The UN General Assembly will convene three High-Level Meetings (HLM) on health during its 78th session (UNGA 78) in New York. The meetings present a historic opportunity for world leaders to reposition world health on the political agenda. These sessions aims to once again commit to the world’s public health goals of ending tuberculosis, delivering universal health coverage, and strengthening pandemic prevention, preparedness, and response.
The HLMs come at a crucial time as the world recovers from the coronavirus pandemic. In its aftermath, the world is also still gripped by multiple humanitarian and climate crises.
These high-level meetings bring unprecedented focus on global public health at the UN General Assembly. For instance, the September 21 High-Level Meeting on Universal Health Coverage convenes countries and stakeholders to accelerate progress toward health for all. Discussions will include a review of implementation of the 2019 Political Declaration as well as noting gaps and solutions to move towards universal health coverage by 2030.
Upholding the human right to health and building equitable health systems are essential to achieve UHC. At the event, Movendi International hopes to shed particular light on the obstacle to the world’s Sustainable Development Goals and UHC that alcohol is. Movendi International will also host a high-level side event to highlight the ways in which the world stands to benefit from improved alcohol policy.
Experts express frustration over lack of clarity in UN declarations on pandemics, UHC and TB
Leading global health experts and activists expressed frustration at the draft political declarations to be adopted by world leaders at the General Assembly.
The key criticisms of the three declarations are:
- They offer no advancement on previous international agreements.
- They are devoid of human rights safeguards.
- They do not chart a clear path to improved access to healthcare and medicines, especially in low-middle income countries and among vulnerable groups.
The draft political declaration on UHC was also described as being a “missed opportunity” to expand on UHC commitments. This is because all the measures in the 2023 declaration were also covered in the last UN HLM on UHC in 2019.
Alcohol and the Sustainable Development Goals
Alcohol causes a multitude of health, social, and economic harms that adversely impact sustainable development. Through its harms, alcohol impedes all three dimensions of development with far reaching consequences for society as a whole. This is because alcohol harm jeopardizes human capital, undermines economic productivity, destroys the social fabric, and burdens health systems.
Alcohol effects 14 out of 17 SDGs adversely, as well as a total of 54 targets they hope to achieve.
The products and practices of the alcohol industry are jeopardizing human capital, undermining economic productivity, eroding the social fabric, and burdening health systems. And they harm human happiness and well-being. In addition to human health the alcohol industry also harms planetary health.
Evidence analyzed and compiled by Movendi International shows that alcohol cuts across many areas of the 2030 Agenda, putting a total of 14 SDGs at risk.
These include:
- Eradication of poverty,
- Ending world hunger,
- Ensuring healthy lives for all,
- Ensuring quality education for all,
- Achieving gender equality for all,
- Ensuring drinking water for all,
- Promoting decent work and inclusive, sustainable economic growth for all,
- Reducing inequalities,
- Making cities safe and inclusive for all,
- Ensuring sustainable consumption,
- Combatting climate change,
- Protecting terrestrial ecosystems,
- Promoting peaceful and inclusive societies, and
- Revitalising global partnerships for the SDGs.
This clearly shows the major risk that alcohol poses for reaching health and development for all. In fact, alcohol drives underdevelopment, degrades ecosystems, fuels the climate crisis and promotes exclusion, deprivation and inequalities.
The potential of alcohol policy in reaching the SDGs
In a new peer-reviewed paper, researchers of the Copenhagen Consensus Center examined the benefit-cost analyses of various NCD interventions in low-income (LICs) and lower–middle-income (LMCs) countries. They analyzed 30 interventions recommended by the Disease Control Priorities Project, including six intersectoral policies, such as taxes and 24 clinical services. Using a previously published model to estimate intervention costs and benefits through 2030, researchers found that intersectoral policies often provided great value for money.
They concluded that there are several cost-beneficial opportunities to tackle NCDs in LICs and LMCs. In countries with very limited resources, the best-investment interventions could begin to address the major NCD risk factors, especially tobacco and alcohol, and build greater health system capacity, with benefits continuing to accrue beyond 2030.
The Copenhagen Consensus Center found that each dollar spent on alcohol policy development will deliver $76 of social benefits. And an alcohol tax increase alone can generate large social benefits at $53 in return for each dollar invested.
Low- and middle-income countries need interventions that use fewer resources while producing the largest effect – targeting the biggest obstacles to development.
According to several peer-reviewed studies, there is clear evidence for the effectiveness of increasing prices through taxation in preventing alcohol harm. This is because it reduces population-level alcohol use, resulting in fewer alcohol-related harms and costs. The resources that these policies generate can then be redirected to create large social benefits for societies.
Alcohol and Universal Health Coverage
Movendi International participates in the High-Level Meeting on Universal Health Coverage to ensure greater recognition of the alcohol burden on healthcare systems and to advocate for full use of alcohol policy to improve healthcare capacity to respond to public health issues.
The heavy burden of alcohol harm worldwide urgently requires a more responsive health system that prioritizes prevention and health promotion. Screening and brief interventions for all who need it is also a vital component of this response.
Effectively tracking and monitoring alcohol as a risk factor for disease, multi-morbidity and pre-mature death is also a crucial challenge. This is due to the pervasiveness of alcohol harm in our societies.
The quantifiable burden of alcohol on healthcare and healthcare resources
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.
- In high income countries alcohol use is the second fasted growing risk factor and in LMICs it 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 the SDGs targets to reduce alcohol use and harm will not be met.
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.
Alcohol harm is massive and burdens health systems severely. For example globally alcohol contributes to 20% of injuries in emergency department presentations. In some low- and middle-income countries 1 in 5 hospital beds are occupied due to alcohol harm.
Costs due to pervasive alcohol harm undermine the strength resilience and capacity of health systems to provide care prevent harm and promote health.
For instance, the high prevalence of alcohol use disorder and addiction in the world cause tremendous pressure on healthcare services.
400 million adults in the world suffer from an alcohol use disorder. That means 7% of all adults in the world have an alcohol use disorder.
But treatment coverage is very low. Fewer than 1 in 5 people receive treatment for alcohol use disorders – less than 1 in 10 in in low- and lower-middle-income countries.
The Organization for Economic Cooperation and Development (OECD) released a landmark report in 2021 detailing the economic harm caused by the alcohol industry. Alcohol-related diseases and injuries incur a high cost to society. Life expectancy is nearly one year lower than it would be, on average, if alcohol consumption in a population would be lower.
An average of 2.4% of health spending in OECD countries goes to dealing with the harm caused by alcohol consumption – and the figure is much higher in some countries. In addition, poor health due to alcohol consumption has detrimental consequences on labour participation and productivity.
A call to action for the achievement of SDGs and UHC
That is why alcohol policy in general and alcohol taxation in particular are powerful tools to help reach health for all by increasing fiscal space and reducing avoidable healthcare burden and spending.
Funding people-centered primary healthcare through alcohol taxes is an important tool that needs to receive greater attention. Country best practices on how to improve health system functioning through alcohol policy exist and should be integral part of the UHC discussions going forward.
Sources
Official website, World Health Organisation “UN General Assembly High-Level Meetings on Health 2023“
News/ Official website, World Health Organisation: “Unprecedented Focus on Global Public Health at Un General Assembly“
Official website United Nations: “High-Level Meetings of the 78th Session“
