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International Social Work. 2017 Nov 1; 60(6):1619-1631.Lesotho has the third highest rate of HIV prevalence in the world. One of the factors accounting for this trend is thought to be ubiquitous labour migration in the country. This article uses data collected among migrant labour women in Maseru (N = 30) to investigate possible factors for the spread of HIV among them. A high rate of multiple concurrent sexual relationships, coupled with lack of commitment to condom use, was found among participants. This article proposes social action to pressure industry merchants to facilitate regular meetings of migrants with regular sexual partners.
JAMA. 2017 Oct 3; 318(13):1208-1210.Add to my documents.
Arlington, Virginia, SPRING, 2017 Aug. 38 p.Mapping the maize millers was a nationwide exercise. The National Working Group on Food Fortification (NWGFF) approved the activity, which aimed to inform stakeholders about the status of the maize milling industry in Uganda. This exercise resulted from the learning exchange visit to the Sanku project site in Tanzania and aimed to establish baseline information on maize flour processing and the status of maize flour fortification in Uganda. The survey took place in the four major regions of the country: central, eastern, western, and northern. It reached 780 maize millers from 62 districts. Survey results indicated the central region has the highest percentage of maize millers (38 percent), followed by the eastern (22 percent), and the northern (22 percent). The western region has the lowest percentage of maize millers (18 percent). Most maize millers (46.3 percent) have a production capacity of 1-5 metric tons (MTs) per day. Across all regions, reliable availability of electricity was the biggest challenge faced by maize millers. In addition, most of the maize millers in Uganda exhibited at least one poor manufacturing practice (relating to infrastructure, sanitation, or availability of storage facilities of raw materials and finished products). At the time of the survey, results showed that only 0.5 percent (4 maize millers out of 780) were actively fortifying their products. While the survey also found that 1.8 percent of the millers (14 out of 780) have installed food fortification equipment, most of these have not yet adopted the practice of fortifying. A number of recommendations have stemmed from these findings: 1) to support maize millers who installed equipment to calibrate their dossiers in order to start fortification, 2) to sensitize the millers on the use of food grade equipment, 3) to increase public awareness on the benefits of consuming fortified foods, and, 4) to explore feasible technologies to scale up maize flour fortification. Finally, maize millers in all regions asked for reduced electricity tariffs and improved power quality.
Phnom Penh, Cambodia, Population Council, Evidence Project, 2017 Apr. 12 p. (Policy Brief; USAID Cooperative Agreement No. AID-OAA-A-13-00087)This policy brief presents selected findings from a stakeholder and situational analysis of women’s health in the context of garment factories in Cambodia, carried out by the Cambodia Worker Heath Coalition (WorkerHealth) under the Evidence Project, with financial support of USAID / Cambodia. The objectives of the stakeholder and situational analysis were to: 1) identify key relevant stakeholders and understand their technical expertise, focus areas, and experience in workplace activities and policy change; 2) understand organizational relationships among the stakeholders identified; and 3) determine opportunities and strategies for working collaboratively to improve worker health and support systemic and scaleable improvements. Ultimately, this policy brief is meant to be a resource for efforts to improve the health and well-being of female garment workers.
Washington, D.C., World Bank, 2013.  p. (Africa Development Forum)This book brings together new household and enterprise data from 41 countries in Sub-Saharan Africa to inform policy makers and practitioners on ways to expand women entrepreneurs’ economic opportunities. Sub-Saharan Africa boasts the highest share of women entrepreneurs, but they are disproportionately concentrated among the self-employed rather than employers. Relative to men, women are pursuing lower opportunity activities, with their enterprises more likely to be smaller, informal, and in low value-added lines of business. The challenge in expanding opportunities is not helping more women become entrepreneurs but enabling them to shift to higher return activities. A central question addressed in the book is what explains the gender sorting in the types of enterprises that women and men run? The analysis shows that many Sub-Saharan countries present a challenging environment for women. Four key areas of the agenda for expanding women’s economic opportunities in Africa are analyzed: strengthening women’s property rights and their ability to control assets; improving women’s access to finance; building human capital in business skills and networks; and strengthening women’s voices in business environment reform. These areas are important both because they have wide gender gaps and because they help explain gender differences in entrepreneurial activities. It is particularly striking that while gender gaps in education tend to close with higher incomes, gaps in women’s property rights and in women’s participation in reform processes do not. As simply raising a country’s income is unlikely to be sufficient to give women equal ability to control assets or have greater voice, more proactive steps will be needed. Practical guidelines to move the agenda forward are discussed for each of these key areas.
