Movendi Analysis: Second Revised Version of Political Declaration Text

Comparative Analysis Political Declaration HLM4 NCDs and Mental Health

Movendi International has developed a detailed comparative analysis of the political declaration from Zero Draft to Rev.1 document to the latest Rev.2 document, focusing on concrete alcohol policy measures, and placing this in the broader context of how other risk factors and policy packages (SAFER, Best Buys) are treated. 

What Has Been Removed or Weakened: Alcohol Policy Best Buys

From Zero Draft of the Political Declaration

• The Zero Draft originally included specific, high-impact population-level measures, in line with the SAFER technical package and WHO Best and Good Buys:
  • (i) Enforcing restrictions on exposure to alcohol advertising;
  • (ii) Restricting the physical availability and ease of access to retail alcohol;
  • (iii) Enacting and enforcing drink-driving laws.

These are clear references to three of the five SAFER measures.

Movendi International had recommended to further improve this section because only two Best Buys and one good buy, but not the other good buys were listed.

Improvements could be made by listing the four quick buys (this matters because it covers the mental health dimension of alcohol harm, too) or by referencing the SAFER alcohol policy blueprint that member states had endorsed through the 2022 WHO Global Alcohol Action Plan.

To the Rev. 1 Document of the Political Declaration

• These SAFER-based measures are retained but demoted in prominence:
  • Paragraph 43(f) still reads: “reduce harmful use of alcohol including through acceleration of the implementation of the Global Strategy… by: (i) enforcing restrictions on alcohol advertising; (ii) restricting availability and access; (iii) enacting drink-driving laws.”

No improvements have been made to increase clarity, logic, and coherence of the document. Instead, the references to three of the five SAFER measures have been demoted in prominence. 

To the (latest) Rev. 2 Document of the Political Declaration

• All concrete alcohol policy actions are removed. 
• Paragraph 43(f) is now reduced to:
  • “Reduce harmful use of alcohol through the implementation of the Global Strategy to Reduce the Harmful Use of Alcohol (2010) and the Global Alcohol Action Plan 2022–2030” – without any policy examples or language from SAFER or Best Buys.

This makes alcohol policy now the most inadequately addressed solution for any NCDs and mental health risk factors.

The current language has multiple flaws:

1. It communicates that alcohol policy is the lowest priority in the efforts to prevent and reduce NCDs and mental health conditions.
2. In doing so it disregards and ignores the call from member states in 2022 when the World Health Assembly unanimously adopted the Global Alcohol Action Plan 2022 – 2030 to “accelerate action” on alcohol as a “public health priority”.
3. In the decision for the WHO Global Alcohol Action Plan, member states clearly endorsed both the set of high-impact, evidence-based alcohol policy measures as well as the SAFER alcohol policy blueprint. It would make more sense in logic, coherence, and clarity of the political declaration for paragraph 43(f) to list either the alcohol policy best buys or the SAFER alcohol policy blueprint.

Setback in Alcohol Policy Compared to Other Risk Factors

Over the three versions to develop the political declaration of the fourth high-level meeting on NCDs and Mental Health, alcohol policy has substantially been eroded – to the point of meaninglessness.

This is visible from comparison with other NCDs and Mental Health risk factors

Conclusion: Alcohol is the only major modifiable risk factor where cost-effective, high-impact, evidence-based population-level policy solutions were removed completely during negotiations.

Key Differences in how the Political Declaration Frames: Alcohol Policy vs. Tobacco Control

This chart illustrates a clear discrepancy in how the Rev. 2 document of the Political Declaration treats tobacco and alcohol as major NCD and mental health risk factors. While tobacco is addressed with concrete policy measures, strong WHO guidance (FCTC), time-bound targets, and explicit protection from industry interference, alcohol policy is reduced to vague commitments and stripped of proven interventions such as marketing bans, availability limits, and screening and brief interventions.

This seriously disregards alcohol’s role in the global NCDs crisis as well as in the global mental health crisis. And these omissions severely undermine the use of alcohol policy measures to prevent and reduce NCDs and mental health conditions.

The framing of tobacco versus alcohol harm also reveals this discrepancy: tobacco-related deaths, including those from second-hand smoke, are emphasized, while alcohol’s harms – despite causing 2.6 million deaths annually – are only vaguely referenced as “harmful use” and other key aspects are missing, such as: second hand harms from alcohol and the mental health burden due to alcohol.

• Alcohol use disorder (AUD) affects ca. 7% of the global adult population.
• According to the Global Burden of Disease (GBD) Study, alcohol is the number one risk factor for death and disability (DALYs) among people aged 15–49 years globally.
• Since 2006, the total number of healthy life years lost due to alcohol-related cancer in the world has increased by 11%. 

This is a textbook case of ongoing interference of the alcohol industry in global health policy – a textbook case of policy capture where alcohol harm is politically and rhetorically downplayed despite a greater societal burden and a mental health crisis.

