Alcohol in a global perspective:
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1 Alcohol in a global perspective: World Health Organization initiatives to reduce alcohol related harm Department of Mental Health and Substance Abuse Rome, 12 April 2007
2 Harmful use of alcohol Public health consequences Contributing factors Policy responses
3 Leading 12 selected risk factors as causes of disease burden (WHO, 2002) High Mortality Developing Countries = Major NCD risk factors 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 Source: World Health Report 2002 World Health Organization
4 Contributing factors
5 Reasons to drink As psychoactive substances; change mood As intoxicants; escape sober reality. As liquids; quench thirst. As sources of calories; foodstuffs. Dependence creates its own demand The different alcoholic beverages also carry a wide variety of symbolic meanings, positive and negative.
6 Who is at risk? Public-health concepts and general theories of vulnerability apply to harmful use of alcohol Various risk and protective factors have been identified Much alcohol is drunk either in high-risk situations or on heavy-drinking occasions, or both. And alcohol is a psychoactive dependence producing substance.
7 Contributing factors Upstream and downstream determinants Alcohol has very little to do with alcohol related problems Alcohol exposure per se Alcohol has a lot to do with alcohol related problems The focus shapes the policy response
8 Policy responses
9 Different levels for policy action (Personal) Community Regional (sub-national) National Sub-regional Regional Global
10 Effective interventions regulating the marketing of alcoholic beverages, regulating and restricting the availability of alcohol; enactment of appropriate drink-driving policies; reducing the demand through taxation and pricing; raising awareness and support for policies; Risk reduction interventions at point of sale/consumption; providing easily accessible and affordable treatment; implementing screening programmes and brief interventions against hazardous and harmful use of alcohol.
11 Specific considerations Need for champions and enablers? Who are the key stakeholders and their power relations? What are the side effects and are they important?
12 The Italian scene Sub-national, national and sub-regional developments in Europe Commission Communication on an EU strategy on alcohol Framework for alcohol policy in the WHO European Region Global developments in WHO Developments in other regions which can feed into the European and Italian agenda
13 WHO governing structure UN specialized agency 193 Member States The World Health Assembly Executive Board 6 Regional Committees Consensus driven Mostly non-binding
14
15 EAAP
16 EAAP
17 Framework for alcohol policy
18 Previous resolutions in the World Health Assembly (WHA) 1979: Development of the WHO Programme on alcohol related problems 1983: Alcohol consumption and related problems : Very little political activity (except for Europe) 2004: Health promotion and healthy lifestyles
19 WHA Resolution "Public-health problems caused by harmful use of alcohol" Initiated by a group of European countries Co-sponsored by more than 50 countries Adopted by all Member States after several rounds of discussions
20 WHO Secretariat Priority Areas for Implementation of the WHA Resolution Assessment of public health problems caused by harmful use of alcohol Reviewing evidence and developing recommendations on effective strategies and interventions Developing global and regional information systems on alcohol Collaboration with relevant stakeholders Constructing an appropriate framework for global activities to reduce alcohol-related harm Providing support to countries and regions
21 Progress in WHO Regions since adoption of the WHA resolution EURO: Framework for Alcohol Policy in the WHO European Region resolution adopted by the Regional Committee for Europe, 2005 AMRO: First Pan American Conference on Alcohol Public Policies, 2005 AFRO: Technical consultation on public health problems caused by harmful use of alcohol, May 2006 SEARO: Resolution on public health problems caused by harmful use of alcohol adopted and policy document endorsed by the Regional Committee, August 2006 EMRO: Resolution adopted by the Regional Committee (2006) WPRO: Regional strategy developed and endorsed by the Regional Committee (September 2006)
22 WHA60 in May Effective interventions and strategies to reduce alcohol related harm on the agenda Secretariat report on the item with a comprehensive assessment of public health problems caused by harmful use of alcohol. The deliberations among MS will decide the future for global alcohol policy development.
23 Different levels for policy action (Personal) Community Regional (sub-national) National Sub-regional Regional Global
24 More information WHO HQ: WHO Regional Office for Europe:
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