The new report summarizes the main outcomes of a WHO workshop on the implementation of alcohol policy solutions in the countries of the Commonwealth of Independent States (CIS), which can be considered as “first movers” of implementing alcohol control policies. Despite their crucial contribution to reaching the noncommunicable disease (NCD) target of a 10% reduction in per capita alcohol use by 2025 in the WHO European Region, CIS countries often remain as under-researched success stories of alcohol control.
The workshop was held on December 4 and 5, 2019 in Moscow, Russian Federation. The aim of the workshop was to change the research attention to alcohol policy development in the CIS countries and to create a platform for knowledge and experience exchange. The report documents the main outcomes of the first meeting of representatives of all CIS Member States as well as technical experts on alcohol control and highlights the many effective and cost-effective measures that have been introduced in these countries to prevent and reduce alcohol-attributable harms.
CIS countries are alcohol policy champions
The report recognizes the contributions of the CIS countries – Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, the Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan and Uzbekistan – in reaching the target of a 10% reduction in per capita alcohol use, agreed on globally in the NCD Global Monitoring Framework, by 2025.
The CIS countries are the ‘first movers’ in implementing certain alcohol policies, such as minimum pricing of alcohol or total alcohol marketing bans in the WHO European Region,” said Nino Berdzuli, Director of the Division of Country Health Programmes, as per WHO Europe.
Many of these countries adopted best buys – measures that have been recommended as cost-effective by WHO for many years. Given that these countries have the experience of real-life implementation of these policies and can share that with other Members States across the Region,” added Berdzuli.
Nino Berdzuli, Director of the Division of Country Health Programmes, WHO Europe
Many of the CIS countries adopted the WHO recommended cost-effective alcohol policy best buy solutions. These helped to reduce the heavy alcohol burden in the CIS countries, especially those in eastern Europe.
The best buy alcohol policy solutions are:
- increase excise taxes on alcoholic beverages;
- enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising, promotions and sponsorship; and
- enact and enforce restrictions on the physical availability of retailed alcohol.
CIS countries therefore can be considered as “first movers” in introducing key alcohol polices over the past years and accumulating knowledge on their practical implementation. Consequently, it is crucial that CIS countries share these experiences and best practices among each other and with other countries and regions.
Overall, the WHO European Region is currently on track to meet the global NCD target of at least 10% relative reduction in per capita alcohol use, but this is only because of the CIS countries’ contribution.
Alcohol policy works
In CIS countries, a general decline in total alcohol per capita consumption has been observed over the past years, according to the WHO Europe report, while alcohol consumption levels were stagnating at European Union (EU) level. This may be related to the fact that many CIS countries are successfully implementing effective alcohol policy models, including the WHO best buy solutions.
The WHO Europe report, summarizes success stories and lessons learned from CIS countries in implementing alcohol pricing policies, marketing policies and labelling, as well as the monitoring of policies and how these countries dealt with unrecorded alcohol consumption.
The report is the first step of a WHO initiative to set up a new alcohol policy platform for the exchange of knowledge and best practices among CIS countries and beyond. The experiences of these “first mover” countries are expected to help others in the region with heavy alcohol burdens.
Alcohol pricing policies in CIS countries
Various CIS countries introduced minimum pricing a long time ago, raising it over time to adjust for inflation, sometimes in tandem with increases in alcohol taxes. CIS countries can therefore be considered as “first movers” in implementing minimum pricing on alcohol and more evaluation studies from this part of the Region are needed to improve the evidence base.
For example, the implementation of a higher minimum price on vodka in Russia in 2010 had led to a substantial decline in cheap alcoholic beverages in smaller retail outlets, which overall has contributed to a decline in alcohol consumption at population level.
But more research is needed in other CIS countries to evaluate their effects in real-life settings over time.
The need for a binding treaty on alcohol
The report also highlights the discussion of policy makers and health experts about the parallels between tobacco and alcohol, for instance regarding the need to introduce warning labels on alcohol products.
It was criticized that there is no framework convention on alcohol that would, as an internationally binding instrument, require alcohol labelling.
Tofig Musaev, Head of Population Health Department, Public Health and Reforms Centre of the Ministry of Health of Azerbaijan, added to his presentation that it is very necessary to develop a WHO document that would define the international binding framework for alcohol policy, following the example of the WHO Framework Convention on Tobacco Control.
Tudor Vasiliev, Head of the Monitoring, Evaluation and Integration of Medical Assistance Division of the Republican Narcology Dispensary in Chisinau, Republic of Moldova, noted that each country has its own specificities, in general but also in the way alcohol policies are developed. It would therefore be important to have an international guiding framework that could unite the course of action of various countries, similar to the WHO Framework Convention on Tobacco Control. He noted that this is something that might be discussed in the future as part of the emerging network, and mentioned that it might be useful to revisit the now 25-year-old European Charter on Alcohol, as a lot of new evidence on alcohol has accumulated.
Rakhatbek Mamytkozhoev, specialist from the Kyrgyzstan Association of Village Health Committees, emphasized that a CIS country network could be the starting point for developing a regional framework for alcohol control, which can lay the ground for the development of a framework convention for alcohol similar to the WHO Framework Convention on Tobacco Control.