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Progress on Global Alcohol Strategy

A web-based public hearing was conducted by WHO during October/November 2008. This was followed by separate consultations with the economic operators (alcohol producers and related industries) and international NGOs and health professionals.

The consultation for NGOs was held in December 2008.

GAPA issued the Statement below to the web-based hearing:

WHO Global Strategy GAPA Response

The Global Alcohol Policy Alliance (GAPA) welcomes the decision of the WHA to call upon the WHO to develop a global strategy to combat the harmful use of alcohol. GAPA, established eight years ago, is a world-wide alliance of regional and national NGOs and Institutes. Its governing board is drawn from members covering all continents. GAPA’s mission is to “reduce alcohol-related harm world- wide by promoting science based policies independent of commercial interests”.

We note that WHO is particularly interested in getting views on integrated approaches that can protect at-risk populations, young people and those affected by the harmful drinking of others.

Young People

For policies to be effective in both the short term and the long term they must involve youth.

The World Development Report has emphasised the ‘importance of developing human capacity in youth’. GAPA respects the role of youth. Youth have a right to their own voice and to be heard when policies are being formulated that will have a direct effect on their lives. The involvement of youth is especially important in the developing world.

The World Bank has pointed out that the developing world’s 1.3 billion young people aged 12-24 are the next generation of economic and social actors and emphasises that ‘as a result of epidemiological transition from communicable to non-communicable diseases…. young people are exposed to a different range of health risks than before’.

The report goes on to warn: ’missed opportunities to invest in and prepare this generation will be extremely costly to reverse, both for young people and society’.

At the same time it must be recognised that the alcohol problem is not just a matter of the inappropriate drinking patterns of young people. Young people are also affected by parental drinking problems and some, even before their birth (foetal alcohol problems). They can also be harmed by anti- social behaviour, accidents at home, work and on the roads, caused by the drinking of others.

Effective strategies to reduce alcohol-related harm

To combat harm effectively, strategies must embrace a public health, whole population approach, complemented by targeting atrisk groups. Strategies also need to tackle both supply and demand. Effective population strategies are well documented. Among them are: price; hours of sale; minimum purchase age and outlet density.

Measures protecting third parties as well as the drinkers themselves include: drink driving safety measures relating to BAC limits, random breath testing and licence suspension and health and safety at work regulations.

The marketing strategies of the drinks industry are of significance globally and they require monitoring and regulating; particularly in the areas of advertising, sponsorship and production of new drinks that are targeted to attract young people. Market analysts recognise that the drinks industry is highly innovative and that new product development is a vital factor in its profitability. The ‘rave’ and ‘recreational’ drug scene in the 1980s and 90s in the UK, for example, caused the industry to fear a loss of markets and it was seen by the industry as a major threat. This is clearly seen in Whitbread’s Director of Marketing’s remark: “Young people seem less prepared to sip beer for hours, culturally they like short sharp fixes…the challenge for the industry is to make alcohol part of that choice.”

Similar marketing strategies are now being deployed in India. The President of UB Group Spirits Division in 2004 stated: “The entire Indian map is changing. There has been a huge explosion of disposable income among the young; moreover social drinking has increased. And today users are looking for products that are aligned with global trends; the demand for new age flavours is increasing. The Indian market is ready for alcohol beverages with exotic fruit flavours”.

The UB Group’s Financial Report 2006 states:

‘Youngsters seeking western lifestyles typically begin by drinking beer and move into spirits. The brand positioning of UB Spirit Brands is designed to attract these upwardly mobile and aspirational customers”.

The industry’s marketing has a global outreach that contributes to similarities of patterns of drinking in different cultures. The influence of traditional protective cultures is on the wane. The world is experiencing the growth of a global drinking culture with patterns of drinking that are not dissimilar from one region to another. To avert the adverse effects of this trend requires a coordinated response at international, regional and national level.

WHO must appreciate why GAPA considers that the determination of a global alcohol strategy should be free of drinks industry influence. There is a role for industry in the implementation of policy and in adhering to the required standards. Their role is to market their product responsibly, to comply with national rules and regulations, to provide appropriate training for those who sell and serve alcohol. However, the industry should not be permitted to obstruct the formulation of alcohol policy. GAPA supports the WHO Europe Ministerial Conference declaration of 2001:

“Public Health policies concerning alcohol need to be formulated by public health interests without interference from commercial interests”.