Alcoholic beverage companies and the HIV response in sub-Saharan Africa: A case study of HIV programs at Heineken and SABMiller.
Arlington, Virginia, JSI Research and Training Institute, Strengthening High Impact Interventions for an AIDS-free Generation [AIDSFree], 2016 Mar.  p. (AIDS-Free Case Study Series; USAID Cooperative Agreement No. AID-OAA-A-14-00046)Close to 26 million people (70 percent of those living with HIV globally) were living with HIV in 2014 in sub-Saharan Africa, and the number of new infections was estimated at 1.4 million. Sub-Saharan Africa accounted for 66 percent of the global total of new HIV infection. Forty-one percent of all people living with HIV in the region were accessing antiretroviral treatment (ART). In the same year, 790,000 people died of AIDS-related causes. Despite improved access to ART, HIV continues to have a significant impact on economic development in sub-Saharan Africa. Morbidity and mortality among the region’s 26 million HIV-positive people affect companies at every operational level: from staffing and training through production and distribution. This case study presents the responses developed by the alcoholic beverage companies Heineken and SABMiller to address HIV within their African business communities. Both companies have contributed to the HIV response, not only within their operating companies or subsidiaries, but also at community and national levels by partnering with governments, NGOs, and international organizations.
The Impact of Company-Level ART Provision to a Mining Workforce in South Africa: A Cost-Benefit Analysis.
PLoS Medicine. 2015 Sep; 12(9):e1001869.BACKGROUND: HIV impacts heavily on the operating costs of companies in sub-Saharan Africa, with many companies now providing antiretroviral therapy (ART) programmes in the workplace. A full cost-benefit analysis of workplace ART provision has not been conducted using primary data. We developed a dynamic health-state transition model to estimate the economic impact of HIV and the cost-benefit of ART provision in a mining company in South Africa between 2003 and 2022. METHODS AND FINDINGS: A dynamic health-state transition model, called the Workplace Impact Model (WIM), was parameterised with workplace data on workforce size, composition, turnover, HIV incidence, and CD4 cell count development. Bottom-up cost analyses from the employer perspective supplied data on inpatient and outpatient resource utilisation and the costs of absenteeism and replacement of sick workers. The model was fitted to workforce HIV prevalence and separation data while incorporating parameter uncertainty; univariate sensitivity analyses were used to assess the robustness of the model findings. As ART coverage increases from 10% to 97% of eligible employees, increases in survival and retention of HIV-positive employees and associated reductions in absenteeism and benefit payments lead to cost savings compared to a scenario of no treatment provision, with the annual cost of HIV to the company decreasing by 5% (90% credibility interval [CrI] 2%-8%) and the mean cost per HIV-positive employee decreasing by 14% (90% CrI 7%-19%) by 2022. This translates into an average saving of US$950,215 (90% CrI US$220,879-US$1.6 million) per year; 80% of these cost savings are due to reductions in benefit payments and inpatient care costs. Although findings are sensitive to assumptions regarding incidence and absenteeism, ART is cost-saving under considerable parameter uncertainty and in all tested scenarios, including when prevalence is reduced to 1%-except when no benefits were paid out to employees leaving the workforce and when absenteeism rates were half of what data suggested. Scaling up ART further through a universal test and treat strategy doubles savings; incorporating ART for family members reduces savings but is still marginally cost-saving compared to no treatment. Our analysis was limited to the direct cost of HIV to companies and did not examine the impact of HIV prevention policies on the miners or their families, and a few model inputs were based on limited data, though in sensitivity analysis our results were found to be robust to changes to these inputs along plausible ranges. CONCLUSIONS: Workplace ART provision can be cost-saving for companies in high HIV prevalence settings due to reductions in healthcare costs, absenteeism, and staff turnover. Company-sponsored HIV counselling and voluntary testing with ensuing treatment of all HIV-positive employees and family members should be implemented universally at workplaces in countries with high HIV prevalence.
