Looking back
Ten years World Health Assembly.
The World Health Organization is celebrating its 75th anniversary this year. During one of the celebrations at the World Health Assembly (WHA76) in Geneva, I realized that I’ve attended these meetings every year for a whole decade. And when I checked, I even found a blog post I wrote back in 2013 from the World Health Assembly (WHA66).
I feel very grateful for this opportunity to contribute to making alcohol policy the priority it should in global health. I also feel thankful to the people I’ve met and work(ed) with along the way. And I feel inspired by the progress I can see.
Three examples illustrate well how times have changed for alcohol policy: civil society, the WHO Secretariat, and member states of the World Health Organization (WHO).
Civil society stepping up for evidence-based alcohol policy
In 2013, then Movendi International President Sven-Olov Carlsson and I attended the World Health Assembly to help secure the alcohol policy solutions among the NCDs “best buys”. I remember how we worked with the delegations of Thailand and Sweden (Sven-Olov knew the minister of social affairs very well) to help protect the inclusion of alcohol taxes, advertising bans, and availability limits in the NCDs global action plan. At the time, alcohol was the forgotten risk factor in the NCDs agenda.
Ten years later this has changed.
We’ve developed awesome partnerships with the NCD Alliance, the Union for International Cancer Control (UICC), Vital Strategies, International Federation of Medical Students’ Associations (IFMSA), World Cancer Research Fund International (WCRFI), and more recently the World Heart Federation (WHF).
And they’ve each contributed immensely to accelerating alcohol policy as a public health priority at the WHO level.
I don’t think we would have the SAFER initiative today without the support of the NCD Alliance and the significant contribution of Vital Strategies.
The support of our friends in the NCDs prevention and control community was essential for the adoption of the WHO Global Alcohol Action Plan in 2022. And together we work to protect WHO and global health from conflicts of interest and interference by health harmful industries, such as Big Alcohol.
Growing understanding of and support for alcohol policy at WHO
Another example is how the WHO Secretariat addresses alcohol harm today.
I remember how surprised I was ten years ago when I learned how few people and how little funding the WHO leadership was allocating to work on preventing and reducing alcohol harm. After the adoption of the WHO Global Alcohol Strategy in 2010, resources – both human and financial – actually declined for WHO’s work on alcohol. So, the few colleagues working with alcohol policy had their work cut out for themselves.
In our efforts to mobilize broader support and mainstream alcohol policy considerations in other global health agendas, we realized how little other WHO units and departments where concerned with and working on alcohol harm as obstacle to their own global health agendas, such as ending violence against children, promoting women’s, children’s, and adolescents’ health, ending the tuberculosis and HIV/ AIDS epidemics, road safety, universal health coverage and primary healthcare.
A decade later, alcohol is not the overlooked issue in global health anymore.
Nevertheless, there is still much more to do. And we expect that the WHO Secretariat further improves the way it addresses alcohol harm and policy across the global health agenda.
But now the interest of different WHO units and departments in alcohol policy has increased a lot. We experience it in our formal meetings and in the small chats during the World Health Assembly. NCDs, road safety, social and commercial determinants of health, violence prevention, health promotion, and even HIV/ AIDS, are all areas where I’m seeing improvements in how alcohol policy is being incorporated.
A growing coalition of member states championing alcohol policy
I think we can also see inspiring improvements in the commitment of WHO member states to advance alcohol policy at home and request accelerated action from the WHO Secretariat.
A decade ago member states championing alcohol policy at the WHO level were few and far between: I mentioned Sweden and Thailand earlier and should add Norway and Sri Lanka that have made a tremendous difference for global alcohol policy, concerning the Global Alcohol Strategy as well as the inclusion of alcohol policy in the NCDs global action plan and the Sustainable Development Goals.
Over the last ten years, we helped grow the coalition in size and strength. It showed in the high-level side event at the United Nations in 2018. It showed at last year’s World Health Assembly with our side event and with the unanimous adoption of the WHO Global Alcohol Action Plan in 2022. It even shows in the growing number of statements addressing alcohol at the World Health Assembly.
Working with member states is one of the most inspiring parts of my work. We are seeing increasing interest and requests for alcohol policy support “back at home”. And I experience growing support and commitment from governments to making alcohol policy the priority it should be at the WHO level.
