Global advocacy safeguards the Integrity of Alcohol Strategy

The last Edition of the Globe drew attention to our unease with the WHO Executive Board’s decision to place on this year’s World Health Assembly agenda a proposal to “collaborate with” economic operators. We called upon alcohol policy advocates to safeguard the integrity of the WHO by alerting their respective member states to the risks involved in such collaboration. We stated that there were two positions that could be taken: either to support the resolution as it stood or seek to amend the request to the Director General to “collaborate with the economic operators’ by replacing it with ‘to consult with the drinks industry”.

We knew that change would only be achieved if Member States could be persuaded to propose an amendment at the Assembly. We were also acutely aware of the diplomatic effort that had taken place to achieve even this degree of consensus on the need for a Global Strategy on Alcohol. Consequently there were those that took the position to live with the resolution as it stood, since they considered that to suggest further changes had the real potential of destroying this fragile consensus and of losing the momentum gained over decades in favour of a global alcohol strategy. This was not the position of the Globe.

Getting the Resolution changed was crucial on several counts of principle:

In agreeing to collaborate with a vested interest, WHO would have acted in direct contradiction to its own ethical principles and codes of practice.

By not differentiating between the status of Member States and other stakeholders the Resolution was creating a dangerous precedent that could lead to the inappropriate involvement of other economic operators in other areas of health policy. The changes advocated by the Globe would restore the rightful distinction in the relationship between the WHO,member states and other stakeholders.

The WHO’s own Expert Committee had advised the WHO to maintain its position of non-collaboration. The Globe unequivocally supported the Expert Committee’s view in this respect.

The Globe was aware of the influence that economic operators have within developed countries and, increasingly, within developing countries. An official mandate to proceed with collaboration would be exploited at all levels by the drinks industry to the detriment of many member states adopting effective population based alcohol control policies. The Globe’s role, together with its NGO supporters, was to voice these concerns with member states and particularly with health officials.

Due to the efforts of those who responded to our call, we are pleased to report that the Assembly in May 2008 amended the Board’s proposal in favour of one that safeguards the rightful distinction between the WHO’s relationship with Member States and other stakeholders including NGOs and the economic operators. The final text now directs WHO:

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

At the Assembly 36 countries spoke on the issue. All 36 countries supported the need for a Global Strategy. Six countries, with Thailand making a significant contribution, supported an amendment proposed by New Zealand which called for a change to the wording of the EB’s resolution and for a change to the emphasis on collaboration – restricting the term to relate only to Member States. The importance for alcohol and health policy of this change cannot be underestimated. Nor should we lose the significance of the fact that Rwanda and Kenya, wholly supported by African member states, initiated the resolution.

The Globe considers that it is now incumbent on the Global Alcohol Policy Alliance and its kindred organisations to respond effectively to the opportunity that developing a global strategy provides. We can do this by building capacity through networking, information sharing, and by cooperating in the development of targeted research and training.

Building capacity through networking:

An effective network of youth organisations, research institutions, advocates and civil society organisations needs to be strengthened to provide the WHO with an authoritative non-governmental voice on alcohol policy.

A network based on engagement with civil society including all major faiths, development agencies, justice, health, social and safety agencies,will provide a broad base for consultation in related fields where alcohol use is a contributory factor to health, social and cultural harms.

Research and training:

Advocacy-training courses for key professions and groups to be organised and

Research capacity to be built up to contribute to the evidence base.

GAPA will also need to work with others to safeguard the integrity of alcohol policy in its formulation and implementation at all levels.

Having learned the lessons from the tobacco field, the drink industry is proactively involved in the formulation of national alcohol policies across the globe. These policies seek to perpetuate the industry’s position on self-regulation, commercial freedom and targeted interventions to deal with what they deem to be a ‘minority’ that abuse alcohol.

GAPA will need to continue its advocacy for public health and population based approaches at regional, national and global levels and continue to challenge the underlying assumptions of the industry’s position by presenting the case for evidence-based approaches to national governments.Where round-table structures exist, such as the Alcohol and Health Forum in Europe, GAPA will need to monitor its activities and evaluate the likely value of the involvement of the NGO sector over time.

