The Amsterdam Group

Derek Rutherford

Is there common ground between public health and the industry and together with their social aspect groups can they be trusted in any form of partnership?

An examination of the words and actions of the industry should provide the answer.

The Amsterdam Group (TAG), formed in 1990, is an alliance of Europe's leading producers of beers, wines, and spirits who work together as well as with governments and other interested groups in addressing social problems related to the excessive or inappropriate consumption of alcoholic beverages. TAG lists its objectives as:

"encouraging responsible consumption and contributing to combating abuse.; promoting understanding and tracking research on biomedical and social issues; and safeguarding responsible commercial communications through effective self-regulation".

TAG's member companies at European level are active in: the Confédération des Producteurs de Spiritueux, which has 35 national organisations, and the Confédération des Brasseurs du Marché Commun.

TAG's members are also active in industry actions on alcohol 'misuse' and education carried out by thirty world wide Social Aspect Organisations.

TAG has published two reports to the European Union in 1993 and 2000 which clearly show their opposition to the public health model. They state:

• Evidence suggests that the prevalence of alcohol-related problems is not directly related to the average per capita consumption, but rather to problematic patterns of drinking.

• Policies aimed at the reduction of overall per capita consumption (in the form of limiting the overall sales of alcoholic beverages through marketing and production restrictions and high taxation) does not address those who abuse the product.

• The notion of individual responsibility for drinking behaviour needs to be stressed and that no collective regulation can ever replace individual responsibility.

With regard to public policy Anderson and Lopez1 point out:

"Public policy needs to take into account that harm is not restricted to heavy drinkers but at the same time recognise that most harm among those who are low average drinkers of alcohol arises due to episodes of intoxication or heavy drinking on isolated occasions. Policies to strongly discourage such behaviour in light drinkers must therefore also receive sufficient priority in implementing the public health response to alcohol problems in society".

The following areas of concern are taken from the Amsterdam Group's report and contrasted with the actions of their members.

Young people and alcohol

TAG will support and participate in education programmes which give balanced and accurate information about alcohol and its effects, aimed at:

• young people directly;

• parents, schools, youth clubs and other relevant authorities;

• ensure that all promotional and advertising campaigns are effective self-regulation;

• develop and promote materials which educate young people about the dangers of drinking and driving;

• train people in the HORECA sector (hotels, restaurants and cafes) not to sell to underage drinkers.

Contrast the above with the fact that members of TAG launched alcopops and continually bring new designer drinks onto the market which especially appeal to the young.

Drinking and Driving

TAG says it is fully committed to encourage the industry to undertake practical steps to help reduce the number of drink-related driving accidents, by, for example:

• working with the hotel, restaurant, cafe and bar (Horeca) sectors to develop anti-drink driving initiatives, including encouraging the availability of alcohol-free products;

• developing and supporting educational programmes which teach that driving when impaired by alcoholic beverages is unacceptable and that the law must be observed;

• support research into issues such as the attitudes of drivers who drink excessively and how best to change them;

• support focused activity aimed at the chronic problem of drinkers who persistently drive whilst over legal limits;

• the industry will continue to collaborate with road safety organisations, governments and other interested parties. Educational programmes aimed at the young should be a priority.

Yet in its actions the Industry shows it is against effective legislation. In the early 1990's CADD, the Campaign Against Drink Driving, approached the industry's social aspect group in the UK, the Portman Group, for financial help and was told that if they dropped their campaign to reduce the legal limit and introduce random breath testing, money might be forthcoming. Over the years the Portman Group has continued to be against such action. In 1997 the British government said it was 'mindful' to reduce the limit to 50mgs per cent. Despite the EU recommending this limit, the UK remains one of three EU countries above it. The Portman Group has been implacably opposed to such a change. Portugal's Social Aspect Group, on the day it was launched, requested the Portuguese Government to raise BAC from 0.5 per cent to 0.8 per cent.

Commercial Communications and Self Regulation

TAG considers Commercial Communications should:

• be legal, decent, honest and truthful and conform to accepted principles of fair competition and good business practice;

• be prepared with a due sense of social responsibility and be based on principles of fairness and good faith;

• not in any circumstances be unethical or otherwise impugn human dignity and integrity.

