1. 5th NCD Seminar 6th September 2011 Lausanne, Switzerland
The WHO global strategy to reduce the harmful use of alcohol in a national context
Mr Dag Rekve
Technical Officer
Management of Substance Abuse
Department of Mental Health and Substance Abuse
World Health Organization

2. World Health Organization
The WHO global strategy to reduce the harmful use of alcohol endorsed by the 63rd WHA resolution
12 September, 2018
12 September 2018
…the global strategy for reducing the harmful use of alcohol is a true breakthrough. 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.
Dr Margaret Chan
Director-General
World Health Organization
Closing speech at WHA63 2 2

3. Policy making
Policy
implementation

4. WHO governing structure
UN specialized agency
193 Member States
The World Health Assembly
Executive Board
HQ in Geneva
6 Regional Committees
Consensus driven
Mostly non-binding

6. WHO`s research strategy
measuring the problem;
understanding its cause(s);
elaborating solutions;
translating the solutions or evidence into policy, practice and products; and
evaluating the effectiveness of solutions.

7. Too big burden to be neglected

8. Global distribution of alcohol-attributable deaths and DALYs

9. Different perspectives
Percent of total
Risk factor

10. Distribution of alcohol-attributable male deaths (of all male deaths)

11. Critical issues
Alcohol exposure and incidence and clinical course of infectious diseases
Alcohol exposure and harms to others including FAS/FASD
Potential movements in abstention rates and changes in female drinking patterns
The positive effects of alcohol consumption and possible implications for policy decisions

12. Effective counter measures exist
Effective measures:
regulating the marketing of alcoholic beverages, (in particular to younger people);
regulating and restricting availability of alcohol;
enacting appropriate drink-driving policies;
reducing demand through taxation and pricing mechanisms;
raising awareness and support for policies;
providing accessible and affordable treatment for people with alcohol-use disorders; and
implementing screening programmes and brief interventions for hazardous and harmful use of alcohol

13. Plus numerous regional resolutions, strategies and frameworks
Important milestones
October 2002: World Health Report 2002
May 2005: WHA58.26
May 2007: WHA60
May 2008: WHA61.4
May 2010: WHA63.13
Plus numerous regional resolutions, strategies and frameworks

14. The development of the strategy
Stage I. Broad consultation process
Web-based consultation
Consultation with economic operators
Consultation with NGOs and health professionals
Consultation with UN agencies and IGOs
Stage II. Draft strategy development
Regional technical consultations with Member States (February – May 2009) in 6 WHO regions
Draft development by the Secretariat in collaboration and consultation with Member States (May – October 2009)
126th session of the Executive Board
WHA 63
ting.

15. The content of the strategy
The global strategy:
complements and supports public health policies in Member States;
gives guidance for action at all levels;
sets priority areas for global action;
contains a portfolio of policy options and measures that could be considered for implementation and adjusted as appropriate at the national level

16. WHO global strategy: Five objectives
(a) raised global awareness of the magnitude and nature of the health, social and economic problems caused by harmful use of alcohol, and increased commitment by governments to act to address the harmful use of alcohol;
(b) strengthened knowledge base on the magnitude and determinants of alcohol- related harm and on effective interventions to reduce and prevent such harm;
(c) increased technical support to, and enhanced capacity of, Member States for preventing the harmful use of alcohol and managing alcohol-use disorders and associated health conditions;
(d) strengthened partnerships and better coordination among stakeholders and increased mobilization of resources required for appropriate and concerted action to prevent the harmful use of alcohol;
(e) improved systems for monitoring and surveillance at different levels, and more effective dissemination and application of information for advocacy, policy development and evaluation purposes.

17. Achieving the objectives of the global strategy
Requires global, regional and national actions on
levels of alcohol consumption
patterns of alcohol consumption
contexts of alcohol consumption
wider social determinants of health
Special attention needs to be given to reducing harm to people other than the drinker and to populations that are at particular risk from harmful use of alcohol

18. Global strategy: recommended ten target areas for policy measures and interventions
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

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

20. WHO global counterparts network 1. meeting 8-11 February 2011

21. The role of WHO national counterparts for implementation of the global strategy
establish the working mechanisms and plans for the global network;
elaborate priority areas and implementation plans for reducing the harmful use of alcohol at the global level;
discuss priority areas and plans for implementing the global strategy at the regional level;
discuss monitoring and reporting on the implementation of the global strategy at different levels;

22. Technical support and capacity building
Implementation structures for the Global strategy to reduce harmful use of alcohol
Global network of
WHO counter-parts
WHO
Secretariat
Global level
Coordinating council
Task force on Public health advocacy and partnership
Chair of the global network
Chairs of regional networks
Chairs of task forces
WHO Secretariat
Chairs of working groups
Task force on
Technical support and capacity building
Task force on Resource mobilization
Task force on Production and dissemination of knowledge
International partners and other stakeholders
Technical working group(s) on selected target areas for national action

23. Challenges of Monitoring
Unreliable or invalid data
Incomparable data
Establishing uniform definitions
Need for historical data
Resources

24. Framework for monitoring and evaluation

25. The implementation of the global strategy to reduce the harmful use of alcohol
Strong global and regional leadership
Effective mechanisms for coordination and collaboration between all levels
Appropriate engagement of relevant stakeholders
Sufficient recourses available

27. Issues to consider in policy formulation
Replicability - can the intervention be implemented in different contexts and circumstances?
Sustainability - are the required human, technical and financial resources such that the interventions can be continued for long enough to have the desired and lasting effect?
Scalability - can the interventions be expanded to the scale required to be meaningful?
Political feasibility - can the intervention be implemented in different political circumstances, e.g., with respect to timing, values, power structure, etc.?
Economic feasibility - what are the required investments and are these reasonable? How can the finances be made available? What has to be given up by other sectors?
Technical feasibility - are the tools required to make the intervention happen available or can they be made available?

28. Level of involvement
Informing: To provide stakeholders with balanced and objective information to assist them in understanding the problem, alternatives, opportunities and/or solutions
Consulting: To obtain feedback from stakeholders on analysis, alternatives and/or decisions
Involving: To work directly with stakeholders throughout the process to ensure that public concerns and aspirations are consistently understood and considered
Collaborating: To partner with stakeholders in each aspect of the decision including the development of alternatives and the identification of the preferred solution

29. WHO`s research strategy
measuring the problem;
understanding its cause(s);
elaborating solutions;
translating the solutions or evidence into policy, practice and products; and
evaluating the effectiveness of solutions.

30. Thank you for your attention!
Exit the maze of harmful use of alcohol for better global health
Thank you for your attention!