Nanny state on tour

This study calculates how much UK foreign aid was spent on lifestyle interventions targeting smoking, drinking, eating, and sedentary behaviour. UK taxpayers spent £44.6million on 35 "nanny state" foreign aid projects in 47 countries between 2005 and 2018. Such foreign aid has ballooned in recent years. The majority (84.4%) of the £44.6 million was spent from 2016 to 2018. The three biggest categories of spending were anti-smoking projects (65.7% of total "nanny state" aid), salt-reduction schemes (20.2%) and weight-loss interventions for children and adolescents (1.9%). DfID-commissioned projects accounted for 51.3% of lifestyle intervention spending. The Department of Health, responsible for only 0.7% of Official Development Assistance (ODA) in 2017, funded 27.8% of "nanny state" projects. Similarly, the Department for Business, Energy, and Industrial Strategy commissioned 20.8% of the projects, while only commanding 5.4% of ODA in 2017. This supports the theory that non-DfID spenders of UK foreign aid are less likely to prioritise poverty reduction. Our analysis finds that there are better uses for health-related foreign aid than the 'nanny state' projects identified in this study. For example, insecticide-treated bednets to prevent malaria in Sub-Saharan Africa are twenty times more cost-effective in terms of life-years saved than implementing smoke-free workplaces, a policy that was pursued in Cape Verde, Chad, Madagascar, Sierra Leone and Zambia as part of a £5.3million tobacco-control programme in the region in 2016. Misallocating resources means wasting opportunities to save lives.