WHO will need to offer bold and courageous leadership and to safeguard the integrity of the alcohol policy strategy. To achieve these ends it will be important for the WHO to enter into partnership with a broad range of civil society and professional networks. These will include specific nongovernmental alcohol policy and prevention organizations and importantly more general bodies such as international development agencies, justice, health, social and safety agencies, youth organisations and research institutes.

WHO also has an important role in enlisting the support and cooperation of other United Nation institutions by seeking to establish an inter-agency working group with ILO, UNESCO and UHDP.

SEARO, WPRO and EURO reports and resolutions adopted by their respective Committees have mentioned the challenge to policy arising from trade liberalisation and its adverse impact on alcohol prevention policies. The WHO should invite representatives of the FAO, WTO and the World Bank to the inter agency group, if established, in order to encourage an appreciation among such bodies that alcohol is no ordinary commodity and enlist their support to enable the implementation of effective policy to reduce harm.

The strategy needs to addres the millennium goals. There is a relation between alcohol and poverty that can have a deleterious impact on sustainable development. As well as the economic consequences, there is the fact that alcohol-related mortality is often highest among the poor in society. International Development Agencies have an important role to play in raising awareness about the issue and in seeking ways to address the inequalities exacerbated by problems relating to alcohol. It would appear appropriate for WHO to organise a workshop for International Development Agencies to discuss the matter.

What GAPA can contribute

GAPA sees its future role in terms of supporting WHO by the creation and fostering of supportive networks at global and regional levels able to disseminate relevant information, provide policy advocacy and to undertake specific tasks such as the monitoring of alcohol marketing. Its international journal, the GLOBE, has very wide global circulation and keeps its readers abreast of the latest information and developments in the field of alcohol policy

Since its inception, GAPA has been developing NGO regional networks in order to provide a forum for alcohol policy advocates and to bring to the attention of governments and nongovernmental agencies the social, economic and health consequences of alcohol consumption and related harm.

Impressed with the success of EUROCARE (the European Alcohol Policy Alliance), GAPA has developed similar networks in the Asia Pacific Region (APAPA) and in India (IAPA). Recently it has supported the successful establishment of the first Alcohol Policy Youth Network in Europe and is advising on the development of a youth network in Nigeria. It is planned that these networks will link up with those in the Asia Pacific region (such as the Thai Stop Drink network) to encourage the growth of a global alcohol policy youth network.

In tackling all of these challenges, WHO will need the assistance and support of NGOs and civil society organizations at all levels. NGOs have particular strengths that make them valuable partners of governmental organizations:

  • The capacity to work with a whole range of other bodies in health, social services, education, transport and industry and commerce;
  • Effective ways of mobilizing community resources, attracting people and persuading them to give of their time and skills;
  • Flexibility in identifying and responding to needs without being weighed down by topheavy decision-making structures that stifle innovation;
  • To mobilize civil society for the promotion of alcohol policies which safeguard individuals, the family and society from the negative consequences of alcohol abuse;
  • Establishing appropriate coalitions: forming alliances with other NGO’s on specific issues that they have in common;
  • Delivering cost effective services.

Conclusion

One of the successes of the WHO European Alcohol Action Plan was the adoption in 1995 of five ethical principles in relation to alcohol by the WHO Ministerial Conference in Paris and their reaffirmation at the Ministerial Conference in Stockholm in 2001. In our view, consideration should be given to endorsing these ethical principles as a call to action at the global level. GAPA recognises that there is no one-policy panacea. What is required from WHO is a list of policy options that have proven validity. From these options policy makers can choose and adapt them to their particular social, economic and political cultures.

When WHO has adopted its global alcohol strategy, GAPA will be prepared to work with WHO in gaining support for its implementation. Given strong leadership from WHO, the task of NGOs will be to mobilise civil society to accept ownership of the problem and help to create the political will necessary to successfully reduce the global burden of disease caused by alcohol.

For other responses to the WHO web-based public hearing see http://www.who.int/substance_ abuse/activities/hearing/en/index. html

Note: David Jernigan’s article ‘Intoxicating Brands: Alcohol Advertising and Youth’ on pages 16-19 of this issue of the Globe.