By María Isabel Calderón
Shifting Towards A Commercial Determinants of Health Perspective
For more than nine decades, the National Cancer Institute (Instituto Nacional de Cancerología, INC) has worked towards comprehensive cancer control in Colombia, integrating specialised clinical care, scientific research and, with increasing strength, public health action and public policy. This trajectory has left a clear lesson: cancer prevention is not defined solely within health services, but also in the environments where economic, regulatory and political decisions are made that shape patterns of consumption.
In 2022, alcohol began to occupy an explicit place on the institutional agenda of the INC. That year, the Institute decided to strengthen its approach to alcohol as a preventable risk factor, incorporating a commercial determinants of health perspective. This shift was not incidental: it responded to the growing body of evidence recognising alcohol as a carcinogen, its substantial contribution to the cancer burden, and the persistent gap between scientific knowledge and existing public policies.
That same year, the INC took a first step in the public arena by convening a meeting entitled “Diálogos sobre Alcohol” (Dialogues on Alcohol). More than an isolated event, this space marked the beginning of an open institutional conversation, in which the decision to prioritise alcohol in cancer prevention in Colombia was made explicit. Key actors from the health sector, academia and civil society were identified, including Movendi International, with whom it was possible to build synergies. From this starting point, we joined the process as actors and the issue began to gain visibility within our developments on the public health and cancer control agenda, enabling necessary debates on regulation and taxation in the country.
This progress was possible because the approach to alcohol was integrated into the strategic work of the Group of Policies and Social Mobilisation, responsible for translating evidence into public action. From this space, the issue was incorporated into processes of regulatory and media monitoring, political advocacy agendas and the Institute’s social mobilisation strategies, allowing alcohol to move from being a risk recognised in technical circles to becoming a priority for intervention in decision-making arenas.
Knowledge generation only makes sense when it is put at the service of prevention and the protection of public health.”
María Isabel Calderón
Through this process, the INC understood that alcohol consumption cannot be interpreted solely as an individual decision, but rather as the result of environments shaped by weak regulatory frameworks, aggressive marketing strategies and a cultural narrative that minimises its harms. As the leading cancer institution in Colombia, the Institute could not afford to remain on the sidelines or to disregard a clearly established risk. This implied recognising the need to articulate with existing collectives and with its sectoral counterpart, the Ministry of Health and Social Protection, in order to contribute cancer-specific evidence, counter industry tactics and strengthen decision-making in arenas where the INC’s technical legitimacy and social mobilisation actions are decisive. From this point onwards, a central message for cancer prevention was reinforced: there is no safe level of alcohol consumption.
As a result of this path, in 2025 the INC took an unprecedented institutional decision: to publish, for the first time, a Political and Legislative Bulletin on Alcohol, with the aim of translating scientific evidence into clear inputs for decision-makers, journalists, social organisations and health sector actors (1).
This document marked a milestone by explicitly positioning alcohol within the debate on public policies and cancer control in Colombia.
In parallel, the Institute promoted the publication of an academic article that deepens the analysis of alcohol from the perspective of public policy and the commercial determinants of health, contributing evidence to the regional debate and strengthening the dialogue between research and political action (2).
Both products reflect a shared conviction: knowledge generation only makes sense when it is put at the service of prevention and the protection of public health. This process has also highlighted the need to update existing strategies in Colombia and to embark on a determined path towards the effective implementation of SAFER (the WHO’s alcohol policy initiative).
Integrating Alcohol-Cancer Messaging Into Social Mobilisation Strategies
At the same time, the INC understood that advocacy cannot remain confined to documents or technical spaces. For evidence to have real impact, it must circulate, be discussed and be lived in the territories. For this reason, alongside its editorial and academic work, the Institute decided to take this message to the community, integrating it into its social mobilisation strategies.
This work has also been strengthened directly with the community through collective intervention actions in community settings, particularly in spaces known as “MoVidas comunitarias” (MoVidas, a wordplay combining movidas [movements] and vidas [lives]; comunitarias meaning community-based), where the INC promotes healthy lifestyles, physical activity and cancer prevention from a territorial and participatory logic. Within this framework, the event “Vuelta por la Vida” (Ride for Life) has been consolidated, in its 2023 and 2024 editions, as an emblematic setting for bringing these messages to the public. Along the routes, people encountered materials that make alcohol visible as a risk factor for cancer, such as the message “Evita el consumo de bebidas alcohólicas” (Avoid the consumption of alcoholic beverages) and the fact that 98% of alcohol-attributable cancer deaths occur before the age of 69, reaffirming that prevention is also built in public space, in movement and in community.
