Global Alcohol Strategy Endorsed

“The global strategy for reducing the harmful use of alcohol is a true breakthrough”, stated Dr Margaret Chan, Director of the World Health Organization, after delegations from all 193 Member States had reached consensus on the resolution ‘Strategies to reduce the harmful use of alcohol’.

In her closing remarks to the delegates Dr Chan stated, “This strategy gives you a large and flexible menu of evidence-based policy options for addressing a problem that damages health in rich and poor countries alike. The strategy sends a powerful message: countries are willing to work together to take a tough stand against the harmful use of alcohol”.

Together with the endorsement of the strategy, the WHA called upon Member States:

• to adopt and implement the global strategy to reduce the harmful use of alcohol as appropriate in order to complement and support public health policies in Member States;

• to reduce the harmful use of alcohol, and to mobilize political will and financial resources for that purpose;

• to continue implementation of the resolutions WHA61.4 on the strategies to reduce the harmful use of alcohol and WHA58.26 on public-health problems caused by harmful use of alcohol;

• to ensure that implementation of the global strategy to reduce the harmful use of alcohol strengthens the national efforts to protect at-risk populations, young people and those affected by harmful drinking of others;

• to ensure that implementation of the global strategy to reduce the harmful use of alcohol is reflected in the national monitoring systems and reported regularly to WHO’s information system on alcohol and health.

It further requested the Director- General:

• to give sufficiently high organizational priority, and to assure adequate financial and human resources at all levels, to the prevention and reduction of harmful use of alcohol and implementation of the global strategy to reduce the harmful use of alcohol;

• to collaborate with and provide support to Member States, as appropriate, in implementing the global strategy to reduce the harmful use of alcohol and strengthening national responses to public health problems caused by the harmful use of alcohol;

• to monitor progress in implementing the global strategy to reduce the harmful use of alcohol and to report progress, through the Executive Board, to the Sixtysixth World Health Assembly.

A comprehensive outline of the strategy was reported in the Globe Issue 3 2009. (Website:http://www.ias.org.uk/resources/
publications/theglobe/ globe200903/gl200903_index. html)

Non-governmental organizations in official relations with WHO were permitted to speak from the floor of the Assembly at the end of the debate. Three organizations WHO’s Director-General, Dr Margaret Chan, at the closing session took up this privilege.

The World Council of Churches Action for Health, representing a broad spectrum of faith communities and civil society networks in over 150 countries, strongly supported the strategy and urged the WHO to begin its implementation as soon as possible following its adoption and ensure that there would be adequate resources available to carry out its intent. Profoundly aware of the effect of alcohol use on poverty and ill-health, they had developed an important collaboration with the Global Alcohol Policy Alliance and were committed to collaborate with different civil society groups and with governments to ensure that public health is given due consideration in this matter.

The Churches Action for Health noted the following components of the Strategy: Its foundation rested on strong, evidence-based policies affecting price, availability and marketing of alcoholic beverages; addressed the need for resource development and prioritization in implementing alcohol prevention strategies at the global and national levels; recognized that the involvement of civil society was essential in creating the political will to address alcohol issues and implement national and global prevention strategies; acknowledged the responsibility for health-sector leadership within multi-sectoral collaboration on efforts to combat alcohol problems at all levels; and suggested a special focus on protecting the young, non-drinkers, and populations at risk from harmful use of alcohol, such as women, indigenous peoples and other low-income or minority groups.

The World Medical Association also speaking on behalf of the International Council of Nurses, the International Pharmaceutical Federation, the World Confederation for Physical Therapy and the World Dental Federation, which form together the World Health Professional Alliance - WHPA. The Alliance speaks for more than 26 million health care professionals worldwide, working to improve global health and the quality of patient care and facilitating collaboration among the health professions and major stakeholders.

Health professionals strongly welcomed the Strategy but wished to draw attention to the following matters:

Although the strategy acknowledged the responsibility for health-sector leadership on efforts to combat alcohol problems, they believed that the role of health professionals in prevention and treatment interventions of alcohol problems should be given more attention, underlining the pivotal role that they play in terms of education, advocacy and research, as well as treatment. They strongly recommended that the role of economic operators - with vested interest in production and sale of alcohol and alcoholic products - be clearly limited in the implementation of the strategy, so that policies and programmes at all levels are developed on the basis of public health interests, independent of commercial influence. The WHPA urged Member States to address the critical need for adequate resources for the implementation of the strategy, especially in low and middle-income countries with high or increasing consumption of alcohol.

Representatives of The International Federation of Medical Students Association (IFMSA) stated that young people, including its 1.2 million medical student members, are affected by the harmful use of alcohol. They believed that an effective global strategy could reduce this burden. The alcohol attributed disease burden lies more with younger people than older people. Of all years lived with disability attributable to alcohol, 34% were experienced by persons aged 15-29 years, 31% by those 30-44 years, and 22% by those aged 45-59. It was also a significant factor contributing to violence and unprotected sex among young people. The International Federation of Medical Students’ Associations strongly supported the implementation of effective strategies to reduce the harmful use of alcohol.

As young people and the next generation of health professionals, the IFMSA was concerned about the manipulative marketing of the alcohol industry. They considered that the global strategy should advocate ways of protecting the young generation from such marketing.

The problem of the harmful use of alcohol was still often neglected within the curricula of medical schools. As medical students and future health professionals, they wished to see improvements within medical curricula on how to effectively prevent, diagnose and treat this serious public health problem. IFMSA concluded their statement:

“We, as the International Federation of Medical Students’ Associations Team of Officials, appreciate the efforts of WHO and its Member States to tackle the global burden of harmful use of alcohol. We strongly recommend the approval and effective implementation of the global strategy to reduce the harmful use of alcohol”.

In a WHO press statement, after the endorsement of the strategy, Dr Ala Alwan, WHO Assistant Director-General said, “The resolution and the strategy set priority areas for global action, provide guidance to countries and give a strong mandate to WHO to strengthen action at all levels on reducing harmful use of alcohol”. Harmful drinking is also a major avoidable risk factor for non-communicable diseases, in particular cardiovascular diseases, cirrhosis of the liver and various cancers. It is also associated with various infectious diseases like HIV/AIDS and TB, as well as road traffic accidents, violence and suicides. Successful implementation of the strategy will require concerted action by countries, effective global governance and appropriate engagement of all relevant stakeholders. To this end, WHO will also encourage that the strategies to reduce the harmful use of alcohol are included as an integral part of work on global development and in related investment decisions.

GAPA Comment

We welcome the historic decision by the Assembly, since concerted action to reduce global alcohol problems is long overdue. In the many member-state interventions, from both developed and developing countries, delegates requested that alcohol problems receive a higher priority at WHO and that more resources be allocated to address those problems.

The important concerns identified in the debate included the increasing culture of binge drinking and the expanding influence of the marketing and advertising for alcoholic beverages. Having witnessed the force of the lobbying tactics of the drinks industry among member states, we concur with the concerns of the International Medical Students in their official statement in the debate “over the manipulative marketing of the alcohol industry” and the WHPA “that the role of economic operators be clearly limited…so that policies and programmes at all levels are developed on the basis of public health interests, independent of commercial influence”. The strategy highlights the effectiveness of focusing on policies regarding pricing, availability and marketing of alcohol. The response of the drinks industry and their financially sponsored social aspect organizations will require vigilant scrutiny.