.

.

WHO GLOBAL ALCOHOL STRATEGY

Maristela G. Monteiro, M.D., Ph.D.Senior Advisor on Alcohol and Substance

Abuse

World Health Assembly resolutions addressing alcohol-related public health

problems• 1979: Development of the WHO Programme

on alcohol related problems• 1983: Alcohol consumption and related

problems• 1986: Prevention of mental, neurological and

psychosocial problems• 1989: Prevention and control of drug and

alcohol abuse• 2002: Mental health• 2004: Health promotion and healthy lifestyles• 2005 (58th WHA): Public health problems

caused by harmful use of alcohol

• WHA58 (May 2005): Resolution "Public health problems caused by harmful use of alcohol".

• WHA60 (May 2007): Report of the Secretariat on strategies to reduce harmful use of alcohol with global assessment of public health problems caused by harmful use of alcohol and discussions on the draft resolution. Resolution on a global strategy for lack of consensus- consultation process put in place.

• Informal consultation (December 2007) with Member States on strategies on reduce harmful use of alcohol – 9 policy areas for action identified.

• EB122 (January 2008): Considered a report from the Secretariat and the draft resolution calling for a global strategy to reduce the harmful use of alcohol.

Process leading to the resolution of alcohol at the World Health Assembly 2008

After noting that they had not reached a consensus last year, delegates adopted a resolution calling upon WHO to produce a draft global strategy to reduce the harmful use of alcohol.

Sixty-First World Health Assembly (2008) resolution "Strategies to reduce the

harmful use of alcohol"

Context of a process towards a global strategy to reduce harmful use of alcohol

Action Plan for the Global strategy on

noncommunicable diseases

WHA58 resolution "Public health

problems caused by harmful use of

alcohol"

Global strategy on harmful use

of alcohol

2007 2002 2005 2006 2013

Development of regional strategies in WPRO, SEARO

(existing in EURO)

World Health Report 2002

WHO Expert Committee on

Problems Related to Alcohol

Consumption

2008 2010 2003

FCTC

WHA61.4 resolution

"Strategies to reduce the

harmful use of alcohol"

Global Survey on Alcohol and

Healthand ATLAS

survey on PTR for SUD

The development of the strategy

Stage I. Broad consultation process • Web-based consultation• Consultation with economic operators• Consultation with NGOs and health

professionals• Consultation with UN agencies and

IGOsStage II. Draft strategy development • Regional technical consultations with

Member States (February – May 2009) in 6 WHO regions

• Draft development by the Secretariat in collaboration and consultation with Member States (May – October 2009)

• 126th session of the Executive Board• WHA 63

The content of the strategy

The global strategy: – complements and supports public

health policies in Member States;– gives guidance for action at all

levels; – sets priority areas for global

action; – contains a portfolio of policy

options and measures that could be considered for implementation and adjusted as appropriate at the national level

Effective counter measures existEffective measures:• regulating the marketing of alcoholic

beverages, (in particular to younger people);

• regulating and restricting availability of alcohol;

• enacting appropriate drink-driving policies;

• reducing demand through taxation and pricing mechanisms;

• raising awareness and support for policies;

• providing accessible and affordable treatment for people with alcohol-use disorders; and

• implementing screening programmes and brief interventions for hazardous and harmful use of alcohol

Strong links with NCDs

Global distribution of all alcohol-attributable deaths by disease or injury, 2004

Causative risk factors

Tobacco use

Unhealthy diets

Physical inactivity

Harmful use of alcohol

Non-com

municable diseases

Heart disease and stroke Diabetes Cancer Chronic lung disease

5 STRATEGIC OBJECTIVES

• Raised global awareness of the magnitude and nature of the health, social and economic problems caused by harmful use of alcohol, and increased commitment by governments to act to address the harmful use of alcohol;

• Strengthened knowledge base on the magnitude and determinants of alcohol-related harm and on effective interventions to reduce and prevent such harm;

• Increased technical support to, and enhanced capacity of Member States for preventing the harmful use of alcohol and managing alcohol-use disorders and associated health conditions;

• Strengthened partnerships and better coordination among stakeholders and increased mobilization of resources required for appropriate and concerted action to prevent the harmful use of alcohol;

• Improved systems for monitoring and surveillance at different levels, and more effective dissemination and application of information for advocacy, policy development and evaluation purposes.

Guiding principles• Public health interest and evidence based• Policies should be equitable and sensitive to national, religious and

cultural contexts.• All involved parties have the responsibility to act in ways that do not

undermine the implementation of public policies and interventions to prevent and reduce harmful use of alcohol.

• Public health should be given proper deference in relation to competing interests and approaches that support that direction should be promoted.

• Protection of populations at high risk of alcohol-attributable harm and those exposed to the effects of harmful drinking by others should be an integral part of policies addressing the harmful use of alcohol.

• Individuals and families affected by the harmful use of alcohol should have access to affordable and effective prevention and care services.

• Children, teenagers and adults who choose not to drink alcohol beverages have the right to be supported in their non-drinking behavior and protected from pressures to drink.

• Public policies and interventions to prevent and reduce alcohol-related harm should encompass all alcoholic beverages and surrogate alcohol.

10 TARGET AREAS• (a) leadership, awareness and commitment• (b) health services’ response• (c) community action• (d) drink–driving policies and countermeasures• (e) availability of alcohol• (f) marketing of alcoholic beverages• (g) pricing policies• (h) reducing the negative consequences of drinking

and alcohol intoxication• (i) reducing the public health impact of illicit alcohol

and informally produced alcohol1• (j) monitoring and surveillance.

The implementation of the global strategy to reduce the harmful use of

alcohol• Strong global and

regional leadership• Effective mechanisms for

coordination and collaboration between all levels

• Appropriate engagement of relevant stakeholders

• Sufficient resources available

Policy making

Policy implementation

Implementation structures for the Global strategy to reduce harmful use of alcohol

Global network of

WHO counter-parts

WHOSecretariat

Global level

Coordinating council

Task force on Public health advocacy and partnership

Chair of the global

network

Chairs of regional networks

Chairs of task forces

WHO Secretariat

Chairs of working groups

Task force on Technical support

and capacity building

Task force on Resource

mobilization

Task force on Production and

dissemination of knowledge

International partners and other

stakeholders

Technical working group(s) on

selected target areas for national

action