarkastelu hahmottaa yhteistyön muotoja, haasteita ja tuloksia. Tutkimus tarkastelee sosialistisen maan tieteentekijöiden toimintaa kansallisessa ja kansainvälisessä tutkijayhteisössä sekä heidän erilaisia selviytymismallejaan pitkällä aikaväillä vuosina 1945 1989. Luonnontieteilijät nousevat tutkimuksessa esiin niin menestyneinä keksijöinä, tieteen managereina, yhteiskunnallisina kriitikkoina kuin myös salaisen poliisin vainoamina epähenkilöinä. Henkilöesimerkkeinä on kaksi kemistiä, Franti ek orm ja Otto Wichterle. orm oli T ekkoslovakian tiedeakatemian puheenjohtaja 1960-luvulla ja Wichterle tunnetaan erityisesti pehmeiden piilolinssien keksijänä. Molemmat olivat tietoisia kansainvälisen yhteistyön ja liikkuvuuden merkityksestä heidän tutkimukselleen. Kommunistiselle puolueelle kansainvälinen yhteistyö oli sen sijaan ongelma. Todistellakseen lojaalisuuttaan Neuvostoliitolle T ekkoslovakian oli rajoitettava omien tutkijoiden yhteistyötä länsimaisten tieteentekijöiden kanssa. Vapauden määrään, jonka puolue oli luonnontieteilijöille valmis sallimaan, vaikuttivat paitsi poliittiset suhdanteet myös taloudelliset tekijät. Näitä muutoksia kuvaa Wichterlen esimerkki. Wichterle ei ollut kommunistisen puolueen jäsen ja hän kritisoi avoimesti tieteen paikallisia käytäntöjä. Siitä huolimatta hän toimi tiedeakatemian alaisen instituutin johtajana, ministeriön neuvonantajana, kansainvälisen tiedeorganisaation aktiivisena jäsenenä sekä Prahan kevään aikana poliittisena vaikuttajana. T ekkoslovakian halukkuus osallistua tieteellis-teknologiseen vallankumoukseen ja tieteen kansainväliseen kilpailuun kiihtyi 1960-luvulla. Prahan kevään aikaisista tieteen uudistuspyrkimyksistä tärkeimpiä oli kansainvälisen liikkuvuuden lisääminen. Tutkimus osoittaa, että yksilöt, joilla oli riittävästi auktoriteettia, ammatillista osaamista ja vaikuttamisväyliä, kykenivät vaikuttamaan tiedepolitiikkaan. Neuvottelu vallanpitäjien kanssa oli edellytys sille, että tutkimuksen tekemisen ehdot paranivat. Myös puolue oli riippuvainen luonnontieteilijöiden osaamisesta. Heitä konsultoitiin mm. taloudellisesti merkittävissä kysymyksissä. Luonnontieteilijöiden ammatillinen osaaminen sai 1960-luvun lopussa suuremman painoarvon tiedemaailmassa kuin puoluekirja. Muuttuneet realiteetit ja tiedemiesten aktiivisuus mahdollistivat yhden menestyksekkäimmistä idästä länteen suuntautuneista teknologiasiirroista eli pehmeiden piilolinssien lisenssin myymisen Yhdysvaltoihin vuonna 1965. T ekkoslovakian miehitys elokuussa 1968 oli vakava takaisku t ekkoslovakialaiselle tiedeyhteisölle. Miehitys ja sitä seurannut normalisointi vaikeuttivat ja rajoittivat tieteentekijöiden ammatillisia mahdollisuuksia ja liikkumavapautta. Yksilötasolla Prahan kevään ajatukset jäivät elämään ja pohjustivat samettivallankumouksen jälkeisiä uudistuksia. ; This research analyses the activities of prominent scientists in Czechoslovakia during the Cold War. The research highlights the active role of individual scientists and investigates their participation in national and international scientific communities as well as their manifold survival strategies and room for manoeuvre. The role of natural scientists in society is illustrated by case studies of two chemists, Franti ek orm the President of the Academy of the Czechoslovak Sciences and Otto Wichterle the inventor of the soft contact lens. The individual scientists recognised the dependence of their research on world science. They had to engage in constant negotiations with the state, which in turn attempted to limit this necessity because of its own political and ideological dependency on the Soviet Union. As the case studies exemplify, individuals with sufficient authority, scientific capacity and access to the Party structures could, however, use their bargaining powers to influence science policy. At the level of the natural sciences the Communist Party was dependent on the expertise of scientists and had to consult them on issues that were relevant among others for solving larger economic questions. The strategies of the two scientists to navigate in their professional lives do not always fit the stereotypical dichotomy of communist and non-communist but are far more nuanced. The study argues that the amount of the freedom granted to natural scientists varied in time and was a consequence of many factors. One of the historical events influencing the scientists' amount of freedom was the Czechoslovak invasion in August 1968. It had dramatic consequences for Czechoslovak society for years to come. It forced the case study scientists to give up their highly ambitious professional careers. The world-class scientists became persona non gratae and were followed by the State Security Police. In this research, the August 1968 occupation of the country by the Warsaw pact forces and its aftermath presents itself as a historical watershed. The study is divided into three