1. Module 13- The Global Alcohol Strategy and regional plan of action
Part One- Alcohol Policy and Public Health
This module describes the policy response to alcohol-related problems at the regional and global levels. Here we describe the World Health Organization’s global alcohol strategy and PAHO’s regional plan of action. We also describe how to develop an action plan to address the effects of harmful alcohol use.
Module 13- The Global Alcohol Strategy and regional plan of action
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2. Learning Objectives
Upon completion of this module you will be able to:
Describe the development and adoption of the WHO global alcohol strategy
Describe the regional plan of action on alcohol
Upon completion of this module you will be able to describe the development and adoption of the WHO global alcohol strategy and the regional plan of action on alcohol.
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3. 63rd World Health Assembly (17-21 May, 2010)
Resolution WHA63.13
"Global strategy to reduce the harmful use of alcohol"
In May, 2010, the 63rd session of the World Health Assembly met in Geneva, Switzerland to deliberate on the world’s most pressing health issues. As part of their deliberations, the 193 United Nations Member States adopted a Global Strategy to Reduce the Harmful Use of Alcohol. The strategy gives guidance to both Member States and to the World Health Organization on ways to reduce the harmful effects of alcohol.
In the debate at the Assembly, delegates pointed to the global aspects of the problem and requested that alcohol problems receive a higher priority at the WHO. The main issues identified in the debate were the increasing binge drinking among young people worldwide, and the expanding influence of alcohol marketing and advertising.
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4. WHO Global Strategy (2010)
Collaboration between the WHO Secretariat and Member States
All important stake-holders were consulted, including the alcohol industry and NGO’s
Unique consensus among WHO’s 193 Member States on ways to tackle harmful use of alcohol
The Global Strategy was developed through a long collaboration between the WHO Secretariat and Member States, including PAHO.
All important stakeholders were consulted, including the alcohol industry and the major nongovernmental organizations. The Strategy represents a unique consensus among WHO’s 193 Member States on ways to tackle harmful use of alcohol.
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5. WHO Strategy Objectives
Raise global awareness and increase commitment by governments to act
Strengthen the knowledge base
Increase technical support to Member States and enhance their capacity to respond
Strengthen partnerships and coordination
Improve systems for monitoring, surveillance and information dissemination
The WHO Global Strategy has five objectives: (1) raise global awareness of the health, social and economic problems caused by alcohol, and increase commitment by governments to address the harmful use of alcohol; (2) strengthen the knowledge base on the magnitude of alcohol problems and the determinants of alcohol-related harm, as well as research on effective interventions to reduce and prevent such harm; (3) increase technical support to Member States and enhance their capacity to respond to the harmful use of alcohol and associated health conditions; (4) strengthen partnerships and provide better coordination among stakeholders. In addition, Member States should mobilize the resources required for concerted action to prevent the harmful use of alcohol; (5) improve systems for monitoring and surveillance at different levels, and more effective dissemination of information for advocacy, policy development and evaluation purposes.
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6. 10 Target Policy Areas 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
The WHO Strategy’s policy options and interventions are grouped into 10 target areas, which were identified during the consultation process. These areas should be seen as supportive and complementary: (1) Provide leadership, raise awareness and stimulate strong political will and commitment (2) Strengthen the ability of health services to respond to alcohol-related problems, not only by means of clinical response but also through advocacy. (3) Mobilize communities mobilized for action to reduce problems and support victims (4) Strengthen drink–driving policies and countermeasures, using deterrence approaches as well as measures to create a healthy driving environment (5) Regulate the public and commercial availability of alcohol (6) Reducing the impact of marketing of alcoholic beverages, especially the influence of marketing on youth (7) Promote pricing policies to reduce underage drinking and to halt progression towards drinking large volumes of alcohol and/or episodes of heavy drinking, and to influence consumers’ preferences (8) Support harm reduction approaches to reduce the negative consequences of drinking and alcohol intoxication (9) Reduce the public health impact of illegal and informal alcohol through quality control, inspection and taxation (10) Conduct monitoring and surveillance of trends in alcohol use and alcohol-related problems.
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7. Regional Plan of Action for Reducing Harmful Use of Alcohol
Implement global strategy
Technical cooperation on 10 policy areas
Regional network for alcohol and public health
The regional plan of action in the Americas includes aspects of the global strategy as well as the creation of the Pan American Network for Alcohol and Public Health, also known as PANNAPH.
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8. Regional Plan Strategic Areas
Development and implementation of national public health policies, plans, laws, and resource allocation
Strengthen public health measures among high-risk groups: homeless, prisoners, sex workers, children and adolescents, and pregnant women
Alcohol-related policies as part of general health policies, plans and laws
The following strategic areas should be covered in any action plan. Strategic Area 1: Development and implementation of national public health policies, plans, laws, and resource allocation. Strengthen public health measures among high-risk groups: homeless, prisoners, sex workers, children and adolescents, and pregnant women. Alcohol -related policies as part of general health policies, plans and laws.