Global Health: Science and Practice. 2015 Sep 10; 3(3):446-461.While fortification of staple foods and condiments has gained enormous global traction, poor performance persists throughout many aspects of implementation, most notably around the critical element of regulatory monitoring, which is essential for ensuring foods meet national fortification standards. Where coverage of fortified foods is high, limited nutritional impact of fortification programs largely exists due to regulatory monitoring that insufficiently identifies and holds producers accountable for underfortified products. Based on quality assurance data from 20 national fortification programs in 12 countries, we estimate that less than half of the samples are adequately fortified against relevant national standards. In this paper, we outline key findings from a literature review, key informant interviews with 11 fortification experts, and semi-quantitative surveys with 39 individuals from regulatory agencies and the food fortification industry in 17 countries on the perceived effectiveness of regulatory monitoring systems and barriers to compliance against national fortification standards. Findings highlight that regulatory agencies and industry disagree on the value that enforcement mechanisms have in ensuring compliance against standards. Perceived political risk of enforcement and poorly resourced inspectorate capacity appear to adversely reinforce each other within an environment of unclear legislation to create a major hurdle for improving overall compliance of fortification programs against national standards. Budget constraints affect the ability of regulatory agencies to create a well-trained inspector cadre and improve the detection and enforcement of non-compliant and underfortified products. Recommendations to improve fortification compliance include improving technical capacity; ensuring sustained leadership, accountability, and funding in both the private and the public sectors; and removing political barriers to ensure consistent detection of underfortified products and enforcement of applicable fortification standards. Only by taking concrete steps to improve the entire regulatory system that is built on a cooperative working relationship between regulatory agencies and food producers will a nutrition strategy that uses fortification see its intended health effects.
Better vaccines for healthier life. Part I. Conference report of the DCVMN International 14th Annual General Meeting Hanoi, Vietnam.
Vaccine. 2014 Nov 12; 32(48):6325-9.The Developing Countries Vaccine Manufacturers' Network (DCVMN) brought together nearly 220 senior representatives of governmental and non-governmental global health organizations, as well as corporate executives of emerging vaccine manufacturers, from 26 countries for a two-day tailored lectures, Q&A sessions, CEOs panel discussion and networking opportunities, followed by a vaccine-technology symposium and visit to manufacturing facilities in Hanoi, Vietnam. Participants included representatives of 38 vaccine manufacturers, as well as international partners and collaborating research institutions, with 39% female participants. The Vice-Minister of Health to Vietnam commended the speakers and participants to this Annual General Meeting, devoted to achieve our common goal of protecting people against infectious diseases with better vaccines, for a healthier life. He reminded the audience that the first vaccine produced in Vietnam was oral polio vaccine (OPV) in the early 1960s and contributed to polio eradication in Vietnam, in 2000. Through its manufacturing resources, Vietnam eliminated neonatal tetanus in 2005, and has controlled measles and hepatitis B spread. The Ministry of Health hopes that by sharing experiences, delegates at this conference will foster international cooperation and partnerships among organizations. CEOs elaborated on challenges and opportunities for emerging countries. Copyright (c) 2014. Published by Elsevier Ltd.. All rights reserved.
European Journal of Contraception and Reproductive Health Care. 2015 Jun; 20(3):155-157.Add to my documents.
Population and Development Review. 2013 Dec; 39(4):687-704.The most immediate environmental problem in major regions of the world is probably the scarcity of fresh water for agriculture. Insufficiency and irregularity of rainfall require the use of stored water. Both major compartments for fresh water storage -- glaciers and groundwater -- are being depleted rapidly and at similar rates. Drawdown of groundwater is primarily the result of irrigation required to supply the food needs of large populations. Glacier melt is an effect of global warming chiefly caused by high levels of industrial production and transport. However, an important fraction of glacier melt is caused by food chain emissions (agricultural greenhouse gases and black carbon or cooking soot). In toto, the loss of water resulting from food and agriculture may be significantly greater than that resulting from industrial production and transport, the factors more commonly cited. This suggests that the role of population, closely linked to food and agriculture, is central to the depletion of fresh water.
