Year : 2012 | Volume
: 135 | Issue : 2 | Page : 261--263
Global strategy to reduce the harmful use of alcohol
Rajat Ray, PK Anish
National Drug Dependence, Treatment Centre, All India Institute of Medical Sciences, New Delhi 110 029, India
National Drug Dependence, Treatment Centre, All India Institute of Medical Sciences, New Delhi 110 029
|How to cite this article:|
Ray R, Anish P K. Global strategy to reduce the harmful use of alcohol.Indian J Med Res 2012;135:261-263
|How to cite this URL:|
Ray R, Anish P K. Global strategy to reduce the harmful use of alcohol. Indian J Med Res [serial online] 2012 [cited 2020 Jan 28 ];135:261-263
Available from: http://www.ijmr.org.in/text.asp?2012/135/2/261/94224
Global strategy to reduce the harmful use of alcohol (World Health Organization, Geneva) 2010. 38 pages. Price: US$ 15.00; in developing countries: CHF/US$ 10.50
Alcohol is the third leading risk factor for poor health globally. The Sixty-third World Health Assembly (May 2010), building on several strategic initiatives in the past, has attempted building the final global strategy. The 193 Member States of WHO reached at a historical consensus to endorse this global strategy. This WHO document lays out in considerable detail the proposed strategies and interventions under various subsections. The sections viz. Setting the scene, Challenges and opportunities, Aims and objectives, Guiding principles, National policies and measures, Policy options and interventions, Global action: key role and components, and Implementing the strategy are described in a comprehensive manner. Finally, various World Health Assembly Resolutions related to this topic are listed as annexes (I-IV). Evidence for the effectiveness of various interventions is also briefly touched upon.
In the foreword, Dr Ala Alwan, Assistant Director-General, states that the efforts to reduce harmful use of alcohol is more of a developmental issue rather than just a public health issue, especially in developing countries. There is a need to link harmful use of alcohol with socio-economic development. Most of the sections outline the objectives, guiding principles, various areas of interventions and resource mobilization.
The challenge that interventions being perceived as reducing government revenue, employment opportunities, free trade and consumer choice has been addressed. Along with the broad aims of the document that strive to improve health and social outcomes by guidance and complementation of public health policies of Member States, there is also a break down into tangible objectives involving strengthening knowledge base and systems of surveillance along with technical support, global partnerships and co-ordination among various stake holders.
At the policy level, it is suggested that national action should address the 10 recommended areas and establish or appoint a main institute or agency with the responsibility of following up on policies along with co-ordination with other relevant sectors and levels of governments. In terms of health services, capacity building to provide universal access to a wide umbrella of well co-ordinated culturally sensitive services and interventions is recommended. Community action, drink driving policies and countermeasures, and a number of deterrent law enforcements are suggested. To control the availability of alcohol, establishing an appropriate system to regulate production, wholesale distribution and serving alcohol, establishing a minimum age for consumption and prevention of sales to intoxicated persons would help. To challenge the increasingly sophisticated alcohol advertising and promotion techniques, setting up of regulatory frameworks preferably with a legislative basis is advised. Among pricing policies, interventions like establishing a system for specific domestic taxation with an effective enforcement system and restricting price promotions are recommended among others. The risk of stringent pricing policies favourably impacting a thriving illicit market has to be kept in mind. The need to regulate drinking context, reducing the alcohol strength in different beverages, etc. are discussed under measures to reduce the negative consequences of intoxication. Various measures for effective monitoring and surveillance have also been described.
In this monograph WHO pledges to provide leadership, strengthen advocacy, collaborate with Member States to develop evidence based policy options, promote networking and exchange of experience among countries. It will collaborate with other major partners in the United Nations system, intergovernmental organizations, civil society, research institutions and professional associations, economic operators in alcohol production and trade and the media. WHO will provide guidance and technical tools for capacity building with particular focus on low to middle income countries. WHO also intends to further expand and consolidate information in the area through developing appropriate data collection mechanisms and enhancing collaboration.
Overall 'Global strategy to reduce harmful use of alcohol' has succeeded in comprehensively laying out the issues and possible approaches that will be critical in all the public health efforts to address the harmful use of alcohol. There is enough leeway for Member States and local bodies to modify and re-adjust these strategies according to specific cultural and socio-economical needs. The disparities between developing and developed countries in terms of available evidence for interventions, infrastructure, resources, etc. has been kept in mind and particular focus has been assured to address these issues with due respect to regional initiatives. Preventive aspects have been stressed adequately with initiatives involving the youth.
It is evident that all interventions and strategies mentioned in this document have a strong evidence base. But emphasis could have been added to those strategies that have been found to be more effective compared to others.
Some of the issues that have not been addressed are how to deal with the stigma related to alcohol, seeking treatment, barriers to treatment and work place intervention. Among various health services' strategies, initiatives need to be undertaken to address the negative perceptions of various health care professionals and motivate them to actively look out for alcohol use disorders along with appropriate provisions in trauma centres and emergency rooms.
Even though the document stresses the importance of giving individual Member States the flexibility to develop their own policies depending on local public health needs, a much more clear strategy is required regarding how it will approach conflicts with international trade agreements and commitments. Despite freedom to pursue measures to protect public health, clauses about excluding 'unjustifiable discrimination' and 'disguised restrictions to trade' may lead to subjective interpretations depending on the perspectives of conflicting stakeholders.
In conclusion, this document is successful in laying the foundation to develop a comprehensive menu of policy options and strategies to address the issue of harmful use of alcohol. Most importantly, it should provide the necessary momentum for all of us to move forward in the endeavour to effectively address the myriad social, economical and public health issues emanating from alcohol use disorders. Follow up action by the individual Member States is the need of the hour.