The Addictions France Association has published its fifth report on the practices of the alcohol lobby in France. This timely report is published at the beginning of Emmanuel Macron’s second five-year term as President of France. It investigates the French alcohol industry lobby’s actions between 2017 to 2021. The report covers the first five-year term of President Emmanuel Macron. It reveals that Mr Macron’s first term was marked by an unprecedented influence of Big Alcohol on public health policy.
The report reveals the way how the government dealt with key public health topics related to alcohol during the first mandate period. This includes the debate about consumer labeling as well as information about the various attempts to weaken the Evin’s Law.
A highly concerning revelation is the presence of the alcohol industry lobby at the heart of power. This has allowed Big Alcohol to be considered legitimate prevention actors by the Elysée (the presidential office), despite their continuous attempts to block, delay, and water down effective alcohol prevention measures.
Some of the threats to public health as a result of the alcohol industry lobby’s actions during this time period have been exposed:
- Negotiations to improve the visibility of the pictogram warning pregnant women not to consume alcohol (launched in 2017 by former Health Minister Agnès Buzyn) have not been successful.
- The extension of a tax to wine-based premixes which are highly accessible low-end, often foreign wines became an intense battle. Even though the measure was clearly intended to protect young people.
- Watering down the national alcohol action plan.
- The alcohol industry provides a prevention plan as per the request of the Elysée.
Nicolas Simon, former president of the National Association of Prevention of Alcohology and Addictology, professor of medicine and addiction expert at the CHU de Marseille (Bouches-du-Rhône), highlights the contradiction and conflict of interest of getting the alcohol industry to provide a prevention plan.
Half of the alcohol consumed in France is consumed by 8% of the population,” said Nicolas Simon, former president of the National Association for Prevention in Alcoholology and Addiction, professor of medicine and addictologist at the CHU de Marseille (Bouches-du-Rhône), as per l’Humanité.
All the turnover of alcohol is therefore made by a tiny part of the population that consumes a lot. If ever, with a magic wand, there were only [low dose] consumers, the alcohol industry would collapse.”Nicolas Simon, former president of the National Association of Prevention of Alcohology and Addictology, professor of medicine and addictologist at the CHU de Marseille (Bouches-du-Rhône)
The Addictions France Association has denounced the narrow alcohol prevention plan of the French government which only focuses on young people, pregnant women, and driving under the influence; and avoids more effective public health measures such as increasing prices, reducing access to alcohol, and reducing advertising of alcohol products.
Nicolas Simon points out that not only does the government not care about prevention but it doesn’t take care of patients with alcohol problems either.
A government that does not push in the direction of public health is problematic… we should at least take care of patients,” said Professor Simon, as per l’Humanité.
Here at Marseille University Hospital, I have to send my patients to peripheral hospitals because there is not even an addiction service.”Nicolas Simon, former president of the National Association for Prevention in Alcoholology and Addiction, professor of medicine and addictologist at the CHU de Marseille (Bouches-du-Rhône)
Big Wine lobbyist was an adviser to President Macron
This level of influence on public health policy-making by the alcohol industry was made possible in France by how far the lobby had infiltrated the government.
In 2017, President Macron appointed Audrey Bourolleau as an adviser on “agriculture, fishing, forestry, and rural development” in his cabinet. She worked in this role till 2019. Audrey Bourolleau was also the head of Macron’s campaign group devoted to questions of agriculture and food, in his first election five years ago and again in the second election in 2022. Previously Audrey Bourolleau was the chief lobbyist for the French wine industry, working for the lobby group, Vin & Société since 2012.
Ms. Bourolleau was a part of the alcohol lobbying effort which led to the fourth stage of the “unraveling” of the Evin’s Law which took place in the end of 2015. By this time certain mentions linked to local territories and the heritage of alcoholic beverages had been taken out of the scope of the law against the advice of then-Minister of Health Marisol Touraine but with the consent of then-President François Hollande and his Minister of Economy Emmanuel Macron.
At the same time, Ms. Bourolleau created for alcohol industry lobby group Vin & Société a campaign on benchmarks of consumption. This campaign was denounced by the High Authority for Health as “an advertising campaign that is diverting a medical tool to fight against the dangers of alcohol “.
An exposé by “Le Monde” reveals how Ms. Bourolleau helped protect alcohol industry interests and diminished alcohol policy-making in the French government while she was serving President Macron from 2017 to 2019.