parts. The first part offers a historical background with a particular emphasis on the period of the Nazi occupation and the subsequent period of socialism until 1960. From the era of relative autarky and restricted contacts with the outside world in the 1950s, Czechoslovakia went further than other countries of the socialist bloc in its aspiration to improve Western cooperation. International cooperation was one of the priorities of Czechoslovak natural scientists. When the opportunity was given, scientists published in international journals, participated in conferences, organised them, and were involved in international scientific organisations. The second part covers the gradual liberalisation of the 1960s and the events of the Prague Spring in 1968. Czechoslovakia gradually acknowledged the necessity to cooperate with Western universities and scientific communities. Moreover, problems in the intra-bloc cooperation worked as a catalyst for further Western cooperation. Through participation in these scientific communities scientists gained Western recognition. In order to maintain its international reputation Czechoslovakia had to acknowledge the meaning of those organisations. The third part of this study investigates the consequences of the occupation and the era of so-called normalisation until the collapse of communism in 1989. By the end of the 1960s from the point of view of the Soviet Union Czechoslovakia had crossed the line of what was permitted. The invasion and its aftermath were an example of how politics forcefully interfered in the realm of science and influenced the life of individual scientists. The research relies on empirical and critical qualitative analysis of sources. The research uses social and political history approaches by setting the case study examples into the wider social and political context of the time. It thus looks at Czechoslovak society through the prism of academia. The research focuses on cooperation, interactions and attempts to avoid divisions into polar categorisations. Instead of opting exclusively for either a macro or micro level perspective, three levels are used in the analysis: a micro level (individual level), a middle level (the Academy of Sciences) and a macro level (the state and international level). The case studies of prominent chemists exemplify all three levels as well the interactions between the respective levels. Macro level source material used in this study consist mainly of the documents of the Central Committee of the Communist Party of Czechoslovakia, the Ministry of Foreign Affairs and the State Security Police. At the middle level this study uses material from the archives of the Academy of Sciences such as reports on science policies and foreign exchanges, documents of chemical institutes, the patent department and travel reports of scientists. At the micro level, correspondence, biographies, autobiographies and interviews are the most important sources. In this study, the innovation of the soft contact lens represents a high-level Eastern achievement in science and technology. The study shows how the liberalisation process of Czechoslovak society created conditions for technology transfers from East to West as happened with the soft contact lens. The transfer required both government support and an opening up towards the West. Without these conditions the transfer of the lens would have not been realised, but Otto Wichterle was someone who rose to the challenge. The licence for the soft contact lens was sold to the USA in 1965 and after that it revolutionised the contact lens industry worldwide. Hence, in this study the natural sciences are used as an example of a phenomenon of penetration of the Iron Curtain from East to West. The focus is on forms of cooperation without direct relation to Cold War competition in armaments production. These forms of scientific cooperation therefore rather supported further and more efficient contacts and connected the two societal systems. In Czechoslovakia, the desire to succeed in the worldwide revolution of science took more radical form in the late 1960s than elsewhere in Eastern Europe. Concepts like the Scientific and Technological Revolution and the integration of world science began to appear in the official rhetoric on scientific issues from the mid-1960s onwards. It seems that Czechoslovakia grasped the opportunity offered by the notion of the Scientific and Technological Revolution. As a result of the Warsaw Pact invasion and the following normalisation, these ideas supporting academic freedom were shelved for two decades. However, at the level of individual scientists, these ideas which had been allowed to be expressed openly in the late 1960s survived symbolised by the election of Otto Wichterle as the President of the Czechoslovak Academy of Sciences after the Velvet Revolution. After 1989 Czechoslovakia began to rapidly re-establish academic contacts with Western scientific communities. At least at the level of freedom of movement, the ideas and hopes of the Prague Spring reformers of science were finally fulfilled.
