WHO Forum turns global attention to alcohol harm prevention

The heads of the world’s leading alcohol harm prevention organisations, policy makers, health care providers, academics, and philanthropists have arrived in Geneva this week for the World Health Organization’s (WHO) first global Forum on alcohol drugs and addictive behaviours.

Dr Oleg Chestnov, Assistant Director-General Noncommunicable Diseases and Mental Health at the World Health Organization, says the new WHO initiative aims to strengthen international partnerships and collaboration in order to tackle some of the most pressing issues of our time.

“Harmful use of alcohol as well as drugs and addictive behaviours have devastating effects on individuals, families and their communities and have enormous socioeconomic impacts at national and global levels. We have a shared responsibility to prevent and reduce this burden.”

Alcohol control and implementation of the Global strategy to reduce the harmful use of alcohol endorsed by the World Health Assembly is one of three major thematic areas being explored during the conference.

Day One of the Conference saw a group of Non-Government Organisations, including the World Medical Association, IOGT International, the Global Alcohol Policy Alliance and NCD Alliance, invited to make opening statements, highlighting what they saw as the most crucial aspects to be addressed and the challenges faced in responding to alcohol harm.

Those statements are published below in full.

The World Medical Association is the global federation of National Medical Associations representing the millions of physicians worldwide. We have a long-standing commitment towards the reduction of the harmful impact of alcohol on health and society and we actively supported the adoption of the Global strategy to reduce the harmful use of alcohol adopted by the World Health Assembly in 2010. In 2015, the WMA endorsed the Declaration on alcohol which completes usefully its policy in addressing the problem of alcohol related harm.

The WMA notes with concerns the heavy burden of disease and injury associated with alcohol consumption. This is a critical challenge to global public health. To make meaningful reduction of the harmful impact of alcohol and other non-communicable diseases, we believe that it is critical to take action on the broader factors which influence people’s health behaviour: these social, cultural, environmental and economic factors are the major influences on quality of life, good health and length of disability-free life expectancy. They also determine the magnitude of health inequalities.

Addressing the social determinants of health that are contributing to the increase in alcohol burden is beyond the health sector alone. Strategies of prevention demand the collaborative engagement of multiple sectors such as finance, trade, education or recreation. It therefore does not limit itself to the health target of the SDGs 2030, but extends to the overall global goals to end poverty, fight inequalities and protect our planet.

We recommend developing all-inclusive policies addressing the root causes of alcohol patterns as well as strengthening health systems to identify and improve a country’s capacity to develop policy and lead actions that target alcohol problems.

In addition, we recommend the following priorities:

1. Regulate the affordability, accessibility and availability of alcohol, in particular through rigorous pricing policy and restriction of the alcohol marketing;
2. Support and promote the role of health and medical professionals in early identification, screening and treatment of harmful alcohol use;
3. Raise awareness of alcohol-related harm through public education and information campaigns;
4. Foster multi-disciplinary collaboration and coordinated inter-sectoral action.
5. Limit the role of the alcohol industry in alcohol policy development as its commercial priorities are in direct conflict with the public health objective of reducing overall alcohol consumption.

Danielle Guy
World Medical Association

26 June 2017

Dear Chairman, distinguished delegates, colleagues, ladies and gentlemen, It is an honor and privilege to address you today.

On behalf of our members – 143 civil society organizations from 57 countries please allow me to highlight three crucial aspects of a comprehensive response to the harm caused by alcohol, other drugs and addictive behaviors:

The first aspect is prevention.

Prevention strategies based on independent scientific evidence, using high impact policy measures and working with families, schools, and communities can ensure that people can lead healthy, sustainable lives. For every dollar spent on prevention, at least ten can be saved in future health, social and economic costs.

The second aspect is environment.

For people to be able to make sustainable lifestyle choices and lead healthy lives, the environments they live and work in do matter greatly. That is why population-based measures, like the three alcohol policy best buys, are essential tools.

IOGT International is the premier global interlocutor for evidence-based policy measures and community-based interventions to prevent and reduce harm caused by alcohol and other drugs.

The third aspect is the 2030 Agenda and the Sustainable Development Goals.

For example, harmful use of alcohol is a major obstacle to sustainable development, adversely impacting all three dimensions of development: the social, environmental and economic dimension. We heard that about 2 billion people are using alcohol, but many more are affected by alcohol-related harm in families, workplaces, communities and economies.

Alcohol-related harm is not a fringe issue. Therefore our collective response to alcohol and other drugs will matter greatly for the success or failure in achieving the SDGs.

In this collective effort, we do have a powerful opponent: the alcohol industry, like the tobacco industry, obstructs evidence-based public policy making and spreads uncertainty about scientific evidence concerning alcohol-related harm and population-based alcohol policy measures; therefore it will be crucial going forward to safeguard WHO and governments from undue influence.

