Call for a Global Strategy

This section of the Globe tracks the progress of the resolution calling for a Global Strategy on Alcohol from the WHO Executive Board Meeting in January 2005; Fifty- Eighth World Health Assembly Resolution in May 2005; the impasse reached at the Sixtieth World Health Assembly on a new resolution; through to the draft and amended resolution discussed at 122nd Session of the WHO Executive Board in January 2008. It also contains a summary of the key findings and recommendations of the WHO Expert Committee 2007; and tables outlining the data on the disease burden attributable to alcohol in 2002.

The Globe has collated the material in this way to provide a full background for alcohol policy advocates concerned over the risks of collaboration between the international public health authority and the alcohol industry.

Progress of the Resolution
The Globe Editorial (Issue 1 & 2 2007) refers to the difficulties encountered at the World Health Assembly in May 2007, when the process relating to the Global Strategy on Alcohol became stalled in committee. A simple resolution was finally adopted that ‘strategies to reduce the harmful use of alcohol and related documents should be included in the agenda of the EB in January 2008 and that the Director General, in the interim, continue her work on this matter’.

Mindful of the difficulty in achieving consensus, and of the emotive and complex nature of the alcohol issue, the New Zealand representative chaired a consensus building meeting on the 3rd December 2007 when agreement was reached on the content and language of a further draft resolution to be presented to the EB in January 2008. Kenya and Rwanda agreed to propose the resolution. (see page 22).

GAPA, on seeing the draft, welcomed its formulation since it represented a balanced and pragmatic approach. GAPA’s only concern centred around the wording of paragraph 2(3) in the draft resolution:

“to collaborate with Member States during the entire process, and actively consult with intergovernmental organizations, health professionals, nongovernmental organizations and economic operators on ways they would contribute to reducing harmful use of alcohol.”

GAPA would have preferred to see a clear distinction between ‘consulting with’ the economic operators and the other stakeholders named. A possible viable amendment would have been:

(3) to collaborate with Member States during the entire process, and actively consult with intergovernmental organizations, health professionals and nongovernmental organizations.

(4) to consult with economic operators on ways they could contribute to reducing harmful use of alcohol;

GAPA considered that the above amendment would have safeguarded the interests of public health in determining alcohol policy, whilst recognising the legitimate involvement of economic operators in the implementation of policy aimed at reducing harm.

However, GAPA representatives observing the EB process were informed that any amendments presented at the EB stage would risk unbalancing the consensus, creating further controversy and causing further delay. GAPA accepted this, believing that any amendments likely to impede progress would be resisted.

Dr Chan, Director General, in her opening address to the EB at its 122nd Session on the 21st January 2008 commented: “You will consider a report on strategies to reduce the harmful use of alcohol. As a starting point for your discussions, this report catalogues the broad range of damage at many levels of health, associated with the harmful use of alcohol.This is a problem we need to take very seriously.”

On Wednesday 23rd January, ahead of schedule, Rwanda, on behalf of the 46 African countries presented the resolution and other EB members supported. Slovenia (having the Presidency of the European Union) spoke on behalf of the EU endorsing the resolution. Japan expressed support, followed by Iraq on behalf of the EMRO countries.

New Zealand commented that they welcomed further efforts for global action and thanked Rwanda and the African countries for their work on this issue. The USA representative referred to the issue of illicit and unregistered consumption and stated that economic operators needed to be fully engaged as partners in the process. Latvia and Turkey supported the resolution, focusing on the impact of harmful alcohol consumption in their respective societies. China supported the resolution with reference to the need to take measures to tackle the specific circumstances in each country. The language of the resolution was referred to by the Bahamas on behalf of the CARICOM countries. The resolution was well drafted and gave due recognition to the issue of the variation in resources across regions. Sri Lanka in supporting the resolution reiterated the serious problems caused by alcohol and the ‘alcoholisation’ of cultures.

Mexico, having thanked the secretariat of Member States for preparing the draft resolution, felt that it needed to be strengthened and proposed several amendments. Mexico had prepared a pro-industry amendment, paving the way towards not only ‘consultation’ but also ‘collaboration’ with the ‘economic operators.’

The amended text read:
“to collaborate and consult with Member States as well as with intergovernmental organizations, health professionals, nongovernmental organizations and economic operators on ways they could contribute to reducing harmful use of alcohol;”

Non-Executive Board Members Cuba, Russia and Chile supported the resolution.Cuba in particular had given careful attention to the debate and thanked those who had drafted the resolution. Chile went on to support Mexico’s amendment and Cuba also came in to support the amendment proposed by Mexico. Rwanda expressed gratitude for those who expressed support for the resolution and indicated that Mexico’s amendments would be acceptable. Slovenia on behalf of the EU also accepted the amendment. New Zealand, whilst supporting the amendment, struck a note of caution stating that further amendments could potentially create problems for the progress of the issue.

On behalf of the Secretariat, the Assistant Director General (Non-Communicable Diseases and Mental Health) responded to some of the issues that had been raised and,with particular reference to the comments of the USA delegate, stated that there was an ongoing consultative process with the beverage alcohol industry and that the next consultation meeting with them was scheduled for 21st February 2008.

Globe comment: Despite the fact that the amendments were tabled ‘late in the day’ and the EB was ahead of schedule, no member asked for an adjournment until the next day in order to reflect on the consequences of the amendment. An amendment that, in our opinion, substantially altered the tenor of the previously worded agreed draft. It left one with the belief that pre-agreement had been negotiated in the ‘corridors’.