Integration of alcohol measures into United Nations Sustainable Development Cooperation Frameworks
Report
Only 7% of countries include alcohol measures in UN Sustainable Development Cooperation Frameworks.”
Integration of alcohol measures into United Nations Sustainable Development Cooperation Frameworks. Geneva: World Health Organization; 2024.
Background
United Nations Sustainable Development Cooperation Frameworks (UNSDCFs) are important tools for planning and implementing country-tailored UN activities in line with the 2030 Agenda for Sustainable Development. UNSDCFs are jointly designed and co-signed by the UN development system in the country and the respective government.
The Cooperation Framework guides the entire programme cycle, driving planning, implementation, monitoring, reporting and evaluation of collective UN support for achieving the 2030 Agenda.
UN Sustainable Development Group
Alcohol negatively impacts 14 of the 17 Sustainable Development Goals (SDGs) spanning all three dimensions of the 2030 Agenda. It has a direct impact on health-related targets such as those for maternal and child health infectious diseases (HIV, viral hepatitis, and tuberculosis) noncommunicable diseases (NCDs), mental health and road injuries.
UNSDCFs can play a crucial role in accelerating countries’ progress to reaching SDG target 3.5 – “Strengthen the prevention and treatment of substance abuse including narcotic drug abuse and harmful use of alcohol” by positioning alcohol policies and interventions as national strategic priorities calling for joint UN action.
This report aims to describe if and how alcohol has been integrated into UNSDCFs as a risk factor for developing NCDs and/or as a link to mental health and behavioural conditions. The results will also support discussions at the UN General Assembly High Level Side Event on “Alcohol policy for delivering a better present and safeguarding the future” on the September 23, 2024, in New York.
We know that achieving the 2030 Agenda for everyone, everywhere is humanity’s best chance of ensuring the progressive realization of human rights and a future of peace and prosperity for all. The new UN Cooperation Frameworks offer a tremendous opportunity to scale up implementation of the 2030 Agenda and demonstrate concrete results on the ground.”
Amina J. Mohammed, United Nations Deputy Secretary-General, Chair of the United Nations Sustainable Development Group
Methodology
The analysis was based on the methodology developed by the Secretariat of the United Nations Interagency Task Force on the Prevention and Control of NCDs (UN NCD Task Force) to assess the integration of NCDs and/ or mental health in UNSDCFs.
Further information on the methodology can be found in the Task Force’s most recent UNSDCF analysis report.
A UNSDCF is considered to include alcohol if referenced as part of the UNSDCF strategic priorities and/ or results matrix section.
The strategic priority section defines key national development priorities and strategies to address these, and it is often paired with a theory of change. The results matrix outlines the outcomes linked to the strategic priorities, specific outputs that contribute to reaching the outcomes, and indicators to monitor progress and report results.
Alcohol measures that were not explicitly described in the UNSDCFs may have been overlooked. For example, if the UNSDCF mentioned “substance abuse” without specifying the word “alcohol”, it would have been excluded from the analysis. In addition, the annual UN country team result reports have not been examined, which could have provided additional insights into alcohol policy initiatives within the country or area.
Key findings Integration of alcohol measures into UNSDCFs
UNSDCFs that were rolled out between 2020 and 2023 were analysed. Of the 135 countries that rolled out a UNSDCF during this period, 9 countries (7%) included alcohol measures as a strategic priority and/or as a metric.
Specifically that means:
- 93% (126/135 countries) did not include alcohol policy measures,
- 3% (4/135) integrated alcohol policy measures solely in the results matrix,
- 2% (3/135) integrated alcohol policy measures solely in the strategic priorities section,
- and 2% (2/135) integrated alcohol policy measures in both sections.
Most (5/9, 56%) of the countries that include alcohol measures are in the WHO European Region, (Albania, Armenia, Belarus, Montenegro, and Serbia); two are in the WHO South-East Asia Region (Indonesia and Timor-Leste); one is in the WHO African Region (Sao Tome and Principe); and one is in the WHO Western Pacific Region (China).
No countries in the WHO Americas region and WHO Eastern Mediterranean Region included alcohol measures in their UNSDCF.