A meeting like this shows, what our members experience around the world:

There’s wide interest in tackling harmful substances. And there is a big need for more technical assistance from WHO to decision-makers in governments and parliaments, for example concerning alcohol taxation in particular and alcohol policy development in general.

In this spirit we are hopeful that this forum will generate much needed momentum, political will and urgency. What we discuss here matters and what we do afterwards has the potential to improve people’s health, save lives and foster sustainable development.

Kristina Sperkova
International President,
IOGT International

26 June, 2017

Chair,

The Global Alcohol Policy Alliance is an international network of non-governmental organisations and people working in public health agencies who share information on alcohol issues and advocate evidence-based alcohol policies, “free from commercial interests.”

Having followed the development of the Global strategy to reduce the harmful use of alcohol and later the implementation of it over the years, we see that the resources allocated to addressing these harms are miniscule. New developments like cross border marketing, including in social media, and economic treaties only exacerbate the situation. The low and middle income countries are targeted and they are the ones who are going to provide the future profits of the multinational alcohol industry. These countries lack the resources to stem the tide. And changing this is not easy, as pointed out in an intervention in the NCD debate at the recent World Health Assembly. Ghana, on behalf of the whole African region pointed out: “The glaring and continued underfunding of work to accelerate implementation of NCD prevention and control measures in the region needs to be addressed, particularly in the area of industry interference that block measures to implement domestic taxes on health-harming products in order to ensure the self-financing of national responses.”

We are convinced that a legally binding instrument to strengthen the public health response to harmful use of alcohol is needed. We were encouraged by observing the debate at the WHA where Sri Lanka, on behalf of 11 SEARO countries; Estonia on behalf of the three Baltic states; and other countries like Botswana and Norway pointed to the problems mentioned and asked the DG to initiate and resource an Expert Committee to report on the alcohol control situation and progress. More than 10 years have passed since the Expert Committee on alcohol met last time. Let this be the first step – it is now time that bold steps are taken – and that resources are mobilised to support them.

Mr Øystein Bakke
Secretary
Global Alcohol Policy Alliance

26 June 2017

Distinguished delegates,

Thank you for the opportunity to deliver this statement on behalf of the NCD Alliance, a global civil society network dedicated to addressing NCDs as a health and development challenge around the world.

In 2015, 70% of global deaths were from NCDs. Many of those deaths were preventable and occurred before the age of 70. 80% of “premature” NCD deaths occur in low- and middle-income countries.

The rate of increase of NCD prevalence in LMICs is markedly pronounced, with development transitions contributing to increased exposure to risk factors for NCDs. Alcohol use is a key modifiable risk factor for multiple preventable NCDs. Around half of alcohol related deaths in 2015 were due to NCDs. Lowering alcohol consumption across populations is instrumental to lowering NCD burdens, as is reflected by the inclusion of a 10% reduction target in the Global Monitoring Framework for NCDs.

The need for increased action on alcohol control has also been highlighted by the inclusion of prevention and treatment of harmful alcohol use alongside NCDs in the Sustainable Development Goals.

Cost-effective interventions and policy options for reducing alcohol-related NCD burden, based on the Global Alcohol Strategy, are set out in Appendix III of the Global NCD Action Plan and focus on three key areas of action common across NCD risk factors: availability, pricing, and marketing policies.

And yet, as this meeting’s background documents show, implementation of these measures around the world is insufficient and highly uneven and progress will not be achieved ‘without significant further global and national commitment, investment, and coordinated action to increase regulatory and enforcement capacity’. This is an important message as WHO, Member States, other UN Agencies and civil society prepare for the 3rd High-Level Meeting on NCDs set to review progress on NCDs next year in 2018.

We wish to support the calls from Member States, who, responding to the heavy burden in their countries due to alcohol use, have in recent World Health Assemblies, requested the WHO secretariat to increase alcohol control efforts in the context of NCD prevention. Requests include the establishment of a working group on Alcohol and NCDs, consideration of the need for and feasibility of a legally binding international instrument, and calls for a review of the 2010 Global Alcohol Strategy.

Finally, we cannot discuss progress on alcohol control without addressing interference of the alcohol industry with development, implementation and enforcement of public health policy and regulation. As evidenced in research and the reported experience of Member States, alcohol industry tactics mirror those of the tobacco industry, and strategies employed by unhealthy commodity industries are similar and equally concerning across NCD risk factors.

Addressing the commercial determinants of NCDs must be a critical aspect of discussions at and in the lead up to the 2018 UN NCD High-Level Meeting, and we wish to reiterate that the alcohol industry cannot be at the table for policy development, nor should be deemed a viable development partner across the SDGs.

The sale, marketing and promotion of health harming products is at odds with achieving NCD goals and targets and the SDGs. Partnership with those profiting from the consumption of these products conflicts with goals and objectives of protecting and promoting health and development and ending poverty.

Lucy Westerman
Communications and Policy Officer
NCD Alliance

26 June 2017