As the summer is coming to an end and we enter into another intense and exciting autumn  period – with the outstanding highlight being IOGT International’s 68th World Congress – I reflect about the developments in terms of alcohol policy. There are many encouraging examples from around the world, where governments take responsibility for protecting their people from alcohol harm.

A lot is happening around the world and I think it is because there is more and more evidence available to the decision-makers, civil society and research community are finding effective ways to communicate research findings and high-impact solutions to alcohol harm. So, here is a little selection (since the end of last year’s summer) of alcohol policy developments from around the world.

Burundi – growing momentum for alcohol policy

In Burundi, alcohol policy advocates celebrated victory when the government through the Ministry of Trade banned the packing of alcohol in small plastic bags known as sachets.

Due to their low prices and high alcohol content – up to 40% – the sachets were easily accessible to young people and therefore very popular. As a result they were wreaking havoc in Burundi leading various groups to petition the government for their withdrawal from the market. The government’s response is laudable.

Unfortunately the alcohol industry in Burundi has co-opted some Civil Society Organizations to work with them in promotion of so called “responsible” alcohol use.

However, alcohol policy advocacy efforts remain on course. Advocates engaged members of parliament, civil society and representatives of various government ministries in a workshop to reflect on the need for a national alcohol policy. This meeting is hoped to be the first of many in a process that will deliver a policy.

Cheaper beer in Denmark – How many lives will be lost?

The Danish government cut the beer tax by 15% on the 1 July and made alcohol more affordable for not only its own population, but also the neighboring countries like Sweden and Norway (that have higher taxes).

In 2004 Finland cut the tax by 33% and consumption increased by 10%. This led to increase in alcohol related harm, not only for the alcohol user, but also the children and innocent bystanders. It has been reported that alcohol related deaths increased by 23%.

The issue of alcohol excise duties would be best addressed at the European Union level, as countries are often affected by interventions beyond its powers to control.

In the EU current minimum excise duties have not been changed since 1992, meaning that their real value has decreased approximately one third because of inflation. Back in 2006 the European Commission had made a proposal to adjust minimum levels for inflation. At that time unanimity was not obtained and the proposal remains ‘still on the table’ in the Council.

Kenya – growing momentum for alcohol policy

In Kenya an alcohol policy campaigner was appointed as Chairman of NACADA, the National Campaign Against Drug Abuse Authority.

John Mututho, the former Member of Parliament (MP) who tabled a private members bill that became the landmark Alcoholic Drinks Control Act 2010, was controversially appointed to head NACADA, the National Campaign Against Drug Abuse Authority.

Mr. Mututho was first appointed through a gazette notice in September but his appointment was revoked less than a month later following recommendations by the National Security and Administration Parliamentary Committee. Its decision was informed by pending criminal and civil cases against Mr. Mututho, though it was rumored that the revocation was due to lobbying by the alcohol industry. Mr Mututho was however reinstated when MP’s voted against the committee’s decision saying he was a passionate crusader against alcohol harm.

History was made when in Kenya for the first time ever, civil society organizations received funds from the Alcoholic Drinks Control Fund. The fund which was established by the Alcoholic Drinks Control Act (2010) provides that 15% of the proceeds from licenses fees obtained from production and sale of alcoholic beverages should be used to fund civil society programs covering the areas of alcohol research, documentation, prevention education and rehabilitation of alcoholics.

Still in Kenya efforts to curb driving under the influence and road accidents saw the reintroduction of the breath alcohol content measuring device “Alcoblow”.  The devices were introduced through legal notice number 138 of October 2011, following a High Court suspension after motorists raised concerns over hygiene and the risk of disease.

In spite of fierce opposition from some sectors of the public, the National Transport and Safety Authority (NTSA) working collaboratively with the Ministry of Transport are keen on stemming the more than 6,000 road accidents and over 3,000 fatalities recorded in 2013. The new devices include a disposable mouth piece to address hygiene concerns.

