Global Alcohol Strategy on the right track

After more than 20 years on the periphery alcohol was put centre stage in global public health in 2005 when the 58th World Health Assembly (WHA) passed the resolution, “Public health problems caused by harmful use of alcohol” (WHA58.26). This move was not free from controversy and an attempt to pass a new resolution in 2007 failed due to the opposition of some Member States. In May 2008, the Members States were again able to reach consensus on a new alcohol resolution, this time drafted by the group of African countries. This resolution called for a WHO-sponsored Global Strategy to Reduce Harmful Use of Alcohol (WHA61.4).

Since 2008 the WHO Secretariat has been working on developing the global strategy. There exists a strong evidence base on the harm from alcohol as well as the cost effective interventions available. Among other documents this evidence base is summarized in the 2007 report from the WHO Expert Committee on Problems Related to Alcohol Consumption. In addition WHO has engaged in a process of broad consultation including an open web-based solicitation of comments, and round table meetings with economic operators, NGOs and health professionals, and intergovernmental organizations and UN agencies.

The Secretariat also organized a series of collaborative meetings with Member States in each region, and prepared a Working Document which suggested the direction sought in the ultimate Global Strategy. At an informal consultation with Member States on 8 October 2009 in Geneva the Secretariat received feed back on several aspects of the Working Document. A revised Draft Global Strategy was then published in December as part of the documentation for the 126th Executive Board meeting of WHO to be held in January 2010.

Several changes have appeared in the Draft Strategy compared to the previous Working Document. In the Executive Board (EB) meeting the Member States will have the opportunity to address the various parts of the strategy. The EB will then forward the strategy and an accompanying resolution for consideration by the World Health Assembly in May 2010.

The Global Alcohol Policy Alliance reviewed the Working Document and found it to be a good start which should be supported. The present Draft Strategy has been improved in some aspects, but weakened in others. A key area of concern is the revised section on marketing, which supports co-regulation and self-regulation “as appropriate” as parts of the strategy. There is no evidence for the effectiveness of either co-regulation or selfregulation of alcohol marketing. For instance, voluntary codes of good marketing practice are consistently violated in sports sponsorships, and Global Alcohol Strategy on the right track WHO Member States should seriously consider a ban on such sponsorships. The Working Document included bans on this and other forms of marketing as viable policy options; the revised Draft Global Strategy has removed this language. In this area as elsewhere, the evidence base for the strategy is strong and the strategy should remain consistent with that evidence base, particularly regarding the availability (including formal and informal sectors), marketing and pricing of alcohol.

Distinctions made in the draft strategy regarding the roles of different parties are essential, including language regarding conflicts of interest. The engagement of civil society is essential. Economic operators in alcohol production and trade should be seen as players only in their role as developers, producers, distributors, marketers and sellers of alcohol beverages. Appropriate consideration must be given to the commercial interests involved and their conflict with public health objectives.

Along with the Global Strategy there needs to be clear resourcing available for the ongoing development and implementation of the strategy, at global, regional and national levels. Wellresourced countries should be encouraged to indicate how they will contribute resources for the implementation of the strategy. The mobilization, involvement and engagement of civil society will be critical to implementation of the strategy and to establishing the political will to support that implementation. In this regard, GAPA stands ready to contribute.

Øystein Bakke Secretary, GAPA