FORUT contributes in WHO online survey

The magnitude of health related problems related to alcohol consumptionAs a development agency with 25 years of activities in Asia and Africa, FORUT has experienced that alcohol constitutes a double-sided problem in the developing world: On one hand drinking is a severe and additional burden to the poor under underprivileged. On the other hand we see new drinking habits and increasing consumption levels among a growing middle-class in a number of countries. Robin Room et al, in the report “Alcohol in Developing Societies”, points out this important dilemma: “As development occurs, alcohol consumption and resulting problems are likely to rise with increasing incomes.” This is a challenge for public health and development agencies much more so when the multinational drinks industry has realized the same and sees the developing world as their “emerging markets”.

The overall picture of global alcohol-related harm has been very well described and documented by WHO and its experts, eg in the World Health Report 2002. The WHO sponsored study “Alcohol - No Ordinary Commodity” gives good guidance to the understanding of the mechanisms behind the problem and how to take effective action to prevent alcohol-related harm. It is essential that the total consumption approach in this study (and in other key documents) is used as the basis for action, both at national level and by the WHO.

The above mentioned documents give a detailed, realistic and alarming picture of the impact of alcohol consumption on a global scale. As such, we have the necessary basis for taking action, from governments and from NGOs, as well as from WHO and other international organizations.


Effective interventions to reduce health problems related to alcohol consumption:

Our experiences show that the most effective intervention against alcohol related problems is policy control measures, as documented both by Room et. al. and by Babor et. al. mentioned above. This must form the basis for actions by the WHO, as well as for governments and NGOs.
In our strategies we also recommend that control policies are supplemented, but not replaced, with other types of interventions:

• Education and awareness raising;
• Community-based activities involving schools, parents, local government, police, health workers etc;
• Strengthening civil society and mobilizing people through non-governmental organizations;
• Training children and youth in life-skills and giving youth social training;
• Alcohol and drug free leisure time activities

A systematic and evidence-based approach, in particular for developing societies, is described in the FORUT publication “Strategies to Address Alcohol Problems” by Professor Diyanath Samarasinghe, University of Colombo. Even if the examples in this book are drawn from a Sri Lankan background, the thinking and methodology is highly relevant in any country or culture.

Policies and strategies must be based on the evidence and documentation collected by the independent and international alcohol research community and must be formulated by public health and social interest alone, without the interference of the drinks industry with their double agendas.

For WHO we suggest the following:

• Increased research on alcohol in developing societies: hiv/aids, poverty, domestic violence, disaster and conflict situations, the situation of children and women, etc.
• Initiate a closer collaboration between the WHO and other UN agencies that are involved in the above mentioned problems.
• Establish an international structure/agency that can support developing countries, and other governments, in implementing effective strategies against alcohol-related harm.
• Start a process towards removing alcohol products from the international trade treaties under the World Trade Organization (WTO) and transfer the responsibility for alcohol control to the WHO.
• Adoption of an alcohol strategy (or a similar document) at the World Health Assembly in 2007, as a follow-up of the WHA resolution 58.26.

Additional comments

Alcohol and poverty:
Poor people around the globe are vulnerable even to small changes destabilising their daily hand to mouth economy. For those living under harsh circumstances with few possibilities for relaxation, alcohol may seem an easy way out. This is also along the lines of the image portrayed by the alcohol producers – a taste of luxury, recreation and the world beyond everyday worries. But the social, economic, health and other problems created by alcohol use are rather additional burdens for poor people.

Social aspects of alcohol-related harm
In addition to health problems, excessive drinking, drunken behaviour and addiction have a large number of social consequences. Families often carry the burden of alcohol abuse by men. Domestic violence, broken families, neglected children, accidents, a bread winner failing to bring income to the family and money spent on booze instead of food, children’s schooling and other essentials are among the factors involved. Risky sexual behaviour is often under the influence of alcohol (or illegal drugs), and this contributes to the spreading of hiv/aids which has dramatic social consequences in certain regions.

The drinks industry – a driving force behind increased consumption
The saturation of markets for alcohol in the West combined with a higher industry concentration and increased market power, has led to the expansion of the international alcohol industry in new markets in Africa, Asia and Latin-America. The drinks industry has been going through a period of restructuring. New alliances, fewer and bigger companies are the result. The market power of these companies can sometimes spill over into political power and give them a position to advise and influence the legislation.

It is essential that governments, public health institutions and NGOs do not give the alcohol industry recognition as partners in the formulation of national prevention policies. Their first loyalty lies with the shareholders profit and deviate from public health interest. Thus their perspectives are emerging markets to be conquered, new population segments to become alcohol consumers, increasing sales, more effective marketing methods and messages etc. This is particularly a problem in developing countries.