Sri Lanka: Trend Continues: More Lankese Choose Alcohol Free, shows research by ADIC.

ADIC research shows the positive impact of Sri Lanka’s alcohol legislation: The majority of people in Sri Lanka chooses to live alcohol free and the trend shows that alcohol consumption is declining. But those who want to quit using need better support and more alcohol free environments. And decision-makers need protection from aggressive lobbying by the alcohol industry.

Tanzania – growing momentum for alcohol policy

In Tanzania, the Tanzania Alcohol Network (TAANET) is campaigning for the Ministry of Health to designate a national No Alcohol Day. This day would raise the profile of the health, social and economic harms caused by alcohol and serve to build public and political support for alcohol policies.

Also in Tanzania, various aspects of alcohol were explored during the Tanzania Public Health Association’s (TPHA) 30th Annual Scientific Meeting and Annual general Meeting. Out of the 55 papers presented 5 were on alcohol.

The presentations included papers on the Alcohol Situational Assessment study that covered prevalence rates of alcohol consumption across rural and urban areas in Burundi, Kenya and Tanzania.

This five-day meeting was held under the theme, “An Intersectoral Approach to Addressing Social Determinants of Health in Tanzania, Closing the Health Inequality Gaps.”

The increase of research papers on alcohol at such meetings is an important indicator of the growing interest in the subject, an opportunity for advocacy and it generates evidence that can be used to advocate for policies.

Great strides towards gaining political support for alcohol policy and legislation were made during several meetings held between alcohol policy advocates and law makers in the Tanzanian capital Dodoma. Among the achievements made during these meetings were the formation of an alcohol concern group that will work jointly with alcohol experts, to identify issues and gaps in policy and legislation which need review. An action plan to guide the efforts of this group was also developed.

The alcohol policy advocates also reached a consensus with the policy makers on the urgent need to ban alcohol in plastic sachets.  This would make Tanzania the third East African country to enforce a similar ban after Kenya and Burundi, with Uganda hot on their heels. Such a move would lend great momentum to the alcohol policy movement in East Africa. An actual ban is anticipated in 2014.

Reduction of alcohol related harm among global WHO targets to improve health

WHO Member States have agreed on the first ever global monitoring framework to prevent and reduce Non-communicable diseases (NCDs). The overall global voluntary target is to reduce premature death and mortality due to NCDs by 25% by 2025.

World Economic Forum and Harvard School of Public Health estimated that NCDs will cause economic output loss of US$ 47 trillion over the next two decades. NCDs kill more than 36 million people each year of which 14 million are under the age of 70 years old.

Alcohol is 1 of the main 4 risk factors for developing NCDs.

  • The formulation of target of ”10% relative reduction in per capita consumption of litres of pure alcohol among persons aged 15+ years

Rwanda – growing momentum for alcohol policy

In Rwanda, alcohol policy advocates organized a conference titled Stakeholder’s Meeting on the Current Alcohol Policy Situation in Rwanda.

The main objective of the conference was to share progress on the development of evidence based alcohol policies in Rwanda. As part of this, participants were updated on the current status of Rwanda’s policies and laws relating to alcohol abuse.

The conference also sought to reinforce partnership between civil society actors, government and other partners towards fighting against the effects of alcohol in Rwandan society. This meeting was a step towards informing Rwanda’s national response to the harms of alcohol and other drugs.

In addition, a partnership agreement between alcohol policy advocates and journalists was forged following a press conference in Kigali. The idea behind this strategic move was to enlist the support of the media in alcohol policy advocacy and education towards reducing the harms caused by alcohol.

Finally, Regional and international Alcohol policy advocates made their presence felt at the 4th annual EAC (East Africa Community) Health and Scientific Conference in Kigali by releasing a press release titled “Alcohol a Major Obstacle to Economic and Societal Development in Africa-But Will East African Community Respond Properly?

