Legislators of Sao Tome and Principe, concerned about alcohol harm and the high prevalence of alcohol use disorder, designed a comprehensive alcohol control bill to tackle this situation.
Despite the uncertainties about the outcome of the bill’s approval, the process for developing the bill has been inclusive, culturally sensitive, evidence-based, free of industry interference and country-led.


Zila M Sanchez,a Arlindo Carvalho,b Celmira Sacramento,b Filomena D’Alva,b Iazalde Rita,b Sebastiao Pinheiro,b Elisabete M Soares de Barros,c Vilfrido Santana Gil,d Me-Chinho Costa Alegre,d Anne Ancia,d Maristela G Monteiro,e Chidinma A Opokof and Juan E Tello


Sanchez, Zila M, Carvalho, Arlindo, Sacramento, Celmira, D’Alva, Filomena, Rita, Iazalde. et al. (‎2022)‎. Development of alcohol control law, Sao Tome and Principe. Bulletin of the World Health Organization, 100 (‎10)‎, 628 - 635. World Health Organization. http://dx.doi.org/10.2471/BLT.22.288590

Bulletin of the World Health Organization
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Development of Alcohol Control Law, Sao Tome and Principe

Policy and Practice research article


The World Health Organization (WHO) African Region is struggling with increasing harm due to alcohol. Legislators of Sao Tome and Principe, concerned about alcohol harm and the high prevalence of alcohol use disorder, designed a comprehensive alcohol control bill to tackle this situation.

Input into the design of the bill was obtained through interviews involving many stakeholders. The process had five phases:

  1. Scoping the problem to understand the social burden of the harm caused by alcohol.
  2. Updating the evidence on alcohol policies and identifying areas for legislative interventions.
  3. Drafting the bill.
  4. Aligning the legislative framework of the bill.
  5. Initiating the parliamentary procedure.

The new bill scored 92/100 using a standardized alcohol control policy scale. The bill covers all domains of WHO’s 2010 Global Alcohol Strategy, and includes the three most cost-effective interventions for preventing and reducing alcohol harm:

  1. Increased excise taxes on alcohol,
  2. Bans or comprehensive restrictions on exposure to alcohol advertising, and
  3. Restrictions on the availability of retailed alcohol through reduced hours of sale.

The National Assembly plenary session upheld the bill, which is now under evaluation of the specialized First Commission on Political, Legal, Constitutional and Ethical Affairs. Approval of the bill requires the final voting once it is back with the National Assembly and its promulgation by the President.

Drafting an alcohol control bill which is country-led, inclusive, evidence-based and free of interference by the alcohol industry helps prioritize public health objectives over other interests.


In its current format, the new bill would be a comprehensive reference regulation for alcohol policy in Africa’s low- and middle-income countries. The process described by the researchers provides a content reference framework and a stepwise approach for other countries. After the approval of the action plan to effectively implement the WHO Global Alcohol Strategy as a public health priority, other countries will likely embark on similar initiatives.

A different, still successful approach was followed by Malawi.

Lessons learnt

Needs-driven, evidence-based approach

The initiative took place because a group of legislators was concerned with the harm caused by alcohol. The initiative was based on, and driven by, concrete needs. This need kept up interest in continuing the process and ensured the use of evidence to facilitate discussions and reach agreements about the directions to follow.

Inclusive and systematic process

The process for developing the bill was participatory and included the perspectives of a broad range of stakeholders (representativeness), legislators (political will and leadership) and senior experts (evidence and scientific knowledge).

International standards and tools were used to facilitate the convergence towards a comprehensive bill.

Political will for a common goal

The political will to tackle a public health problem prevailed over party interests. Agreement was facilitated by making the well-being of vulnerable communities the main goal. For example, the traditional and homemade production of alcoholic beverages was excluded from the bill due to a lack of financial resources to help those who would be affected if this aspect had been included in the law.

Accountability of parties

Some features of Sao Tome and Principe may have facilitated the approach and process. The country is small in size and population. These features eased accountability between legislators and community members and protected the bill’s development from vested interests, especially from the alcohol industry.

Timeliness and opportunity

The participatory process to develop the bill kept the momentum to ensure a shared vision of the interventions needed to address the problems caused by alcohol. However, the opportunity to sustain these learning efforts may be hindered by the parliamentary procedures and timing, leading to uncertainty about the outcome.

Source Website: WHO