In this context, the work of the INC unfolds simultaneously at two levels: the technical and the community. On the one hand, it promotes evidence-informed decisions aimed at transforming regulatory and fiscal frameworks that currently facilitate alcohol consumption. On the other, it conveys that same message to the territories, recognising that prevention is only possible if it is built with the community and not solely from institutional spaces.
From this comprehensive perspective, the INC’s support for policies such as alcohol taxation responds to a technical and ethical reading of the problem. International evidence consistently shows that pro-health taxes are among the most cost-effective measures to reduce consumption, prevent noncommunicable diseases and save lives. The experience of tobacco control in the Region of the Americas demonstrates that these policies not only reduce the burden of disease, but also generate significant economic returns for health systems (3).
Pro-Health Taxes As Cancer Prevention
In line with this evidence, the INC has adopted in its technical position the recommendations of the World Health Organization and the Pan American Health Organization, which recognise pro-health taxes as a key tool to address alcohol harms (4-6). These orientations are reinforced by economic analyses showing that such measures not only save lives, but also strengthen the sustainability of health systems. World Bank studies show that health taxes represent a concrete opportunity to improve population health, reduce inequities and generate resources for investment in prevention and care in countries such as Colombia (7). Consistently, the WHO has warned that making alcoholic beverages cheaper leads to an increase in noncommunicable diseases, injuries and avoidable deaths, reinforcing the urgency of moving towards more ambitious fiscal policies (8).
The expected impact of these measures is clear: lower population-level consumption, especially among young people; lower cumulative exposure to alcohol over the life course; and, consequently, a progressive reduction in the incidence of cancer attributable to the risk factor alcohol. But there is also a symbolic and cultural impact: reaffirming, from a leading cancer institution, that the protection of public health must prevail over commercial interests.
In the debate currently taking place in Colombia on pro-health taxes, it is essential to shift the discussion away from price increases towards the real problem: the human, social and health costs of consuming an avoidable carcinogen. The question should not be how much an alcoholic drink will cost, but how much it costs the country to normalise a substance that increases cancer risk, overloads the health system and deepens inequities. From this perspective, fiscal policies do not represent an economic punishment, but rather a legitimate tool for the protection of public health.
This work is still recent and remains under construction. There is a long road ahead to translate evidence into effective policies, strengthen institutional capacities and consolidate alliances that allow this debate to be sustained over time. However, the horizon is clear: that alcohol be socially recognised for what it is, a risk factor for cancer, and that its regulation be understood as a legitimate measure for the protection of public health. The institutional aspiration is that, just as tobacco is now widely identified as a carcinogen, alcohol will follow the same path of social awareness and political action, becoming a central axis of cancer prevention strategies in Colombia.
References
- Instituto Nacional de Cancerología. Boletín político: Alcohol. INC; 2025.
- Instituto Nacional de Cancerología. Alcohol y determinantes comerciales de la salud: implicaciones para la política pública. Gerenc Políticas Salud.
- Organización Panamericana de la Salud. El caso de inversión para el control del tabaco: enseñanzas de cuatro países de la Región de las Américas. Rev Panam Salud Publica.
- World Health Organization. Health taxes. WHO.
- Organización Panamericana de la Salud. Impuestos saludables. OPS.
- World Health Organization. WHO launches bold push to raise health taxes and save millions of lives. WHO; 2025.
- Banco Mundial. Impuestos sanitarios en Colombia: una oportunidad para mejorar la salud de la población. Banco Mundial.
- World Health Organization. Cheaper drinks will see a rise in noncommunicable diseases and injuries. WHO; 2026.
About Our Guest Expert
María Isabel Calderón
María Isabel is a Colombian professional in Political Science and International Affairs, with postgraduate studies in Government, Political Studies, and Scientific Communication.
She has more than eight years of experience working on cancer control through the Group of Policies and Social Mobilisation at the National Cancer Institute (Instituto Nacional de Cancerología, INC). Her work focuses on legislative and policy monitoring, as well as political advocacy, to strengthen cancer control, promote health equity, and support evidence-based regulation.
You can follow María Isabel’s work on LinkedIn.
And you can follow the Instituto Nacional De Cancerología on LinkedIn.