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9. Regional Plan Strategic Areas cont.
Promotion of universal prevention of alcohol misuse
Promote evidence-based universal prevention models and best practices
Support social and economic development of women and young people
Strategic Area 2: Promotion of universal prevention of alcohol misuse. Promote evidence-based universal prevention models and best practices. Support social and economic development of women and young people.
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10. Regional Plan Strategic Areas cont.
Promotion of early intervention in primary care settings
Emphasize primary health care in an equitable and non-discriminative manner
Delivery of specialized treatment, outreach and mutual help programs
Provide tools for training the health work force
Promote availability of medication
Strategic Area 3: Promotion of early intervention in primary care settings. Emphasize primary health care in an equitable manner and free from discrimination. Delivery of specialized treatment, outreach, and mutual help programs. Provide tools for training the health work force. Promote availability of medication.
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11. Regional Plan Strategic Areas cont.
Research, monitoring and evaluation
Strategic Area 5:
Strategic partnerships
Strategic Area 4: Research, monitoring, and evaluation
Strategic Area 5: Strategic Partnerships
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12. Regional Situation Lack of effective policies in most countries
Powerful alcohol industry already influencing policy making and pressing to participate in the development of alcohol policies
Lack of a strong voice from civil society pressing for effective policies
The alcohol policy situation in the Latin American region can be described as follows: 1) there is a lack of effective policies in most countries, with no country serving as a model of best practice for other countries. 2) The alcohol industry is a powerful presence in alcohol policy making and has been pressing to participate in the development of alcohol policies at the regional, national and local levels. 3) There is a lack of a strong voice from civil society pressing for effective policies.
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13. Regional Situation, cont.
Lack of technical capacity and financial resources
Fear of economic impact of alcohol policies
Culture of excessive drinking, resistance from the alcohol industry and lack of health systems able to respond to alcohol problems
4) There is a need for technical capacity and financial resources at all levels to support the dissemination of effective alcohol policies. 5) The economic impact of alcohol policies is feared, even though in most cases alcohol policies save lives and money. 6) Alcohol policy in Latin America is handicapped by a culture of excessive drinking, resistance from the alcohol industry and lack of health systems able to respond to alcohol problems.
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14. Regional Situation- Policy
No country with a comprehensive policy to serve as a model to other countries
Best practices do exist and need to be expanded and better documented, particularly in Latin America and the Caribbean
Although there are no countries in the Americas with a comprehensive policy to serve as a model to other countries, best practices do exist and need to be expanded, particularly in Latin America and the Caribbean.
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15. Policy Examples
Reducing hours and days of sale: Brazil, Peru, Colombia, USA, Canada
Drink-driving countermeasures: Brazil, USA, Canada, Mexico
Controlling advertising: Costa Rica
Increasing prices and taxes: USA, Canada, Venezuela, Suriname
Sales to minors: USA, Canada, Brazil (SP)
Brief interventions in Primary Health Care: Mexico, Canada, USA, Chile, Brazil, Panama, Colombia, Dominican Republic
Increased minimum drinking age: USA, Canada
The following are examples of where progress is being made: Reducing hours and days of sale: Brazil, Peru, Colombia, USA, Canada; Drink-driving countermeasures: Brazil, USA, Canada, Mexico; Controlling advertising: Costa Rica; Increasing prices and taxes: USA, Canada, Venezuela, Suriname; Sales to minors: USA, Canada, Brazil (SP); Brief interventions in Primary Health Care: Mexico, Canada, USA, Chile, Brazil, Panama, Colombia, Dominican Republic; Increased minimum drinking age: USA, Canada
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16. Recent Developments
Chile: National alcohol policy and alcohol screening in PHC
Colombia: National alcohol policy development based on 10 target areas
Ecuador: Treatment and care for alcohol problems
Mexico: Revision of national law to better cover alcohol policies
Panama: National plan to reduce alcohol problems
Recent developments in a number of countries suggest that the WHO Global Strategy is beginning to be implemented. CHILE: national alcohol policy and alcohol screening in PHC; Colombia: national alcohol policy development based on 10 target areas; Ecuador: treatment and care for alcohol problems
Mexico: revision of national law to better cover alcohol policies; Panama: national plan to reduce alcohol problems
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17. Recent Developments cont.
Paraguay: National policy to reduce alcohol problems
Peru: New law in Lima on reduced hours of sale
Suriname: Increased import duties on liquors and wines/champagnes but not beer
Venezuela: Increased taxes and prices on alcohol based on economic studies
Paraguay: national policy to reduce alcohol problems; Peru: new law in Lima on reduced hours of sale; Suriname: increased import duties on liquors and wines/champagnes but not beer; Venezuela: increased taxes and prices on alcohol based on economic studies.
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18. These are examples of publications that are being disseminated by PAHO throughout the region in its efforts to promote evidence-based alcohol policy and to promote alcohol screening and brief intervention in primary health care.
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19. REFLECTION
Looking at the regional plan of action, which actions at the national level would you prioritize for your country?
Why?
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