14 November 2019

This study calculates how much UK foreign aid was spent (in 2018 prices) on lifestyle interventions targeting smoking, drinking, eating and sedentary behaviour.UK taxpayers spent £44.6million on ‘nanny state’ foreign aid projects between 2005 and 2018, spread over 35 projects in 47 countries. The three biggest recipients were China (£7.9million), India (£2.2 million) and Colombia (£1.8 million).

‘Nanny state’ foreign aid has ballooned in recent years. The majority (84.4 per cent) of the £44.6million was spent from 2016 to 2018. Annual spending on lifestyle intervention projects equalled £17million in 2016, £16.7million in 2017 and £3.9million in 2018.

Projects in China included a £6.8million ‘research unit’ to reduce the amount of salt housewives add while cooking; in India, £130,605 was spent researching the ‘acceptability and feasibility’ of taxing sugary drinks; and in Colombia, £1million was spent tightening tobacco control laws.

The three biggest categories of spending were anti-smoking projects (65.7 per cent of total ‘nanny state’ aid), salt-reduction schemes (20.2 per cent) and weight-loss interventions for children and adolescents (1.9 per cent).

Almost three quarters (72.4 per cent) of the £44.6million spent on lifestyle interventions abroad was funnelled through just five organisations: the World Health Organization (£15.9million), Queen Mary, University of London (£7.81million), the University of Stirling (£3.46million), the University of York (£3.14million) and the University of Cambridge (£2.06million).

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. That money could have bought three million insecticide-treated bednets. Misallocating resources means wasting opportunities to save lives.