A1262567702UYZwe

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Alcohol not an ordinary commodity

• Ranking of estimated attributable and avoidable
  burdens of 10 leading selected risk factors

• Alcohol, tobacco and nutrition has a big
  proportion of the health burden
• Global Burden
• of Disease

Together 17,6 of DALYs
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The 12 leading selected risk factors for disease
burden in developing and developed countries
High-mortality developing countries
Low-mortality developing countries
Developed countries
1 Underweight Alcohol Tobacco 2
Unsafe sex Blood pressure Blood
pressure 3 Unsafe water Tobacco
Alcohol 4 Indoor smoke
Underweight Cholesterol 5 Zinc deficiency
Body mass index Body mass
index 6 Iron deficiency
Cholesterol Low fruit veg. intake 7
Vitamin A deficiency Low fruit
veg. intake Physical inactivity 8 Blood
pressure Indoor smoke solid fuels
Illicit drugs 9 Tobacco Iron
deficiency Unsafe sex 10 Cholesterol
Unsafe water Iron deficiency 11
Alcohol Unsafe sex Lead
exposure 12 Low fruit veg. intake
Lead exposure Childhood sexual abuse
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Europe the drinking basin

• Europe is the continent where per capita alcohol
  consumption is the highest in the world.
• Indeed, 75 of EU citizens claimed to have drunk
  alcoholic beverages during the past 12 months.
• A quarter of the population (25), however,
  appear not to have consumed alcohol at all at
  least during this period.

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Men WomenEurope 90 81
Eastern
Europe 89 81
North Africa 47 27
South Africa
55 30
South East Asia 26
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Percentage of alcohol users
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Did you drink any alcoholic beverages in the last
30 days?
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Alcohol advertising targeting young people should
be banned in all EU Member States
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Selling and serving alcohol to people under the
age of 18 years should be banned in all EU Member
States
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• 2001 - 2nd WHO Ministerial Conference on Alcohol
  and Young People, Stockholm.
• Publication of report on Marketing Alcohol to
  Young People

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ONE ETHICAL PRINCIPLE FROM WHO

• All children and adolescents have the right to
  grow up in an environment protected from the
  negative consequences of alcohol consumption and,
  to the extent possible, from the promotion of
  alcoholic beverages.

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--- ! ---

• Young people in the EU are particularly at risk,
  as over 10 of female mortality and around 25 of
  male mortality in the 1529 age group is related
  to hazardous alcohol consumption

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• The harmful and hazardous consumption of alcohol
  has effects not only on those who drink, but also
  on others and on society.
• Harmful effects of alcohol tend to be greater in
  less advantaged social groups, and therefore
  contribute to inequalities in health.

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Political strategies

• Strong industry
• Trying to make the problem a personal
  responsibility instead of a public health
  perspective
• Social Aspect Organisation
• Smokers Rights Organisations
• Funding research
• Active in lobbying
• Expansion in new markets, India and China

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Why China and India?

• China the worlds biggest beer market

• Per capita consumption 2004

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Political strategies

• Research to support
• Alcohol and heart
• No connection between marketing and consumption
• Self regulation
• The alcohol industry are afraid of the same trap
  as the tobacco industry

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• Asahi Breweries, LTD.
• Bacardi-Martini
• Beam Global Spirits Wine
• Brown-Forman Corporation
• Diageo PLC
• Heineken N.V.
• InBev 
• Molson Coors
• Pernod Ricard 
• SABMiller PLC
• Scottish Newcastle

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Aspects of advertising

• Large marketing budgets
• Unacceptable campaigns and/or break codes
• 17 floors of Bangkoks tallest building
• Johnny Walker logo and the message
• Drink Dont Drive

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Have the codes worked?
1996-99
2002
Vodka Kick (UK) sponsoring Temptation Island
Strongbow beer.
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WHO Framework Convention on Tobacco Control

• Idea initiated May 1995 48th WHA
• Resolution WHA49.17 1996
• But it wasnt until 1999, a year after the then
  WHO Director-General, Dr Gro Harlem Brundtland,
  made global tobacco control a priority of WHO,
  that work on the WHO Framework Convention on
  Tobacco Control began.

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Political strategies

• Buying influence?
• Both tobacco and the alcohol industry are big
  donors to the US election campaigns
• To avoid restrictions, keep advantages,
  supporting trade agreements WTO, WHO
• Public-private partnership in WHO
• Support non profit organisations

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WHO US interest in alcohol

• a source of pressure on WHO on behalf of
  alcohol industry interests
• 1983 a study on the public health implications
  of alcohol production and trade was stopped by
  the DG to reassure the Reagan Administration
  that WHOs global health programs are in line
  with the principles of private enterprise
• Later published without note of its WHO
  connection (Cavanaugh Clairmonte 1985
  Alcoholic Beverages Dimensions of Corporate
  Power).

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Industry interest in WHO

• alcohol industry watches over WHOs activities
  with care and concern
• considerable effort by industry firms or
  social aspects organizations to influence
  WHOs alcohol programme

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WHO and Alcohol

• WHA58.26 Public Health Problems Caused by
  Harmful Use of Alcohol
• To draw up recommendations and report to the 60th
  World Health Assembly in 2007
• Two issues
• Follow up the present resolution.
• Secure a further strong WHO mandate for alcohol
  policy and strategy after 2007 Global Strategy?
• Consultations held both with industry and NGOs

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Trade treaties
World Trade Organization (WTO) Remove trade
regulations
Alcohol policy/WHO Use regulations for public
health purpose
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In Conclusion.

• Alcohol policies that increase the price of
  alcohol, limit access to alcohol beverages, alter
  the drinking environment and deter drinking and
  driving are likely to reduce alcohol related harm
  
• Implementation and enforcement of these policies
  is essential and community action is an effective
  tool

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In Conclusion

• Treatment, especially brief intervention, shows
  evidence of effectiveness, whereas educational
  approaches show none or little
• Extensive restrictions on marketing would
  probably show impacts both directly and
  indirectly