1. World Health Organization
Alcohol and NCD
7 May 2018
Dr Vladimir Poznyak
Coordinator, Management of Substance Abuse

2. World Health Organization
7 May 2018
Leading causes of attributable global mortality and burden of disease, 2004
Attributable Mortality
Attributable DALYs %
High blood pressure
Tobacco use 8.7
High blood glucose
Physical inactivity
Overweight and obesity
High cholesterol
Unsafe sex
Alcohol use 3.8
Childhood underweight
Indoor smoke from solid fuels 3.3
59 million total global deaths in 2004 %
Childhood underweight 5.9
Unsafe sex 4.6
Alcohol use 4.5
Unsafe water, sanitation, hygiene 4.2
High blood pressure 3.7
Tobacco use 3.7
Suboptimal breastfeeding 2.9
High blood glucose 2.7
Indoor smoke from solid fuels 2.7
Overweight and obesity 2.3
1.5 billion total global DALYs in 2004

3. World Health Organization
7 May 2018
Percentage of disability-adjusted life years (DALYs) attributed to 19 leading risk factors, by country income level, 2004

4. Division by disease or injury of alcohol attributable deaths in the world for the year 2004

5. Alcohol attributable fractions (%) for DALYs of different diseases and injuries in the world in 2004

6. Dose-response relationship between alcohol consumption and the risk of coronary heart disease (Corrao et al, Preventive Medicine, 2004, 38, 5, )

7. PAF (%) for alcohol consumption as a risk factor to cancers worldwide (Danaei et al, Lancet, 2005; 366: 1784–93)

8. Odds Ratios for Esophageal Cancer at Different Amounts of Alcohol Consumption in Relation to the Flushing Response (Brooks et al, 2009, PLoS Med 6(3): e )

9. Global burden of disease (DALYs in 000) attributable to alcohol in 2002 (WHO, 2007)
Diseases and injuries …
Cancer
Neuropsychiatr. disorders
Cardio-vascular diseases
"Beneficial effects" for CVD
"Beneficial effects" for diabetes mellitus
Women
1460
3722
887
-1205
-86
Men
4593
19393
5711
-834
-225
Total
6054
23115
6598
-2309
-312
% of alcohol-attributable burden
9,0
34,3
9,8
93.3
6.7

10. Sixty-First World Health Assembly (2008) resolution "Strategies to reduce the harmful use of alcohol"
Calling upon WHO to produce a draft global strategy to reduce the harmful use of alcohol.

11. Proposed policy options (WHO, 2008, 2009)
World Health Organization
Proposed policy options (WHO, 2008, 2009)
7 May 2018
An array of strategies and policy options can be implemented at various levels according to priorities, problems and needs
Policies and strategies should address:
Levels
Patterns
Context of alcohol consumption
Combination of measures that could be recommended to Member States that target:
Population at large
Vulnerable groups such as young people and pregnant women
Affected individuals
Specific problems such as drink-driving and alcohol-related violence.

12. Target areas for policy options for Member States
Leadership, awareness and commitment
Health services' response
Community action
Drink-driving policies and countermeasures
Availability of alcohol
Marketing of alcoholic beverages
Pricing policies
Reducing the negative consequences of drinking and alcohol intoxication
Reducing the public health impact of illicit alcohol and informally produced alcohol
Monitoring and surveillance

13. Health services' response
World Health Organization
Health services' response
7 May 2018
Prevention, treatment and care for alcohol use disorders and co- morbid conditions
Supporting initiatives for screening and brief interventions for hazardous and harmful drinking at primary care and other settings
Development and effective coordination of integrated and/or linked prevention, treatment and care strategies and services for alcohol use disorders and co-morbid conditions …
Establishing and maintaining a system of registration and monitoring of alcohol-attributable morbidity and mortality, wit hregular reporting mechanisms

14. Global action: key components
Public health advocacy and partnership
Technical support and capacity building
Production and dissemination of knowledge
Resource mobilization