The global tobacco control movement is more than three decades old, but its impact is inconsistent. For every city or nation that takes strong action to reduce tobacco use, there is another where little if anything has been done to help people stop smoking or to establish tobacco control policies opposed by powerful tobacco industries. Tobacco continues to kill and cause debilitating illnesses, severely retarding progress in improving local, national, and global health and economic conditions. Recent data indicate that smoking is the leading cause of deaths from cardiovascular diseases (1.69 million deaths annually), cancer (1.4 million deaths), and chronic obstructive pulmonary diseases (970,000 deaths). About 1.25 billion people smoke cigarettes, representing more than one-sixth of the Earth's population. According to reports from the World Cancer Congress and the 13th World Conference on Tobacco OR Health, held in Washington, D.C., in July 2006, if current trends hold, tobacco will kill a billion people in the 21st century, 10 times the toll it took in the 20th century. These sobering statistics are counterbalanced by some good news. In numerous countries, public health officials, civil society organizations, and various other advocacy groups have joined forces to initiate policies and programs designed to reduce tobacco use. Most comprehensive efforts have included a mixture of awareness raising; restrictions on the sale, promotion, and place of use of tobacco products; and taxes and laws that affect the price and availability of these products. A major milestone was achieved when the landmark Framework Convention on Tobacco Control (FCTC), a global treaty initiated by the World Health Organization (WHO), entered into force on February 27, 2005. As of the end of March 2007, a total of 168 countries had signed the treaty, and 146 of those had ratified it. Parties to the FCTC are expected to create national action plans to meet the treaty's minimum requirements in areas such as tobacco advertising, access to smoking cessation programs, the size of warnings on cigarette packs, and the creation and enforcement of smoke-free public spaces. Wealthier countries have more potential resources at their disposal to implement tobacco control policies, yet there are plenty of examples—some of which are examined in this report's case studies—of innovative and increasingly successful tobacco control efforts in resource-limited places. Central and Eastern Europe and Central Asia, however, remain in dire need of more extensive tobacco control. According to the World Health Organization, tobacco related diseases kill more than 700,000 people a year in the region and nearly 40 percent of middle-aged men die prematurely as a result of tobacco use. In some Eastern European countries, lung cancer mortality rates in men are the highest ever recorded anywhere in the world. The WHO has concluded that tobacco use is the major preventable cause of poor health in the region—and that comprehensive tobacco control is the best investment in health reform. Policymakers have been listening. By 2006, all Central and Eastern European countries and a majority of those in the former Soviet Union had enacted some tobacco control legislative and policy measures. However, many legislative regulations and national tobacco control programs, especially in the less developed countries farther east, are not effectively enforced and still have serious loopholes that prevent them from meeting WHO standards. One common thread has been the leadership of civil society groups in devising, implementing, and demanding the enforcement of tobacco control policies and regulations. Local nongovernmental organizations often have been among the first entities of any kind to advocate for tobacco control in their countries, including accession to the FCTC. Many of these civil society groups have received support from the Open Society Institute (OSI), which first provided grants for tobacco control in 2002. Among OSI's most successful grantees is Poland's Health Promotion Foundation (HPF), which since 1991 has played a leading role in lowering the burden of smoking-related diseases through tobacco control in its home country. Recently, HPF began planning the development of a regional center for tobacco control to enable the sharing of information and expertise on tobacco control throughout the region. Based in Warsaw, the Regional Tobacco Control Network and Center (RTCNC) is expected to be fully operational by the end of 2007. The case studies in this report document the advocacy efforts of NGOs in four countries expected to participate significantly in such regional engagement. The