About fifteen public health organizations, including the French Federation of Addictology and the National League Against Cancer, opposed Ms. Bourolleau’s appointment citing “conflicts of interest which could arise to the detriment of public health”. While Ms. Bourolleau resigned from Vin & Société, the public health organizations pointed out that as per the law on the transparency of public life of 2013, “the appearance of a conflict is enough to characterize it”.
However, Ms. Bourolleau continued to act in her role as adviser on “agriculture, fishing, forestry, and rural development” and continued to help the alcohol industry and thwart public health-oriented alcohol policy-making till she resigned in 2019.
Any measures, if taken by the High Authority for the Transparency of Public Life (HATVP) regarding Audrey Bourolleau’s conflict of interest are covered by professional secrecy, and are not publicly available.
Bourolleau’s trail of thwarting public health alcohol policy-making
Ms Bourolleau certainly did not recuse herself from topics related to alcohol despite her clear conflict of interest. She appears in about half a dozen documents as a facilitator of the alcohol industry lobby at the Elysée, as exposed by Le Monde.
- In autumn 2017 Bourolleau received Antoine Leccia, the president of the Federation of Wine and Spirits Exporters of France who had requested an audience from President Macron by mail.
- Subsequently, in January 2018 Antoine Leccia was part of the presidential delegation during the first state visit to China.
- In March 2019, Bourolleau prepared the “elements of language” that the President must pronounce during the reception at the Elysée Palace of nearly 150 guests from the brewing industry on the occasion of the arrival of the spring beer.
- She included the following concluding statement: “France is no longer itself if it forgets this art of living of which it has so profoundly the genius and your sector contributes to it.” in the President’s address.
- In May 2018, on request by the head of Vin & Société, Krystel Lepresle, Ms Bourolleau facilitated an audience in the Elyseé for alcohol industry representatives to present their proposals for the national public health plan “Priorité Prévention” directly to President Macron.
- This high-level access came in addition to the alcohol industry’s presentation to members of the Prime Minister’s offices and ministries of health and agriculture, as well as to the president of Mildeca.
- In 2019, the Vinexpo Exhibition was placed under the high patronage of the Head of State on instructions of Ms. Bourolleau.
Apart from facilitating high-level access for the alcohol industry lobby and to open doors for influencing the President, Ms. Bourolleau also directly influenced alcohol policy-making in France.
- An email from August 21, 2018, shows how she interfered in the drafting of the national mobilization plan against addictions of the Interministerial Mission for the Fight against Drugs and Addictive Behavior (Mildeca) for the period 2018-2022.
- She advised her collaborators that they must leave no room for the alcohol industry to be questioned in this report.
- The final Mildeca plan shows that Ms. Bourolleau’s suggestions have been taken into account. She succeeded in watering down the national alcohol strategy on behalf of the alcohol industry.
- She opposed the sentence “The challenge now is to communicate the fact that all alcohol consumption involves risks” in the strategy warning that it would make the alcohol industry react strongly and it would question “moderate” consumption.
- The watered-down “compromise” sentence “The challenge is to communicate the fact that the risks associated with alcohol consumption increase with the quantity consumed (risk of cancer without threshold effect, including below the benchmarks)” that she recommended was included in the final Mildeca plan.
- This sentence is not only vague but also less clear. Clearly, Ms. Bourolleau worked to muddy scientific evidence that there is no safe level of alcohol use.
- In another instance, an expert report from the National Cancer Institute (INCa) and Public Health France recommended abandoning the term “abuse” in the national health message and simply saying “alcohol is dangerous for your health.” However, Ms. Bourolleau watered this down, too. Therefore, the final Mildeca plan includes the vague sentence “Develop scenarios for the evolution of the text of the legislative health message.”
Nathalie Latour, then Director General of the Addiction Federation says President Macron cannot escape responsibility for the watering down of the national alcohol strategy and the constant alcohol industry interference in alcohol policy-making in France.
It is a political choice, a system desired by the President of the Republic and the government, not the fact of this woman alone,” said Nathalie Latour, then Director General of the Addiction Federation, as per Le Monde.Nathalie Latour, then Director General of the Addiction Federation
Le Monde: “A wine lobbyist at the heart of Emmanuel Macron’s five-year term and election campaign” [Translated from French]
Association Addictions France: “Alcohol Lobbies: A deleterious influence during the previous five-year term“