Harnessing law for global noncommunicable disease control: evaluating a legal training program, 2014-23

In 2014, the McCabe Centre for Law and Cancer launched its flagship International Legal Training Program (ILTP), which aims to raise the capacity of government lawyers from low- and middle-income countries using the law to address noncommunicable diseases (NCDs). The course consisted of in-person/online training followed by practical implementation by participants through a 'priority project'. To evaluate the ILTP, we conducted a mixed-methods study using: (i) pre- and post-course survey data collected from participants over the last 10 years; (ii) an assessment of legal and policy changes made by participants in their home countries following the ILTP; and (iii) assessment of outcomes reported publicly. From 2014 to 2023, the ILTP had 450 participants from 97 countries and territories over its 13 deliveries. Participants rated the ILTP highly and reported large increases in confidence/knowledge in using law for NCD prevention and control. Priority projects developed by participants contributed to NCD law and policy change in a documented 30 countries, the defence of legal challenges to NCD laws in 5 countries, and the initiation of a legal challenge against the tobacco industry to recover health care costs in 1 country. Evaluation of the ILTP reveals that building the capacity of government lawyers can be effective in driving legal and policy change to better prevent and control NCDs globally. Legal capacity building programs such as the ILTP are essential for addressing NCDs and must be continued and expanded.