nations—Kazakhstan, Moldova, Romania, and Ukraine—are at different stages in tobacco control. The activities of these civil society groups represent a range of strategies reflecting the opportunities, obstacles, and expectations unique to their own nations and circumstances. Taken together, though, the case studies offer important lessons for future tobacco control efforts anywhere in the world. No matter where they live, committed activists generally are able to utilize even a small amount of funding to initiate a process of change; the success of their efforts is multiplied many times over with each increase in resources and capacity. Local leadership of this sort is essential to reversing the current trends in tobacco use, illness, and death that place millions of people at risk. Among the notable lessons are the following: Civil society is crucial to successful tobacco control efforts. The Polish experience in the early 1990s is instructive. After restrictions were lifted on civil society, groups pushed for greater openness about all political, economic, and social issues—including health. Tobacco control efforts gained momentum and policy reforms soon followed, including tobacco control legislation and improved public- and private-sector services designed to raise awareness and promote healthy lifestyles. Experience elsewhere reinforces the strong correlation between comprehensive tobacco control and engaged, fully independent civil societies. Effective tobacco control efforts require comprehensive, multipronged approaches and strategies. Given the power and influence of the tobacco industry in most countries, tobacco control advocates must continually seek to broaden the ways in which they raise awareness of tobacco's negative medical, social, and financial consequences. Important strategies include extensive media campaigns; expanding coalitions within civil society and with government partners; directly challenging policymakers to publicly justify their opposition to tobacco control or reluctance to make it a priority; and collecting and disseminating solid health data, such as the number of deaths and hospitalizations due to tobacco-related illnesses. Economic research is an important, yet often neglected, component of effective advocacy. Policymakers and the general public are often unaware of the massive financial costs to society of tobacco use. Tobacco-related sickness and premature death reduce economic productivity in ways that can be quantified through rigorous data collection. Disabling tobacco-related conditions also force a redirection of individual and public resources from investment and savings—needed to help grow economies and raise living standards—to health care. Tax policies can be used to raise revenues for health promotion activities that lead to a reduction in tobacco-related health care costs. For example, several European countries and U.S. states have raised cigarette taxes and earmarked a portion of the higher revenues specifically for tobacco control activities, such as education and media campaigns. Enshrining health promotion earmarks in laws or government policies improves the likelihood of withstanding tobacco industry pressure to counter comprehensive tobacco control efforts. Media can be a powerful tool for and ally of tobacco control advocates. Tobacco control advocates in Kazakhstan invited members of the media on several tours of Almaty, pointing out violations of the national antitobacco law. The resulting newspaper articles and television coverage helped prompt local officials to introduce the "Smoke-free Almaty" initiative. Such effective use of media is relatively rare in the region. Civil society groups need to train in media advocacy and to share successful strategies and experiences more consistently. Tobacco control regulations and affordable "quit smoking" services are equally important in reducing tobacco use. Restrictions are far more effective in reducing tobacco use when accompanied by health promotion campaigns and accessible, affordable services to help people quit smoking. Incentives for changing behavior must be based on recognition of the medical and psychological elements of tobacco addiction. On their own, punitive measures rarely make an impact on complex behaviors that require extensive treatment and support. Expanded regional learning and cooperation offer clear benefits to local tobacco control efforts. Strategies used successfully in one country or context can have similarly positive impacts elsewhere. Expertise should be tapped more effectively through greater sharing of information and resources across the region, down to the grassroots level. Regional cooperation will also help sustain and expand civil society advocacy that has already shown great promise for improving health. The creation of the Regional Tobacco Control Network and Center should help facilitate such efforts.