The press release discussed the need to recognize the harms caused by alcohol from available scientific evidence. It also linked alcohol to the 5 MDG’s that are negatively affected by alcohol harm.

USA National Transportation Safety Board wants to lower BAC level

Alcohol and road traffic deaths in the USA: in 2001, 32% of America’s 42,196 traffic fatalities were linked to driving under the influence of alcohol. 10 years later, in 2011, the U.S. saw 32,479 deaths – nearly 10,000 fewer than a decade before – but still 30% were attributed to alcohol.

Now the National Transportation Safety Board wants to improve those numbers dramatically by cutting the legal limit for blood alcohol content from 0.08 to 0.05.

Uganda – growing momentum for alcohol policy

In Uganda, alcohol policy advocacy was robust. Several advocacy tools were published among them, the State of Alcohol and Substance Abuse Report, 2013. The report was launched in an event attended by the press and other stakeholders.

1,200 policy briefs describing the burden of alcohol on the Ugandan economy and the cost of inaction were also printed and distributed to Members of Parliament.

Actual attempts were also made to enact legislation on alcohol at both local and national government levels. In Nebbi district an ordinance outlawing daytime sale and consumption of alcohol was enacted. The ordinance also prohibits transportation and consumption of alcohol in sachets and the local gin, Kasese. It’s pending approval by the Attorney General.

A Private Member’s Bill seeking to regulate drinking hours, prohibit sales of alcohol in residential areas, ban promotions and sale of alcohol in sachets, as well as from vehicles was tabled in the Ugandan Parliament.

The Bill, which seeks to ban consumption and sale of alcohol before 5pm will also outlaw sale of alcohol to minors. As usual, the alcohol industry responded by pointing a finger at informal alcohol as the source of alcohol related problems and by suggesting “responsible alcohol use” as the solution.

Finally, Uganda hosted the first ever Kettil Bruun Society (KBS) Alcohol Epidemiology Symposium, this 39th edition of the annual symposium that was held at the Speke Resort Munyonyo.

Lithuania tightening driving under the influence of alcohol regulations

On 26th June 2014 Seimas of the Republic of Lithuania adopted new amendments on Republic of Lithuania Law on Road Traffic Safety that has tightened driving under the influence of alcohol regulations. The new amendment introduced 0 g/l permitted blood alcohol content (BAC) limit for novice drivers (drivers who have held a license for less than 2 years) and all drivers who drive light four-wheel, four-wheel, powerful four-wheel vehicles with a maximum mass exceeding 3.5 tones or with more than 9 seats or transporting dangerous goods. The 0 g/l limit will be adopted for mopeds, motorcycles, tricycles and taxi drivers.

The legal standard BAC for professional drivers who have held their licence for more than two years does not change. It will remain 0.4 g/l. This law will come into force on 1st January, 2015. In 2013, 8% of all reported road accidents were caused by drivers under the influence of alcohol.

Turkey adopts legislation to ban alcohol advertising

The Turkish Parliament passed legislation to ban advertising of alcohol. The measure also bans the sale of alcoholic products between 10 p.m. and 6 a.m., except in tourist zones, and prohibits alcohol sales near mosques and schools. The government says it is aimed at protecting young people from the harms of alcohol.

The law adopted by the Turkish Government bans alcohol marketing, and prohibits alcohol producers from sponsoring events. The law restricts where alcohol retail and consumption is allowed. Furthermore, it will introduce mandatory health warnings on the packaging and prohibit retailers from displaying alcoholic products outside.

Finland’s planned Alcohol Act postponed indefinitely

A planned alcohol legislation overhaul was overturned by government parties last week, and the original schedule for the reform was postponed indefinitely. This means that sales restrictions on beer and the opening hours of licensed premises will remain as they are for the time being. Alcohol related costs total ca €7 billion per year in Finland.