Lessons and reflections from a ten year journey
Reflecting on my first experiences at the World Health Assembly a decade ago and the journey ever since is humbling and inspiring. It feels amazing to take a step back and think about what it takes to help make a little difference.
I’m thinking about four elements:
- Being reliable: It takes showing up consistently – before, during, and after WHO meetings. It requires to make alcohol harm and the benefits of alcohol policy action visible regularly, reliably, and repeatedly.
- Working in partnership and providing support to the partners: It takes a commitment to support the champions of alcohol policy. It’s essential to work in partnerships by learning from partners, adapting to the needs and interests of the partners and co-creating a common agenda, based on evidence and a shared goal. I’ve learned it is important to make it easy for anyone who wants to support alcohol policy acceleration to engage and contribute.
- Developing engaging, welcoming, and value-based communication: In alcohol policy it’s easy to focus on what we are against and to be limited by the belief that facts are persuasive. But it takes an effort to find a common vision and values of why we want alcohol policy action. It requires language that engages people. It requires a welcoming approach. And when we are able to explain the benefits of addressing alcohol harm in terms of values, we are able to grow the coalition for alcohol policy.
- Being ambitious and honest: It takes big efforts to make a difference and advance alcohol policy – at any level. I’ve learned that bold ambition is an important starting point – not to be daunted by the task and by the perception that change is difficult or impossible. It’s not. It might take time but if we never start the journey, we will anyway not make any progress. On this journey, honesty is crucial to evaluate if progress is really visible and to adapt – if necessary – strategies, tactics, and methods.
Looking ahead
Compared to 2013, alcohol policy is firmly on the agenda of the World Health Organization. We’ve certainly made progress with our advocacy effort to make alcohol policy the priority it should be.
At the same time, alcohol harm is not – yet – on the agenda of the WHO units and departments that really need to address it, not to mention other UN agencies and programs. Our advocacy priorities at this year’s World Health Assembly reflect that reality. We have much more work to do.
In my experience, considerations of alcohol harm and the benefits of alcohol policy solutions are on more people’s minds today. I see increased recognition of the magnitude of alcohol harm and the potential of alcohol policy solutions when I talk with different WHO, civil society, and government colleagues. Addressing alcohol as a priority global health issue has become more normal in recent years.
For example, alcohol taxation is a routine element of the discussion about pro-health taxes to promote health and development for all. That was not the case just a few years ago.
I’m encouraged to see that WHO’s mandate to address alcohol has grown stronger. The evidence base about alcohol harm is growing bigger. And the understanding of the benefits and potential of alcohol policy solutions for multiple health and development areas has increased significantly.
All this gives me great hope for the years until 2030 – when the Sustainable Development Goals are supposed to be achieved. And it sharpens my view of what more needs to be done, what more needs to be improved, and what else we will try to change.
We need a global binding treaty on alcohol policy. We need further alcohol policy infrastructure improvements, such as a global ministerial conference. We need much improved conflict of interest protections and firewalls against alcohol industry interference. And we will get there.
What inspires me is how fast some changes have actually happened.
The partnerships we have established hold so much more potential, for example with IFMSA and the International Youth Health Organization – increasing the engagement of young people in alcohol policy at all levels. It’s how and where I started more than 16 years ago.
In our work with member states, there is also much more potential. Some of it takes place behind the scenes so that Big Alcohol cannot interfere and derail specific initiatives. But as Prof. Ilona Kickbusch said at the high-level side event in 2018 and reiterated at the World Health Assembly side event in 2022: the movement starts here and the movement is getting stronger.
Since 2018, there is the SAFER initiative. Since 2022, there is the WHO Global Alcohol Action Plan. Since 2023, there is the RESET initiative.
We now have two WHO two units to partner with in the work to advance alcohol policy at all levels. And we have partners in UNDP and the UN Interagency Task Force on NCDs, as well as in other WHO departments and units.
The infrastructure, the coalition, the evidence-base, even the funding for alcohol policy work has all gotten better and stronger. And it shows at the annual World Health Assembly. I’m excited about the coming years. Onwards. Upwards.
