Contesting tobacco-control policy in Indonesia

Abstract

Over the past decade and a half, the Indonesian government has progressed fitfully and inconsistently toward a stricter tobacco-control policy regime, albeit without much impact on the country's worsening tobacco epidemic. This article explains this pattern of reform in terms of the unequal but changing relationship of power between tobacco companies and tobacco farmers, on the one hand, and tobacco-control advocates based in NGOs, health professional organizations, universities, and international organizations, on the other. The first of these coalitions has had greater structural leverage, better political connections, stronger organizational capacity, greater ability to mobilize popular forces, and more capacity to cultivate a positive public image. But the second coalition has been able to exercise some influence over policy because of changes wrought by democratization. In this analysis, the author engages with the literatures on (1) Indonesia's political economy in the post–New Order period and (2) the politics of tobacco control in developing countries. With regard to the former, the author argues that we need to give greater attention to the role of actors previously excluded from the policy-making process than is currently the case. With regard to the latter, the author contends that more focus is needed on domestic actors and political institutions in shaping tobacco-control policy. Looking to the future, the author suggests that further progress in Indonesia's tobacco-control policies will be contingent upon an ongoing process of struggle; however, there are signs that the tide is turning in favor of the second coalition.