WHO: advocating pro-control alcohol policy worldwide

Wines & Vines, April, 2005 by Elisabeth Holmgren

While the scientific evidence on the potential lifestyle contributions of moderate alcohol consumption has increased around the globe, the World Health Organization (WHO) is continuously highlighting tremendous social concerns of both excessive and moderate consumption. In fact, WHO is working with member countries around the world, including the United States, to introduce policy solutions that are intended to reduce alcohol-related problems. Most recently, WHO's Global Status Report on alcohol policy is "intended to be a response to alcohol-related harm in the interest of public health and social well-being."

The WHO approach reflects recommendations for policy implementation by the 51 countries that have signed the charter, and therefore we can anticipate the continuation of pro-control alcohol policy debate here and abroad. In fact, the WHO Status Report will serve as a resource for member states that are "seeking ways to formulate and implement evidence-based and cost-effective measures to reduce the burden associated with alcohol consumption that are culturally and legally appropriate." The following outlines key messages of the nearly 300-page Global Status Report.

WHO's Outline Of Global Burden

WHO rarely addresses the fact that many people enjoy moderation as part of a well-balanced and enjoyable lifestyle, but rather, emphasizes the social consequences associated with abuse. In fact, WHO features its estimate that of about 2 billion people worldwide who consume alcoholic beverages, 76.3 million have been diagnosed with alcohol use disorders. According to its ongoing analysis, alcohol consumption causes 3.2% of deaths (1.8 million) and 4% of the Disability-Adjusted Life Years lost (58.3 million) globally. Overall, WHO outlines causal relationships between alcohol consumption and more than 60 types of disease and injury. It writes, "Alcohol consumption is the leading risk factor for disease burden in low mortality developing countries, and the third largest risk factor in developed countries."

Furthermore, the report states that on a population level, alcohol-related harm is not confined to the relatively small number of heavy drinkers or people diagnosed with alcohol use disorders. Even nondrinkers can become victims of alcohol-related aggression, for example. Specifically, the report concludes, "Light and moderate drinkers, i.e. the majority of the population in many countries, who occasionally drink at high risk levels, while being individually responsible for fewer harms than heavy drinkers, are collectively responsible, due to their greater numbers, for the largest share of alcohol's burden on society."

Potential Burden Of Use And Abuse

WHO asserts that the growing recognition that "alcohol consumption is a significant contributor to the global burden of disease" means that alcohol requires greater attention by the public health community than it is receiving at present. Specifically, the report calls for appropriate policy responses to "address the various health and social problems associated with use of and dependence on alcohol."

Recommended Alcohol Policy

WHO explains that alcohol policy is intended to reduce social harm and suggests that "government measures to control supply and demand, minimize harm and promote public health" are part of this important public health goal. Suggested alcohol policies can be grouped as:

1. Population-based policies that can shape drinking behavior across the whole population, e.g. taxation, availability restrictions, minimum drinking age

2. Policies targeted at particular problems, such as drinking and driving or sales to minors

3. Policies to help individual drinkers, such as brief interventions or rehabilitation programs

The Global Status Report on alcohol policies claims that individual policies are less likely to impact drinking and alcohol-related harm than several policies working together. To be effective, the report elaborates, alcohol policy should include regulatory and other environmental supports that promote the health of the population as a whole. It is explained that alcohol policy, i.e. measures by government to control supply and demand, minimize alcohol-related harm and promote public health, is among the most important strategies.

Evidence For Control Of Consumption Theories

WHO suggests that with the wealth of scientific evidence currently available, decision-makers are now better placed to make informed public policy choices. According to the status report, the following basic conclusions can be drawn from a review of the research:

* Alcohol problems are highly correlated with per capita consumption; thus, reductions in per capita consumption reduce alcohol problems.

* The greatest amount of evidence with regard to public policy has been accumulated on the price-sensitivity of alcoholic beverage sales, suggesting that alcoholic beverage demand is responsive to price movements, so that as price increases, demand declines and vice versa.

* Heavy drinkers have been shown to be affected by policy measures, including price, availability and alcohol regulation.