In other regions and countries where such structures do not exist, organisations will need to feel supported by GAPA in their task of providing a local counterbalance to the drink industry’s lobbying. The exchange of information and knowledge about movements and developments of alcohol policies and best practice will need to be shared across the GAPA network.

GAPA will respect the role of youth. This issue of The Globe celebrates the constitutive meeting of the Alcohol Policy Youth Network – a network of youth organisations across Europe and a new dynamic voice in European alcohol policy. APYN’s message of youth participation is unambiguous – youth have a right to their own voice, and for this voice to be heard, when policies are formulated that will have a direct influence on their lives. GAPA and its kindred bodies should attempt to engage meaningfully with youth organisations in a wider context so that positive messages can be shared.

Above all the Globe believes that we need to embrace wholeheartedly the role DrAsvall, the former Director General of WHO Europe, outlined for us when he stated: “A particularly important role can be played by enlightened nongovernmental organizations, which can often speak with passion and insight on the true impact of alcohol on individuals, families and communities. Such organizations can also bring the commitment and energy to work even in the face of political risks.”

As for the WHO, it has now the opportunity to develop a strong evidence based Global Strategy to counter the epidemic of alcohol problems that is increasing with growing alcohol consumption in many parts of the world. Regions of the globe with fast emerging alcohol markets and related problems have already begun the work of developing Regional Strategies which can inform the Global Strategy. The deliberations will also be informed by precedents such as the Framework Convention on Tobacco Control which illustrate the mechanisms the member states of WHO have at their disposal to ensure a strong public health response.

The eventual report will need to set out strategies that can be implemented at international, regional, national and local level. It should also outline the actions that can be taken and contributions made by member states and non-governmental organisations to counter and reverse the growth in alcohol related harm.

From the drinks industry we need to see positive deeds and not words in their actions to support measures that will reduce consumption and harm. The industry will need to be closely monitored.

We need to remember Griffith Edwards wise advice to WHO Europe over a decade ago “There is no one policy panacea: inevitably the needed policies will be a mix rather than a master stroke”.

A focus on youth
In this edition of the Globe we focus on youth. Youth are positive actors in policy formulation and advocacy.

The European Youth Forum in their Position Paper on Alcohol Related Harm stated that “Alcohol related harm is an important health and, in particular, social issue for young people. Unfortunately, youth are often depicted as simply a social group misusing alcohol rather than individuals capable of making conscious choices and sometimes the victims of alcohol-related harm. Moreover, youth could also be potential actors who could contribute to addressing alcohol-related issues. In this regard, youth organisations can play an important role through awareness raising, by providing alternative leisure time activities for youth, as well as by being the space where young people can develop their social and personal skills. As these policies often affect young people, interested youth organisations should also be involved and have a say in the policy making.”¹

A less respectful approach to youth is seen in the UK Government’s Youth Alcohol Action Plan (although this should be considered as an interim plan). It identifies five priority areas of which the active participation of youth and youth organisations is sadly lacking. (see page 20)

Active participation of youth in policy making must be a goal for all and a challenge to young people and youth organisations alike.

The market positioning of alcopops and its appeal to youth has been of grave concern for many years. The report from the US Marin Institute (see page 25) highlights the efforts of the Drinks Industry to frustrate the attempts of State legislators to take appropriate action on taxing alcopops. Action that legislators consider important to safeguard the health and well being of youth.

The Indian Health Minister at the launch of the Indian Alcohol Atlas spoke strongly of the need to promote the health of the 600 million youth of India (see page 23). Curbing and controlling the sale and promotion of alcohol will be a central theme of Indian policy. He challenged the media to go and see for themselves the consequences of alcohol use on youth, families and communities in rural areas and to give serious consideration to their own role in enabling the prevention of ill health and harm by adopting responsible policies as they have done in the tobacco field.

From Thailand, Thaksaphon Thamarangsi explores the transitional nature of the alcohol market and exposes the newly introduced strategies deployed by the industry including the creation of youth-friendly beverages. The articles fromThai Health are salient reminders of the way in which promoters of alcohol entice future generations towards alcohol (see page 8).

Reference:
1 Adopted by their Council of Members/Extraordinary General Assembly 27 – 28 April 2007 held in Baku.