What Remains for Alcohol Policy in Rev. 2

• Taxation Target:
  • 80% of countries to increase or implement alcohol and tobacco taxes by 2030 – retained in Rev. 2 (para. under fiscal policy).
• Health Literacy Measures:
  • Alcohol mentioned but with the flawed and misleading concept of “harmful use of alcohol” under public communication strategies, together with tobacco and air pollution.
• Screening & Treatment:
  • “Harmful use of alcohol” is mentioned once under mental health services scale-up – which is misleading in this case as the term also signifies a clinical diagnosis, not the WHO Global Alcohol Strategy definition that the term signifies in the rest of the document; it would be more accurate and less confusing to use language of “alcohol use disorder and addiction”.

But except of alcohol taxation, these are passive, downstream strategies, not the primary population-level alcohol policy solutions called for in the WHO Best Buys.

What Was Lost from Zero Draft to Rev. 2

Updated Strategic Assessment

Our analysis of the three draft versions of the political declaration reveals a clear and deliberate de-prioritization of alcohol policy:

• The Rev. 2 text preserves alcohol taxation – likely due to its fiscal framing and broad support.
• But every other element of evidence-based alcohol policy has been removed or rendered meaningless.
• In contrast, tobacco policy is elevated, showcasing continued double standards.
• Meanwhile, alcohol remains framed in stigmatizing, inaccurate terms (“harmful use”), reinforcing old narratives and ignoring new science (e.g., cancer risks at all levels of use).

Conclusion

Rev. 2 represents a major setback for alcohol policy. Despite decades of evidence and growing global burden, the document:

• Removes the some best and some good buys in alcohol policy
• Fails to acknowledge the SAFER alcohol policy blueprint or the alcohol policy quick buys that are central to the WHO’s own guidance.
• Fails to commit to any target to reduce alcohol consumption or harm.
• Ignores the role of the alcohol industry in shaping harmful environments and obstructing public policy.
• Fails adequately address alcohol harm across NCDs and mental health crises.
• Perpetuates flawed and stigmatising language about alcohol harm and policy.

By contrast, other risk factors are treated with specificity, urgency, and investment – alcohol is the outlier, downgraded to a rhetorical mention.

This erosion of content and the mushrooming of flawed and stigmatising language reflects alcohol industry interference and policy capture during negotiations – and undermines the credibility of the declaration as a science-based, people-centred roadmap to be a turning for NCDs prevention and control and mental health promotion on the way to achieve SDG 3.

Solutions: Restoring Meaning, Ambition, and Impact to Alcohol Policy

To ensure the political declaration delivers on its promise of accelerating NCDs prevention and mental health promotion, governments have a clear opportunity now to restore clarity, coherence, and scientific integrity to how alcohol harm and policy are addressed.

Here are concrete, constructive improvements that negotiators should make:

• Use accurate, science-based language: Replace “harmful use of alcohol” with “harm due to alcohol” or depending on the meaning “per capita alcohol consumption”, such in §12, §43(f), §45.
  • In §56 replace with “alcohol use disorder and addiction”.
• Recognize the scale of alcohol harm: In §13 include more concrete alcohol harm.
  • See three examples above, such as: Alcohol use disorder (AUD) affects ca. 7% of the global adult population.
• Protect and advance fiscal action: In §41 retain and defend the introduction and increasing of alcohol taxation.
  • Alcohol taxation is a key tool for prevention of avoidable harms and costs, revenue generation, health system financing, and health equity and social justice.
• Tackle commercial drivers: In §42 insert “commercial” to include in the list the commercial determinants of NCDs and mental health.
  • And add: “and (ix) regulating health harming industries, ending their subsidies, and protecting against conflicts of interest in NCDs and mental health policy making.”
• Bring policy in line with commitments: In §43(f) Replace the vague reference with a clear, time-bound commitment to implement the WHO SAFER alcohol policy blueprint. A proposed text could read:
  • “Achieve a 20% reduction of per capita alcohol consumption by fully implementing the Global Alcohol Action Plan, especially through cost-effective and high-impact alcohol policy measures of the SAFER package: Strengthen restrictions on alcohol availability, Advance and enforce alcohol impaired driving counter measures, Facilitate access to screening, brief interventions and treatment, Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotion, and Raise prices on alcohol through excise taxes and pricing policies.”
• Defend the alcohol taxation target: Retain and defend the 80% of countries target that have implemented or increased excise taxes on tobacco and alcohol as recommended by WHO by 2030.
  • It is one of the few concrete commitments currently in the text.

These evidence-based adjustments would restore meaning to alcohol policy in the declaration, align the text with WHO-endorsed strategies, and help ensure that NCDs preventions and mental health promotion is truly comprehensive, equitable, and effective.

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