Globalization and Health. 2012; 8:20.BACKGROUND: In order to ensure their population's regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. METHODS: This paper considers the 'make-or-buy' dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania's imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. RESULTS: Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. CONCLUSIONS: Within the "make-or-buy" context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives.
Development Southern Africa. 2012 Sep; 29(3):434-447.This paper, based on a case study of a South African contract cleaning company in Durban, KwaZulu-Natal, adds to the recent literature on the management of the financial impact of the HIV/AIDS pandemic. After situating the research alongside recent contributions that have examined large enterprises, and small, medium and micro enterprises, the paper provides a profile of the company and its predominantly female workforce. The company's management of costs incurred due to HIV/AIDS is critically assessed from the perspective of financial sustainability, using an AIDS Projection Model developed by Matthews (2007). It was found that while continued employment of this workforce is economically sustainable, both from the perspective of the business and the associated provident fund, the costs to employees are far from equitable. The paper therefore recommends the implementation of a holistic HIV/AIDS management programme, including treatment and prevention activities.
How the pill became a lifestyle drug: the pharmaceutical industry and birth control in the United States since 1960.
American Journal of Public Health. 2012 Aug; 102(8):1462-72.Marketing decisions, rather than scientific innovations, have guided the development and positioning of contraceptive products in recent years. I review the stalled progress in contraceptive development in the decades following the advent of the Pill in 1960 and then examine the fine-tuning of the market for oral contraceptives in the 1990s and 2000s. Although birth control has been pitched in the United States as an individual solution, rather than a public health strategy, the purpose of oral contraceptives was understood by manufacturers, physicians, and consumers to be the prevention of pregnancy, a basic health care need for women. Since 1990, the content of that message has changed, reflecting a shift in the drug industry's view of the contraception business. Two factors contributed to bring about this change: first, the industry's move away from research and development in birth control and second, the growth of the class of medications known as lifestyle drugs.
Business and Society. 2012 May 7; 51(2):263-309.This article utilizes a political system framework to trace the political sources of business risk stemming from the unfolding HIV/AIDS generalized epidemic in South Africa. The article integrates relevant dimensions of the fields of international business and political science to facilitate the assessment of such risks for firms. Risk formation and updating is a sequential process. The conditions from which business risk emerges, the politicization of the generalized (i.e., widespread) epidemic through boundary-crossing activities, and "inputs" are explored. The transformation of HIV/AIDS from an epidemic to a business threat is underscored by the South African government's tendency to view the issue as part of the public agenda rather than part of its formal agenda. Governmental inaction, as well as action, led to an array of risks for firms operating in South Africa (e.g., operations, asset impairment, competitive, franchise). Mitigating strategies for managers are discussed, including avoidance, offsetting, transference, sharing, remedy, and anticipation.
Gender, Technology and Development. 2010 Nov; 14(3):423-440.Active political participation and political capital are central to the realization of the progressive vision and progressive agenda. Participation in political institutions, political process, and civic life are initial indicators of political inclusion. This research note seeks to examine the political participation and political capital of rural women farmers through participation in sericulture activities. It is important to study the participation of women in sericulture because they constitute the vital agent for the total production of cocoons in the country. The study is mainly centered on formal political participation rather than substantive political participation. The research findings indicate that there is growing evidence of a mutually reinforcing relationship between formal political participation and involvement in sericulture activities. Participation in civic organizations helped women in political decision making to a greater extent.
[Breastfeeding experiences of women who work at a textile industry from Ceara, Brazil]. Vivencia da amamentacao por trabalhadoras de uma industria textil do Estado do Ceara, Brasil.
Revista Brasileira De Enfermagem. 2011 Jan-Feb; 64(1):66-71.This study aimed to understand the experience of women staff employed in a textile industry from Ceara State, Brazil, after returning to work, compared to the process of breastfeeding or weaning. Qualitative research carried out in June 2007 with five working mothers. The stories of these women, from a set of open-ended questions revealed difficulties in reconciling work and breast feeding, because of their beliefs and lack of social and institutional support. The poor conditions of work which these women are exposed are also determining factors in the continuation or discontinuation of breast feeding, being necessary to extend the improvements in institutions with childcare, milk collection places and escorting permanently of these women, when produce their return to work.
Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter?
