WHO GLOBAL ALCOHOL STRATEGY Maristela G. Monteiro, M.D., Ph.D.

1. . . WHO GLOBAL ALCOHOL STRATEGY Maristela G. Monteiro, M.D., Ph.D. Senior Advisor on Alcohol and Substance Abuse

2. 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

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

4. Sixty-First World Health Assembly (2008) resolution "Strategies to reduce the harmful use of alcohol" 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.

5. 2013 2010 2008 2002 2007 Context of a process towards a global strategy to reduce harmful use of alcohol WHA58 resolution "Public health problems caused by harmful use of alcohol" WHA61.4 resolution "Strategies to reduce the harmful use of alcohol" Action Plan for the Global strategy on noncommunicable diseases World Health Report 2002 2003 2006 2005 WHO Expert Committee on Problems Related to Alcohol Consumption Global strategy on harmful use of alcohol Development of regional strategies in WPRO, SEARO (existing in EURO) Global Survey on Alcohol and Health and ATLAS survey on PTR for SUD FCTC

6. 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 IGOs Stage 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

7. 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

8. Effective 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 Effective counter measures exist

9. Strong links with NCDs Global distribution of all alcohol-attributable deaths by disease or injury, 2004

10. 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.

11. 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.

12. 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.

13. 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

14. Policy making Policy implementation

15. Global level Global network of WHO counter-parts WHO Secretariat International partners and other stakeholders Coordinating council Chair of the global network Chairs of regional networks WHO Secretariat Chairs of task forces Chairs of working groups Task force on Public health advocacy and partnership Task force on Technical support and capacity building Task force on Production and dissemination of knowledge Task force on Resource mobilization Technical working group(s) on selected target areas for national action Implementation structures for the Global strategy to reduce harmful use of alcohol