However, the reformation of the Temperance Act continues and the Government’s aim is to get the Act into force in 2015. The Act will to strengthen the role of municipalities in alcohol harm prevention. Also new legislation restricting alcohol advertising will enter into force in Finland in the beginning of 2015.

Regulation of alcohol marketing in Latvia

The Ministry of Health of Latvia has prepared two draft legislative acts based on measures in the Alcoholic Beverage Consumption Reduction and Alcoholism Restriction Action Plan 2012-2014. The draft legislative act on Handling of Alcoholic Beverages Law includes the prohibition of the display of persons in alcohol adverts and the prohibition to advertise special offerings of alcoholic beverages (except if placed in the point of sale and are not take-away). And the draft legislative act on Electronic media law includes restrictions of alcohol advertising on TV and radio from 6a.m. to 10p.m.

The tighter regulation or outright ban of alcohol advertising is a policy measure that is increasingly being employed in several countries around the world, as the alcohol industry is targeting new consumers. Countries such as South Africa, Thailand, France, Sweden, Norway, Turkey and Russia have all very strong regulations on marketing.

Addiction: Overturn of the proposed alcohol advertising ban in Lithuania

Addiction Journal have published an article that outlines the process how the alcohol industry managed to cancel the attempt to completely ban alcohol advertising  which was originally adopted by the Parliament in 2008 to take effect on 1 January 2012.

In response to the dramatic increase in alcohol-related problems in Lithuania from 2007, the Parliament adopted a number of evidence-based alcohol control measures. Alcohol excise taxes were increased by 20% for ethyl alcohol and fermented beverages in 2008 followed by another 15% (approximately) increase in 2009. The excise for beer was increased by 10% in 2008 and another 10% in 2009, and tax exemptions for small brewers were removed. The penalties for driving under the influence of alcohol were increased, including vehicle confiscation, imprisonment for repeated offenders and the introduction of a lower Blood Alcohol Concentration level for young drivers (from 0.4 to 0.2‰). From 2009, the sale of alcoholic beverages was banned between 10 p.m. and 8 a.m. with only bars and restaurants being exempted.

Additionally alcohol advertising was banned on radio and television from 6a.m. to 11p.m. Paradoxically, the proposal for the total ban of alcohol advertising was recommended by a special Parliament working group with active representatives from the alcohol industry. This proposal was presented as an alternative amendment to be adopted instead of the proposed immediate advertising time restrictions in television. However, the industry’s tactics backfired and both proposed amendments were adopted by the Parliament. From 2008 advertising in television was time restricted and from January 1st, 2012 a total alcohol advertising ban was to be introduced with the small exception of allowing advertisements in retail premises. Therefore, the alcohol industry responded with aggressive lobbying aiming to revoke this ban. Ultimately they succeeded.

The alcohol industry in Lithuania used similar tactics as the tobacco industry globally. For example: creating strong and diverse opposing groups. The industry successfully exerted pressure to change alcohol control legislation. Unequal power distribution made it difficult to withstand combined local and international lobbying to cancel the ban. “Given the global nature of the alcohol industry, there is a need for international regulation to limit the influence of vested interests on national lawmaking,” authors conclude.

Thailand: Health-warning labelling to extend to alcohol

The Department of Disease Control said it would propose a new law requiring all bottles and packages of alcoholic products to carry cigarette-style graphic health warnings for the first time in Thailand.

Under the proposal, health-warning messages and images will occupy at least a quarter of the space on the labels of alcohol products.

Icelandic policy on alcohol and drug prevention, 2020

The Minister of Health has approved a policy until 2020 on alcohol and other drug prevention. Quantifiable targets will be defined on the basis of this policy and a plan of action will be drawn up. The policy covers consumption of alcohol and illegal drugs as well as abuse of prescription drugs which can lead to addiction and dependency.

