1. .. Alcohol and Public Health in the Americas Maristela G. Monteiro, M.D., Ph.D. Senior Advisor on Alcohol and Substance Abuse

2. AMERICAS 2004

3. GBD 2004 IN THE AMERICAS 9.2% OF ALL DALYS IN THE REGION WERE ATTRIBUTED TO ALCOHOL: 14.2% OF ALL DALYS AMONG MEN 3.4% OF ALL DALYS AMONG WOMEN AMERICAS B AND D HAD THE HIGHEST IMPACT 16.7% OF ALL DALYS AMONG MEN 3.4% OF ALL DALYS AMONG WOMEN 347,138 DEATHS FROM ALCOHOL, 5.6% OF THE TOTAL

4. Distribution of alcohol-attributable DALYs by disease group

5. Strong links with NCDs Global distribution of all alcohol-attributable deaths by disease or injury, 2004 Causative risk factors Tobacco use Unhealt hy diets Physical inactivit y Harmful use of alcohol Non-communicable diseases Heart disease and stroke Diabetes Cancer Chronic lung disease

7. ALCOHOL MARKETING - Ecuador

10. First Pan American Conference on Alcohol Public Policies 2005 Brasilia Declaration Recommendations Preventing and reducing alcohol consumption related harms be considered a public health priority for action in all countries of the Americas Regional and national strategies be developed, incorporating culturally-appropriate evidence based approaches to reduce alcohol related harm

11. Brasilia Declaration Recommendations Strategies be supported by improved information systems and further research Creation of a regional network of national counterparts to work together Implement and evaluate policies already known to be effective Priority areas: heavy drinking occasions, overall alcohol consumption, women, indigenous peoples, youth, other vulnerable populations, violence, intentional and non- intentional injuries, underage drinking and alcohol use disorders

12. REGIONAL INITIATIVES Multicentric study on gender, alcohol, culture and harms (10 countries) PAHO-Valencia cooperation agreement on reducing alcohol problems in DOR, GUT, GUY, HON, NIC and PAN INEBRIA Latina (http://www.inebria.net/Du14/pdf/boston_2011_br ochure.pdf) Conference in Boston 21-23 September 2011http://www.inebria.net/Du14/pdf/boston_2011_br ochure.pdf Dissemination of information Regional network of national counterparts (2011) and regional plan of action (2012)

13. 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: – Reducing hours and days of sale: Brazil, Peru, Colombia, USA, Canada – Reducing drink driving: Brazil, USA, Canada, Mexico – Controlling advertising: Costa Rica – Increasing prices and taxes: USA, Canada, Venezuela – Sales to minors: USA, Canada – Brief interventions in Primary Health Care: Mexico, Canada, USA, Chile – Minimum drinking age: USA, Canada

14. Global strategy to reduce the harmful use of alcohol (2010) Developed through a long and intense collaboration between the WHO Secretariat and Member States. All important stakeholders were consulted in the process, including the industry and NGOs. Represents a unique consensus among WHO 193 Member States on ways to tackle harmful use of alcohol at all levels.

15. 10 TARGET POLICY AREAS (a) leadership, awareness and commitment (b) health services’ response (c) community action (d) drink–driving policies and countermeasures (e) availability of alcohol (f) marketing of alcoholic beverages (g) pricing policies (h) reducing the negative consequences of drinking and alcohol intoxication (i) reducing the public health impact of illicit alcohol and informally produced alcohol (j) monitoring and surveillance.

16. ANOC2

18. 950/day Preventable deaths in the Americas