RESET Alcohol is a collaboration of six global organizations: Vital Strategies, which is leading the initiative; Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and World Health Organization (WHO).
RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package.
Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing.
RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns.
RESET Alcohol’s primary policy focus will be on increasing alcohol taxation from a public health perspective and to help governments improve other alcohol pricing policies to reduce alcohol affordability. Alcohol taxation is the single most cost-effective alcohol policy solution.
RESET Alcohol also aims to partner with governments to advance evidence-based solutions to reduce alcohol availability and protect people and communities from alcohol advertising, sponsorship, and promotion.
Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies, as per Health Policy Watch.
The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.”
Adam Karpati, senior vice president, Vital Strategies
Why alcohol taxation matters
Movendi International provides two Special Features on alcohol taxation and more than 550 resource articles about alcohol taxation.
The WHO Global Alcohol Strategy recommends that Member States establish a system for specific domestic taxation that takes into account the alcohol content of the beverage, accompanied by an effective enforcement system. It also encourages countries to review prices regularly in relation to inflation and income levels; ban or restrict sales below cost and other price promotions; and establish minimum prices for alcohol where applicable.
Alcohol taxation is the single most cost-effective alcohol policy solution. It helps reduce overall alcohol use and related harm, as well as heavy and high-risk alcohol use. For instance, young people and adult alcohol users engaging in heavy episodic alcohol use are exposed to serious health and social risks, as reflected in statistics on highway safety, injuries, violent crime, or domestic violence, according to the World Bank.
Secondly, there is good evidence that alcohol use and related harm occurs in a social context, and that alcohol users across the spectrum of different amounts and patterns of alcohol intake influence one another.
This means that reducing alcohol affordability, through ensuring price increases by raising taxes, is effective in reducing the overall level of alcohol consumed in a society, including the consumption of the heaviest alcohol users. Alcohol taxation is proven to reduce heavy and high-risk alcohol use. That’s why it is so effective in preventing and reducing alcohol harm.
The accumulated research findings indicate that population-based policy options – such as the use of alcohol excise taxation to reduce alcohol affordability, reducing alcohol availability and implementing bans on alcohol advertising – are the “best buys”.
Pro-poor, pro-productivity and pro-sustainable development
A World Bank study illustrates that tobacco and alcohol taxes benefit especially lower income households. With increasing alcohol and tobacco taxes and declining alcohol use, better health ensues, less money is needed for smoking-and alcohol related healthcare services and injuries, and labor productivity improves due to reduced sickness and absenteeism.
The World Bank experts find:
This situation as observed in different countries across the world counters the traditional finding that tobacco and alcohol tax increases, by themselves, are regressive – leading to the largest percentage reductions in pre-tax incomes for the lowest-income households.
But the picture changes markedly when the benefits of reduced mortality and morbidity are included. These benefits are strongly progressive, for two reasons.”
Lesotho: Estimated Revenue Impact of Proposed Tobacco and Alcohol Levy, Final Report, World Bank Group Team, January 25, 2017, Executive Summary
Alcohol and tobacco taxation are progressive in two aspects:
- Alcohol harm, for instance, disproportionately affects households and communities with lower socio-economic status. That is why these vulnerable people and communities benefit enormously from declining alcohol use and related harm.
- Improvements of health, employment, and social outcomes are relatively more important to lower-income households because they are more vulnerable to the consequences of alcohol harm due to their lack of resources.
Triple win potential of alcohol taxes
Public health-oriented taxes on tobacco and alcohol are non-distortionary taxes. They have a triple benefit:
- Raise fiscal revenue,
- Reduce and prevent harm due to tobacco and alcohol, and
- Promote health and development by easing the health system burden and facilitating investments into healthcare and health promotion.
Besides revenue raising objectives, the rationale for excise taxes on alcohol is to reflect their harmful external costs. The benefits of higher alcohol taxes are obvious for individuals and entire communities. The benefits result from:
- Reduced alcohol use,
- Preventing the initiation of alcohol use among children and youth, as well as
- Reducing the negative health, social, and economic consequences caused by the products and practices of the alcohol industry.
Nevertheless, in many countries, current alcohol tax rates are evidently far below what is feasible in terms of revenue potential and what is needed to achieve development targets, according to the World Bank.
A study published in The Lancet is providing ground-breaking analysis: the most effective alcohol policy solutions have declined between 2015 and 2020, while it improved for tobacco policies. In fact, the alcohol policy best buys are “systematically neglected at the global level.”
- Most policies targeting alcohol harm have not been fully implemented in 2020. Often, they are not even partially implemented.
- Alcohol advertising is among the best buy measures that are the least widely implemented.
- And in many regions alcohol is becoming more affordable, due to a failure to implement public health-oriented alcohol excise taxes.
Understanding Alcohol Taxation: Design, Potential and Window of Opportunity
In this episode host Maik Dünnbier talks with Dr. Evan Blecher of the World Health Organization focusing on pro-health taxes and specifically the design, potential, and window of opportunity for better alcohol taxation.