BMC Public Health. 2011; 11:261.BACKGROUND: Although there are inequalities in child health and survival in the Democratic Republic of Congo (DRC), the influence of distal determinants such as geographic location on children's nutritional status is still unclear. We investigate the impact of geographic location on child nutritional status by mapping the residual net effect of malnutrition while accounting for important risk factors. METHODS: We examine spatial variation in under-five malnutrition with flexible geo-additive semi-parametric mixed model while simultaneously controlling for spatial dependence and possibly nonlinear effects of covariates within a simultaneous, coherent regression framework based on Markov Chain Monte Carlo techniques. Individual data records were constructed for children. Each record represents a child and consists of nutritional status information and a list of covariates. For the 8,992 children born within the last five years before the survey, 3,663 children have information on anthropometric measures.Our novel empirical approach is able to flexibly determine to what extent the substantial spatial pattern of malnutrition is driven by detectable factors such as socioeconomic factors and can be attributable to unmeasured factors such as conflicts, political, environmental and cultural factors. RESULTS: Although childhood malnutrition was more pronounced in all provinces of the DRC, after accounting for the location's effects, geographic differences were significant: malnutrition was significantly higher in rural areas compared to urban centres and this difference persisted after multiple adjustments. The findings suggest that models of nutritional intervention must be carefully specified with regard to residential location. CONCLUSION: Childhood malnutrition is spatially structured and rates remain very high in the provinces that rely on the mining industry and comparable to the level seen in Eastern provinces under conflicts. Even in provinces such as Bas-Congo that produce foods, childhood malnutrition is higher probably because of the economic decision to sell more than the population consumes. Improving maternal and child nutritional status is a prerequisite for achieving MDG 4, to reduce child mortality rate in the DRC.
HIV / AIDS Policy and Law Review. 2011 Apr; 15(2):22-3.Medical experts are warning that an international trade agreement being brokered between the European Union (EU) and India could greatly restrict the access of people living with HIV in the developing world to life-saving antiretroviral medication.
Impact of the trade-related aspects of intellectual property rights (TRIPS) agreement on India as a supplier of generic antiretrovirals.
Journal of Pharmaceutical Sciences. 2011 Mar; 100(3):816-21.This is a commentary on how the trade-related aspects of intellectual property rights (TRIPS) agreement has impacted India as a supplier of generic antiretrovirals (ARVs). We provide a systematic review of the issues related to the TRIPS agreement that affects India. This includes discussion around (a) the legal landscape underpinning India as a supplier of generic ARVs; (b) supply of second-line ARVs; and (c) the future of generic drug production in India. The proclamation into force of TRIPS-compliant intellectual property law in India is likely to affect its position as a supplier of affordable ARVs, especially drugs brought to market after 2005. Currently, mechanisms exist for the generic production of almost all ARVs in India, including second-line drugs; however, the manufacture of these drugs by generic pharmaceutical companies may require additional market incentives. Compulsory licensing may emerge as an additional mechanism by which India can provide affordable versions of patented drugs to Least Developed Countries (LDCs). Copyright (c) 2010 Wiley-Liss, Inc.
Sahara J. 2010 Dec; 7(4):1-9.Addressing HIV and AIDS is the responsibility of many stakeholders including private sector companies. However, increasing evidence reveals that the majority of companies around the world are yet to acknowledge and respond to HIV and AIDS as a workplace issue. One factor that has been identified in the literature as playing a role in determining whether a company responds to HIV and AIDS, or not, is the industry/sector in which a company operates. This study therefore sought to empirically examine whether in the context of Malawi there were significant variations in the adoption of formal HIV and AIDS workplace policies based on the industry/sector in which a company was operating, as well as analyse the dynamics underlying such variations. Using survey data collected from 152 randomly selected private sector companies in Malawi, the results of this study revealed significant variations in the adoption of HIV and AIDS workplace policies among companies operating in various sectors. Companies in the service sector were leading the adoption compared to companies in other sectors such as the trading sector. Furthermore, the evidence from this study showed that differences in staff participation in the activities of HIV and AIDS institutions may explain the industry/ sector variations. These results provide an important avenue to scale up company responses to HIV and AIDS by intensifying staff participation in the activities of HIV and AIDS institutions. Such institutions appear to play a vital role of providing up to date HIV- and AIDS-related information upon which companies are able to develop a business case for responding to the epidemic.