Iceland has been successful in substantially reducing consumption of alcohol, illegal drugs and tobacco among children under the age of 16 in recent years. In fact the situation in the country in this regard is one of the best in Europe. Furthermore, overall alcohol consumption in Iceland is below the European average, and it seems reasonable to attribute this in part to the country’s conservative alcohol policy.

The Ministry of Welfare led the work on the policy, together with the Ministry of the Interior, the Ministry of Education, Culture and Science and the Directorate of Health. Measures to be taken will address prevention, treatment, post-treatment monitoring and rehabilitation and also the legal framework covering these issues, and they will involve central and local government, the health services, the social services, the educational system, NGOs, law-enforcement agencies and the customs authorities.

Main goals in the alcohol and drug prevention policy until 2020:

  1. To restrict access to alcohol and other drugs.
  2. To protect groups at risk from the damaging effects of alcohol and other drugs.
  3. To prevent young people from starting to consume alcohol or other drugs.
  4. To reduce the numbers of people who develop dangerous habits regarding the consumption of alcohol or other drugs.
  5. To ensure that those with alcohol problems have access to continuous and coordinated services based on best available knowledge and quality standards.
  6. To reduce health damage and the number of deaths related to consumption of alcohol, or other drugs, consumed by the individuals involved, or by others.

Ireland taking major steps on alcohol policies in the new Public Health Bill

Alcohol harm in Ireland is a complex and multi-faceted problem. New measures put forward for inclusion in the Public Health (Alcohol) Bill are a good start to tackle alcohol harm.

Alcohol-related harm in Ireland currently claims three lives a day and costs the State an estimated €3.7 billion annually, putting a particular burden on the already overburdened health services, where 2,000 beds are occupied by people with alcohol-related illnesses every day.

The evidence regarding the need to tackle alcohol harm has been overwhelming for a long time and reports have been mounting for years. Measures address the key areas of alcohol-harm prevention and reduction, including the pricing, marketing and availability of alcohol.

Sri Lanka: More momentum for effective alcohol regulation

Great news coming out of our Regional Parliamentarians and CSO Representatives Workshop: “Health Minister Maithripala Sirisena said his Ministry will fight alcoholism by introducing a ‘National Alcohol Policy’ in the next two months.”

Latvia has introduced health warning messages on advertisements of alcohol

Alcohol adverts will now have to carry warnings in the size of at minimum 10% of the whole advertisement – addressing the prohibition to sell, purchase and give away alcoholic products to young people. Advertising of alcohol at education and medical institutions, public transport and in magazines and newspapers will also be restricted.

Health warnings on advertisements are used as a prevention measure also in other countries: Estonia, Lithuania, Poland, Sweden. Health warning labels are a tool for changing the currently intoxicating alcohol culture and have long-term social utility in helping to establish social understanding that alcohol is no ordinary commodity

Latvia has one of the highest rates of alcohol use by young people among EU countries.

Lithuania on its way to become one of the leading European countries in regulation of alcohol marketing

The Ministry of Health of the Republic of Lithuania has prepared new amendments to the Law on Alcohol Control, suggesting a total ban of outdoor advertising as well as advertising in all media beginning on July 1st, 2015.

Renewed policy focus on youth health and welfare, rather than narrow business interests, presents an opportunity for Lithuania to become one the most progressive European countries in the area of alcohol control.

French beer tax- a step in the right direction

The French government has increased tax on beer by 160%, which is a step in a right direction that will help to address alcohol related harm and improve public budget.

The French Social Insurance budget for 2013 includes some of the best known effective measures to address public health concerns, namely increase in taxes on harmful products. The measures include taxes on beer and tobacco.

Global Binding Standards to hold multinational corporations accountable for Human Rights violations

Good news from Geneva and UN Human Rights Council! The #BindingStandards resolution was adopted and an inter-governmental process is to be launched on a legally binding instrument to tackle corporate Human Rights abuses, to hold powerful multinational corporations accountable when their practices violate basic Human Rights.