For almost all countries, the inclusion of alcohol measures was framed under the need for a shift towards healthier behaviours.
In the case of Timor-Leste, the UNSDCF included alcohol taxation as an example of health financing mechanisms, whereas Albania and Indonesia focused on access to rehabilitation services for alcohol dependence.
In Annex 1, the report provides details of how each country included alcohol measures in their UNSDCFs.
Points for discussion
The inclusion of alcohol policy measures in only 9 out of 135 countries’ UNSDCFs suggests that alcohol policy measures are not seen as a priority and calls for UN country support to bridge the gap by raising awareness with national counterparts and other stakeholders.
Not all countries are expected to prioritize alcohol measures in their UNSDCFs, considering their competing priorities. However, for countries with greater burden, higher alcohol per capita consumption, heavy alcohol consumption episodes, and increasing young people consumption, it is crucial to tackle the root causes driving alcohol consumption and, consequently, due consideration should be given to include alcohol in their UNSDCFs.
To maximize the possibility of alcohol policy measures being included as a priority in UNSDCFs, they should be framed specifically to government focus areas and target groups as well as topics of shared interest by multiple UN agencies. A variety of focus areas can be considered for joint UN action on alcohol policies.
The WHO Global Alcohol Action Plan (2022-2030) should be used as a reference for identifying priority actions when building UNSDCFs.
The GAAP details high-impact strategies and interventions for Member States, international partners and other stakeholders, emphasizing advocacy, partnerships, capacity building, and resource mobilization.
How alcohol policy should be included in UNSDCFs
Alcohol policy measures should be referenced throughout the UNSDCFs to ensure that the burden, vision, and priority actions – along with collaborative efforts between the UN and governments – are effectively integrated and interconnected. Specifically, the UNSDCF should highlight the burden and prevalence of alcohol consumption in the situation analysis, position alcohol policy measures as a national strategic priority, and develop specific outputs and indicators to track progress and report results.
UNSDCFs should call on strengthening a joint approach to alcohol policies and serve as a foundation for joint UN workplans. A tool that could bring together the different UN actions at the country level is the SAFER package, which involves coordinated partner efforts among WHO, UNDP and civil society organizations aiming to reduce alcohol harm.
To strengthen the inclusion of alcohol measures in UNSDCFs, UN agencies at global and regional levels should jointly contact UN country teams with an expiring UNSDCF to identify and/or re-emphasize why reducing alcohol consumption should be a strategic priority and develop country-specific activities.
Examples of thematic areas for framing alcohol measures as a priority in UNSDCFs
| Alcohol thematic area | UN agencies, intergovernmental organizations and development banks at country level |
|---|---|
| Alcohol as a determinant of road safety risks | UNDP and WHO |
| Alcohol dependence and access to prevention, screening, treatment and rehabilitation services | UNDP, UNICEF, UNODC, WHO |
| Alcohol consumption of young people and its impact on brain development and completion of formal education | UNESCO, UNICEF, WHO |
| Alcohol consumption during pregnancy as a risk factor for the child and mother’s health | UNFPA, UNICEF, UN Women, WHO |
| Alcohol consumption as a risk factor for developing NCDs | UNDP, UNICEF, WHO |
| Alcohol consumption as a risk factor for communicable diseases, including HIV/AIDS and tuberculosis | Global Fund, UNAIDS, WHO |
| Alcohol as a determinant of harassment and violence against women and children | OHCHR, UNFPA, UNICEF, UN Women, UNODC |
| Alcohol taxation and marketing restrictions as components of fiscal and social protection policies | ADB, AfDB, EBRD, IADB, IMF, UNDP, WHO, World Bank |
| Alcohol availability, including illicit forms, and its production play a direct role in generating economic disparities and act as a barrier to sustainable livelihoods | ADB, AfDB, EBRD, FAO, IADB, IDLO, ILO, IMF, UNDP, UN-Habitat, UNODC, WHO, World Bank |
| Alcohol as a risk to occupational health and safety and impact on workers’ productivity and absenteeism | ILO, UNDP, WHO |
| Alcohol use in conflict-affected and displaced populations | OCHA, UNHCR, WHO |