[San Francisco, California], Business for Social Responsibility, 2002 Oct. 95 p.Women comprise a majority of the workforce in labor-intensive manufacturing industries such as apparel, footwear, toys, electronics, food processing and house-wares. They also work extensively in the informal sector, including in agriculture and handicrafts. The working environment in these industries can present health hazards to both male and female workers. Women employees, however, risk greater health consequences because they are often of childbearing age and are regarded with less social status than men, causing them to be less educated and more vulnerable. Consequently, they face unique needs in terms of health education, access and nutrition. This report presents the findings of a project initiated by Business for Social Responsibility (BSR) with the support of the David and Lucile Packard Foundation to improve awareness of the reproductive and general health needs of women workers in the global supply chain. This project presented a unique opportunity to support the promotion of women's health programs, including reproductive health issues. The project focused on health programs and practices in four countries - China, India, Indonesia and Mexico. Each of these four countries is a major exporter into the global manufacturing economy, with a large concentration of labor-intensive industries such as apparel, footwear and toys. These industries employ thousands of women workers, the majority in the age group of 16-30. (excerpt)
Developing Economies. 2006 Mar; 46:1-26.The present study focuses on the flow of fiscal and financial resources in China's rural economy during the first two decades of reform. Specifically, we seek to quantify the nature and direction of the capital flows between agriculture and the non-agricultural sectors and between the rural and non-rural sectors. We track identify the flows of three main sources of capital: fiscal flows, financial shifts through the formal banking system, and the implicit taxes that are moving through the grain system as a result of payment of in-kind (e.g., delivery quotas by farmers). Through this analysis, we provide policy makers with a set of measures showing that although in recent years the agriculture-to-industry and rural-to-urban flows have appeared to reverse themselves, as late as 2000 it does not appear as if the government is not directing enough resources into the rural economy. Greater flows, however, are needed if rural China is to modernize. (author's)
Global Public Health. 2006 Feb; 1(1):65-86.Tobacco use kills 5 million citizens globally every year. The World Health Organization (WHO) projects that the number of deaths will double just 15 years from now. Tobacco will then constitute the leading cause of death in the developing world, as it already is in developed countries today. This paper describes the nature and extent of the tobacco pandemic, characteristics of the global tobacco industry, and national and international efforts to diminish the toll of tobacco. The review includes examination of the economic and political strategies employed by the multinational tobacco industry to increase cigarette consumption, as well as the policies that governments have adopted to combat smoking. The most promising development is the new Framework Convention on Tobacco Control, WHO's first-ever international health treaty. While aggressive tobacco control policies can and will diminish the toll of tobacco, the prospects for the foreseeable future appear grim. (author's)
A grim contradiction: The practice and consequences of corporate social responsibility by British American Tobacco in Malaysia.
Social Science and Medicine. 2008 Apr; 66(8):1784-1796.In the wake of the World Health Organization Framework Convention on Tobacco Control, corporate social responsibility (CSR) is among the few remaining mechanisms for tobacco corporations publicly to promote their interests. Health advocates may be unaware of the scale, nature and implications of tobacco industry CSR. This investigation aimed to construct a typology of tobacco industry CSR through a case study of the evolution and impact of CSR activities of a particular tobacco corporation in one country - British American Tobacco, Malaysia (BATM), the Malaysian market leader. Methods included searching, compiling and critically appraising publicly available materials from British American Tobacco, BATM, published literature and other sources. The study examined BATM's CSR strategy, the issues which it raises, consequences for tobacco control and potential responses by health advocates. The investigation found that BATM's CSR activities included assistance to tobacco growers, charitable donations,scholarships, involvement in anti-smuggling measures, 'youth smoking prevention' programs and annual Social Reports. BATM has stated that its model is predominantly motivated by social and stakeholder obligations. Its CSR activities have, however, had the additional benefits of contributing to a favourable image, deflecting criticism and establishing a modus vivendi with regulators that assists BATM's continued operations and profitability. It is imperative that health advocates highlight the potential conflicts inherent in such arrangements and develop strategies to address the concerns raised. (author's)