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Background: Alcohol and substance use has been a long-standing public health challenge across the globe, including in Africa. Research evidence attests that there is no singular approach to the pre...

Background: In response to international efforts to prevent alcohol and substance use we designed this study to give a bibliometric overview of research productivity in alcohol and substance use prevention in Africa. Methods: Review of original research articles authored or co-authored by investigators from African countries on substance use prevention during the period 2008-2018 were done through retrieving them from, Web of Science (WoS), Ebscohost and Pubmed (National Library of Medicine). Key words related to alcohol and substance use were used to retrieve relevant literature. Results: Our search returned 3600 hits, with 34 studies retained. Included studies were conducted in 12 countries across the five regions in Africa (Central, East, North, South and West) and spreading over an 11-year period, 2008-2018. The annual published articles showed a significant rise from 2008 to 2018 with South Africa being ranked number one with a total of 9 (31%) published articles followed by Kenya 4 (13.8%). Bronwyn Myers from South Africa and Atwoli et al from Kenya were the most prolific authors. Age and gender were the most reported risk factors in the selected studies. Medical Research Council of South Africa, Stellenbosch University and Moi University are the active Institutions in alcohol and drug use prevention research. Conclusions: There were few collaborations among Africans themselves yet these collaborations would enhance future alcohol and substance use prevention research productivity. Currently, a wide spectrum of substance use prevention interventions have been implemented throughout the African continent, ranging from individual to community based interventions.

Background: Non-communicable diseases are on the rise across sub-Saharan Africa. The region has become a targeted growth market for sugar-sweetened beverages, which are associated with weight gain, cardiovascular diseases and diabetes. Objective: To identify politico-economic factors relevant to nutrition-related fiscal policies, and to draw lessons regarding strategies to strengthen sugar-sweetened beverages taxation in the region and globally. Methods: We collected documentary data on policy content, stakeholders and corporate political activity from seven countries in east and southern Africa augmented by qualitative interviews in Botswana, Namibia, Kenya and Zambia, and stakeholder consultations in Rwanda, Tanzania and Uganda. Data were analysed using a political economy framework, focusing on ideas, institutions, interests and power, and a ‘bricolage’ approach was employed to identify strategies for future action. Results: Non-communicable diseases were recognised as a priority in all countries. Kenya, Zambia, Rwanda, Tanzania and Uganda had taxes on non-alcoholic beverages, which varied in rate and tax base, but appeared to be motivated by revenue rather than health concerns. Botswana and Namibia indicated intention to adopt sugar-sweetened beverage taxes. Health-oriented sugar-sweetened beverage taxation faced challenges from entrenched economic policy paradigms for industry-led economic growth and was actively opposed by sugar-sweetened beverage-related industries. Strategies identified to support stronger sugar-sweetened beverage taxation included shifting the economic discourse to strengthen health considerations, developing positive public opinion, forging links with the agriculture sector for shared benefit, and leadership by a central government agency. Conclusions: There are opportunities for more strategic public health engagement with the economic sector to foster strong nutrition-related fiscal policy for non-communicable disease prevention in the region.

This paper reports on the design of a study to examine the policy landscape relevant to sugar-sweetened beverage taxation in seven sub-Saharan African countries. The study responds to the need for strong policy to address the rising burden of non-communicable diseases in the region. Sugar-sweetened beverage taxation has been widely recommended as a key component of a comprehensive policy approach to NCD prevention. However, it has proved a contentious policy intervention, with industry strongly opposing the introduction of such taxes. The aim was to identify opportunities to strengthen sugar-sweetened beverage taxation-related policy for the prevention of nutrition-related NCDs in a subset of Eastern and Southern African countries: Kenya, Tanzania, Botswana, Rwanda, Namibia, Zambia, Uganda. The study was conducted as a collaboration by researchers from nine institutions; including the seven study countries, South Africa, and Australia. The research protocol was collaboratively developed, drawing on theories of the policy process to examine the existing availability of evidence, policy context, and stakeholder interests and influence. This paper describes the development of a method for a policy landscape analysis to strengthen policies relevant to NCD prevention, and specifically sugar-sweetened beverage taxation. This takes the form of a prospective policy analysis, based on systematic documentary analysis supplemented by consultations with policy actors, that is feasible in low-resource settings. Data were collected from policy documents, government and industry reports, survey documentation, webpages, and academic literature. Consultations were conducted to verify the completeness of the policy-relevant data collection. We analysed the frames and beliefs regarding the policy ‘problems’, the existing policy context and understandings of sugar-sweetened beverage taxation as a potential policy intervention, and the political context across relevant sectors, including industry interests and influence in the policy process. This study design will provide insights to inform public health action to support sugar-sweetened beverage taxation in the region.