Protecting the unborn baby from alcohol 17 th September 2013 European Parliament, Brussels Brief Summary October 2013 Organised by: Hosted by: With the support of: 17 Rue Archimede I 1000 Brussels I Belgium I Tel +32 (0)2 736 05 72 I Tel +32 (0)2 736 67 82 info@eurocare.org I www.eurocare.org
ALCOHOL - A CAUSE FOR ACTION Alcohol is the world s number one risk for ill-health and premature death amongst the 25-59 year old age group, a core of the working age population and the third leading risk for burden of disease in Europe. Europeans are drinking almost the double of global average. In EU 28 the average recorded consumption of alcohol is 10,2 litres. This results in 120.000 premature deaths (1 in 7 male deaths and 1 in 13 female deaths in the age group 15-64 are related to alcohol). Alcohol is 1 of 4 risk factors for developing non communicable diseases (NCDs) such as cancer and cardiovascular disease. Alcohol harm is disproportionately high among young people and alarmingly 43% among 15-16 year old European students reported heavy binge drinking during the past 30 days and alcohol is the single biggest cause of death among young men of age 16 to 24. It is important to address alcohol in this context and give it the attention needed. Due to the size of the problem and the universal impact, alcohol requires a comprehensive, coordinated response from policy and decisions makers at the European and national levels. 2
The European Alcohol Policy Alliance (EUROCARE) is an alliance of non- governmental and public health organisations with around 55 member organisations across 24 European countries advocating the prevention and reduction of alcohol related harm in Europe. Member organisations are involved in advocacy and research, as well as in the provision of information and training on alcohol issues and the service for people whose lives are affected by alcohol problems. Eurocare was created in 1990 and has become a recognised partner in the alcohol policy field working with both the European Commission and World Health Organisation. Eurocare is a founding member of the European Alcohol and Health Forum as well as a partner in a number of European Union funded projects. Eurocare is a not for profit international organization registered in Belgium. Eurocare and its members do not receive funding from the alcohol industry. The mission of Eurocare is to promote policies to prevent and reduce alcohol related harm, through advocacy in Europe. The message, in regard to alcohol consumption is less is better. 3
Brief Summary overview of the presentations given The event was kindly hosted by MEPs Vincas Paleckis and Radvile Morkunaite-Mikuleniene from Lithuania. Eurocare was honoured by the presence and presentation of Lithuanian Vice- Minister for Health- Gediminas Cerniauskas. They keynote speech was delivered by the Commissioner for Health Tonio Borg. The meeting was chaired by Eurocare President Tiziana Codenotti. In her introduction MEP Morkunaie-Mikuleniene pointed to the lack of data on harm to the unborn baby in the EU. She also emphasised that while the EU is not responsible for health systems in Member States (MS), it still has an important role to play with regard to labelling, recommendations and data collection. The Lithuanian Vice Minister of Health, Gediminas Cerniauskas, referred to one of the priorities of the Lithuanian presidency, health as an investment. He stressed that sustainable health systems was about long term development and public health investments that are supported by science. Investments in unborn children are long-term investments that may have consequences into the XXII Century, but also in the shorter term, e.g. the health of school-aged children and the working population. 4
Researcher Diane Black, adoptive mother of three children with FAS, gave an overview of the risks associated with prenatal alcohol exposure, including retarded growth, neurological damage and brain damage. She pointed out that some recent reports on safe drinking levels during pregnancy had methodological flaws. She also argued that the idea that a safe level has not been established suggests that there is a safe level. However, if the goal is to provide optimal development for the foetus there is not flexibility in recommendations. Lars Møller from the World Health Organization presented findings from the recent WHO Status Report on Alcohol, which show declining or stable alcohol consumption in most of Europe. Nevertheless, Europe is the region in the world with the fewest abstaining women, and episodes of heavy drinking among women have increased. Alcohol policies have become stricter in recent years, however, only a minority of countries in the European region had specific activities on alcohol and pregnancy between 2009 and 2011. The prevalence of drinking during pregnancy is high in most countries. However, it also needs to be noted that data on FASD prevalence are likely to be underestimated and the true cost to the society is likely to be huge. The WHO Global Alcohol Strategy includes action points on alcohol during pregnancy, and the WHO is currently working on guidelines for substance use during pregnancy. The first step in this process is a global epidemiological prevalence study. The first results can be expected in two years time. Researcher Simona Pichini presented the Italian and Spanish experiences with alcohol talking drinking alcohol during pregnancy. She pointed to a lack of data, but identified one Italian study from a wine producing region that found a high FASD prevalence. Studies have also found significant differences in drinking during pregnancy between regions. The lowest prevalence was found in northern regions, which provide more information to pregnant women. In her recommendations she pointed out to the usage of 5
combination of questionnaires and biomarkers to detect drinking during pregnancy and biomarkers of newborn babies to detect FASD. Pierre-Yves Bello from the French Ministry of Health presented the French experience on labelling and the implementation of the warning label on alcohol containers. It was also noted that in France since 1991 there has been a ban on TV advertising of alcohol, a partial ban on radio, regulation of the content of ads, a ban on sponsoring and a requirement that all advertising must have a health message. With regards to labelling, since 2005 all units of alcohol should state that pregnant women should not drink, and a mandatory label has been in place since 2007. The implementation of this logo was accompanied by information at schools, communication campaigns, professional training etc. French authorities have measured beliefs and behaviours both in the general population and among pregnant women. 9 out of 10 women agree that being drunk is a risk to the baby, but still 30% think that some alcohol is fine. Among pregnant women 2 out of 3 know about the health warning. Among those who consume alcohol 3 out of 4 know the logo and almost all understand it. Some data indicate that consumption during pregnancy is decreasing. There has been an increase in knowledge and positive attitudes over the last ten years, but the danger to the unborn child is still largely underestimated. Fransesco Marini from the Local Health Authority of Treviso presented an idea for a European multi channel FASD prevention campaign that targets mothers as well as public at large. The campaign would be collaboration between many countries and between researchers, public authorities and businesses. 6
Health Commissioner Tonio Borg stressed that the first component of the EU Alcohol Strategy stressed the protection of children. He highlighted that the dissemination of information about FASD by Eurocare and the Estonian Temperance Alliance as important commitments under the Alcohol and Health Forum. Commissioner Borg pointed to the lack of data on the prevalence of FASD in Europe, despite the serious consequences that this condition carries. He also stressed that FASD is not just related to heavy drinking, but even lower consumption may affect the foetus. Commissioner Borg pointed out that the principle of subsidiarity means that the role of the European Commission is limited. However, the Commission can coordinate efforts on the national level, mobilize, contribute to better data and stimulate the exchange of information. Commissioner Borg also mentioned the possibility of adoption of health warnings on alcoholic drinks. There is a high level of support from EU citizens on this issue, although it has been met with some political opposition. France was the first country to require health warnings, and the alcohol industry in several countries have followed this example, although not across all EU countries and not across all beverage types. He highlighted that it is necessary for the industry puts it house in order in terms of comprehensive labelling. The EU Alcohol Strategy has recently been evaluated, and Commissioner Borg stressed that the strategy is still in force. However, there is a need to assess where concrete progress has been made and where it needs to be strengthened and amended. Presentations are available on Eurocare website: http://www.eurocare.org/media_centre/previous_eurocare_events/protecting_the_unborn_baby _from_alcohol_2013 7
This document arises from the operating grant which has received funding from the European Union in the framework of the Health Programme. 8