BACKGROUND-AIM:
Article 5.3 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) obliges Partiesto protect public-health policy from the commercial and other vested interests of the tobacco industry. Despite near- universal ratification 184 Parties (as of 2024) implementation remains inconsistent. This study compares the extent and quality of Article 5.3 implementation in South Asia and Eastern Europe between 2019 and 2023, identifying progress, persistent interference, and opportunities to strengthen regional governance.

METHODS:
A comparative, desk-based policy analysis was conducted using (1) WHO FCTC Implementation Reports (2019–2023) from the FCTC Implementation Database; (2) Global Tobacco Industry Interference (TII) Index scores (2019, 2020, 2021, 2023) published by STOP – Stopping Tobacco Organizations and Products; and (3) government and media records documenting tobacco-industry interactions and corporate-social-responsibility (CSR) activities. Countries were assessed against the eight core measures in the Guidelines for Implementation of Article 5.3 (transparency, avoidance of partnerships, CSR prohibition, conflict-of-interest management). South Asia was defined as Bangladesh, India, Nepal, Pakistan and Sri Lanka; Eastern Europe as Armenia, Azerbaijan, Georgia, Moldova and Ukraine. Given changes in Index coverage, analysis focused on country-level trends. The 2023 Index reflects incidents mainly from April 2021 to March 2023.

RESULTS:
Acknowledgment of Article 5.3 improved modestly in both regions, but institutionalization into binding law and practice remains limited. The 2023 Global TII Index reported: Sri Lanka 42 (rank 21/90) – strong implementation with codes of conduct and public-disclosure rules; Ukraine 44 (rank 25/90) – good progress on transparency and coordination; Bangladesh 72 (rank 80/90) – high interference linked to CSR acceptance; Georgia 83 (rank 90/90) – severe interference and minimal safeguards. Common gaps included the absence of mandatory registers of government– industry interactions, cross-ministry codes of conduct, and enforceable penalties for violations. Missing reports were coded as “no report” to avoid conflating data absence with non-compliance.

CONCLUSIONS:
Implementation of FCTC Article 5.3 in South Asia and Eastern Europe remains partial and reactive. Most governments recognize the principle but lack robust, legally binding mechanisms to prevent industry influence. To close this gap, Parties should (1) legislate disclosure of all tobacco-industry interactions; (2) impose a full ban on tobacco-industry CSR; (3) integrate Article 5.3 provisions into civil-service codes across ministries; and (4) establish regional peer-review systems for accountability. Sustained and transparent implementation of Article 5.3 is essential for effective delivery of all other FCTC measures.