Contrast this with the following

• should not encourage excessive or irresponsible consumption, nor present abstinence or moderation in a negative way;

• should not suggest any association with violent, aggressive behaviour;

• should not be specifically aimed at minors nor show minors consuming beverages;

• should not be placed in or on printed media or broadcast programmes directed primarily at minors rather than adults;

• should not promote beverages in media, events or programmes at which the majority of the audience are known to be minors;

• should not create the impression that consumption of beverages enhances mental ability or physical performance e.g. when in engaging in sports;

• should not create the impression that consumption of beverages is a requirement for social or sexual success.

Policy Initiatives

Guinness attempted, in the late eighties, to influence the WHO European Alcohol Action Plan. As a consequence, the first draft of the plan entitled "Conviviality with moderation" which refelected Guinness's views was rejected by member states.

The Portman Group has in the past attacked sensible drinking limits in the UK. and was instrumental in getting them changed. In addition, it challenged the whole basis of the European Alcohol Action Plan (EAAP) and offered "bribes" of £2000 to scientists to attack Alcohol Policy and Public Good – along with the promise to publish anonymously. ICAP was critical of both the EAAP and its theme - 'Less is Better.'

The Amsterdam Group attempted to influence the Second WHO European Alcohol Action Plan by devising a number of amendments:

"a reduction in the harm that can be done by alcohol is amongst the most important public health actions that countries can undertake to improve the quality of life." TAG suggested the amendment: "a reduction in alcohol misuse is amongst"

"risk of alcohol related problems" TAG suggested it became, "consequences of alcohol misuse"

The statement that "alcohol is a psychoactive drug" was deleted - TAG did not like the word drug.

The sentence, "alcohol use and alcohol related harm, such as drunkenness, binge-drinking and alcohol related social problems are common among adolescents and young people in Western Europe" disappeared in TAG's version.

"Responsibilities of the beverage alcohol industry and hospitality sector" is rewritten by TAG as "Industry-society partnerships to reduce alcohol misuse",

"promote high visibility breath testing on a random basis" becomes, in TAG's version: "promote drink driving campaigns".

"place restrictions on the sponsorship by the drinks industry on sports" is, unsurprisingly, deleted by TAG.

The Amsterdam Group did not succeed in changing the plan, even though it put tremendous pressure on those governments over which it has influence. Dr Asfel, the then Director of WHO European Region, in the forward to the plan, said:

'Throughout the preparation of this Plan, relations with the industry have been a particular concern, raised repeatedly in the Standing Committee of the Regional Committee and in the Regional Committee. The Plan contains some references to the role of industry and commerce. It proposes, for example, that the industry and the hospitality sector develop and implement programmes to reduce alcohol-related problems in the drinking environment. After the Regional Office held a meeting with the industry, through the so-called Amsterdam Group, the Group delivered an extensive critique of the Plan, explaining the industry's standpoint and offering suggestions for incorporating this in the text.

Although some of the proposals made by the Amsterdam Group were in accordance with the debate, there was no support from the Regional Committee for a global revision of the text.

Communication with the Group to promote reciprocal information sharing was, however, encouraged. Although some form of cooperation with the industry, commerce and the hospitality sector cannot a priori be ruled out, there was no support for recommending that local and national public health alcohol policies in general be developed in co-operation with them."2

The WHO Ministerial Declaration at its conference in Stockholm issued this caution:

"Public Health Policies concerning alcohol need to be formulated by Public Health Interests, without interference from Commercial Interests."

WHO European Alcohol Action Plan considers it important to:

"support non-governmental organisations and networks that have a specific role to play in informing and mobilising civil society with respect to alcohol-related problems, lobbying for policy change and effective implementation of policy at government level, as well as exposing harmful actions of the alcohol industry."

In June 2001 the EU Council of Health Ministers called for effective mechanisms to: ensure that producers did not produce alcoholic beverages specifically targeted at or designed or promoted to appeal to children and adolescents. The Council further recognised that alcohol is a key health determinant in the European Community.

It is clear that public health authorities and non governmental organisations, that have a particular concern in redressing alcohol related harm and the promotion of public policy, need to keep the industry and its allies at arms length. The industry cannot be allowed to set the political agenda on alcohol policy.

1. Peter Anderson and Alan Lopez, Alcohol and Health - implications for public health authority, WHO Regional Office for Europe, Copenhagen, 1995.

2. Foreword to the European Alcohol Action Plan, 2000-2005, WHO Regional Office, Europe.