Evan and host Maik go deep into the weeds of health taxes, focusing more specifically on alcohol excises taxes. They discuss different terms for health taxes and what they reveal about the purpose and potential of health taxes.
There is strong and growing evidence that pro-health taxes on health harmful products, such as tobacco, alcohol, and sugar-sweetened beverages, are highly impactful and yield significannt return on investment.
A landmark study confirmed this in 2020:
Excise tax increases on tobacco, alcohol and SSB can produce substantial health gains by reducing premature mortality while raising government revenues, which could be used to increase public health funding.”
Summan A, Stacey N, Birckmayer J, et. al. The potential global gains in health and revenue from increased taxation of tobacco, alcohol and sugar-sweetened beverages: a modeling analysis. BMJ Global Health 2020
1. Harnessing the full potential of alcohol taxation
2. Understanding the economic costs of alcohol harm
3. Understanding the social costs of alcohol harm
4. The vast and untapped potential of alcohol taxation for investment in health and development
Taxing alcohol, tobacco, and sugar-sweetened beverages is an effective but underutilized policy for promoting health and preventing disease. They could also assist in raising more funds for the government to support investments and programs that benefit the entire population and improve equity. Alcohol taxation is a win-win-win measure for public health and the economy specifically in recovering from the COVID-19 pandemic.
5. Case studies about the positive impact of alcohol taxation for investment in health and development
More and more governments and organizations are waking up to the potential of alcohol taxation for investment in health and development.
The latest Financing for Sustainable Development report by the UN Inter-Agency Task Force highlights the importance of alcohol taxation.
The case for accelerating action on alcohol harm
Overall, trends in alcohol consumption, alcohol’s contribution to the global burden of disease, and progress towards global targets are all pointing the wrong direction.
Alcohol remains one of the leading risk factors contributing to the global burden of disease. It is the eight leading preventable risk factor of disease. The contribution of alcohol to the global disease burden has been increasing from 2.6% of DALYs* in 1990 to 3.7% of DALYs in 2019.
In low- and middle-income countries alcohol is the fourth fastest rising risk factor for the global disease burden.
Alcohol is the second largest risk factor for disease burden in the age group 10-24 years. Alcohol is the largest risk factor for disease burden in the group 25-49 years.
Modelling forecasts that global targets to reduce alcohol use and harm will not be met.
Lack of progress and failure to implement high-impact alcohol policy solutions
Evidence shows that alcohol policy development has been ineffective over the past decade. With a few notable exceptions, most countries have failed to develop public health oriented alcohol policy solutions in the last decade.
Overall, trends in alcohol consumption, alcohol’s contribution to the global burden of disease, and progress towards global targets are all pointing the wrong direction.
- Without action, Africa could see an increase in both the absolute number and proportion of people consuming alcohol, the amount consumed per capita and heavy episodic alcohol use.
- Southeast Asia has seen a 29% increase in per capita alcohol use since 2010.
- Out of 51 countries in the WHO European Region, only 16 reached the target of a 10% reduction of overall alcohol consumption between 2010-19. But 17 countries saw increases in alcohol use. Almost no progress was achieved since 2016 in the implementation of Best Buys alcohol policy solutions.
- Alcohol remains highly affordable in the WHO Americas region. Between 2012-16, per capita consumption among alcohol users only increased, with 1 in 5 alcohol users consuming heavily.
- Progress in the formulation and implementation of national and local alcohol policy solutions has been insufficient.
- Most countries, especially low- and middle-income countries (LMICs), have NOT implemented a comprehensive set of alcohol policies.
- No low-income country has reported increasing resources for implementing alcohol policy in the last decade.
- Many countries are failing to implement the alcohol policy best buy solutions, with LMICs more likely to have fewer evidence-based and cost-effective policies.
Alcohol affordability
- 95% of reporting countries implement alcohol excise taxes.
- Few use such taxes as a public health policy to reduce consumption.
- Less than half use price strategies such as adjusting taxes to keep up with inflation and income levels, imposing minimum pricing policies, or banning selling below cost or volume discounts.
Alcohol availability
- Less than one-third of countries have regulations on outlet density and days of alcohol sale.
- Some countries, mainly LMICs in Africa, still have no legal minimum purchase age.
Alcohol marketing
- Most countries have some policies on alcohol advertising.
- Alcohol marketing regulation continues to lag behind technological innovations and e-commerce, including rapidly developing new delivery systems.
- Most of the countries that reported no restrictions across all media types were located in the African or Americas regions.
Alcohol is a major obstacle to development,” said Kristína Šperková, President, Movendi International.
It’s not only an obvious health crisis but also a major social justice issue. RESET Alcohol can support governments in advancing proven alcohol policy solutions, which will protect millions of people from harm caused by alcohol companies and promote the health of the most neglected and marginalized people and communities.
Together with our members, we have been working systematically since 2015 to make alcohol taxation the alcohol policy priority it should – given its potential to boost health, development, and justice for millions of people affected by alcohol harms.”
Kristína Šperková, International President, Movendi International
