Introduction to the Special Issue on Public Health and the Global Governance of Alcohol
Preventing harms from alcohol requires intervention at multiple levels – in communities and organisations, and by governments acting at the national, regional and global level. The articles in this symposium issue of the European Journal of Risk Regulation focus on alcohol as a global health problem, exploring how alcohol is governed at the global level, and how it could and should be governed to minimise and prevent harm.
This conceptualisation of alcohol is warranted, not just because of the common experience of countries with alcohol consumption and harm, but because of the increasingly global nature of the alcohol industry and its products. The production and marketing of alcohol is now concentrated in the hands of a small number of transnational corporations. There is a strong global trade in alcohol. There is also significant cross-border marketing of alcohol, particularly through social media.
The treatment of alcohol in trade and investment agreements is impacting the capacity of national governments to intervene and regulate alcohol in a manner protective of the public’s health. At the same time, there is an emergent desire to explore how the instruments of global health governance, including those available through the World Health Organization (WHO) and the Codex Alimentarius Commission (Codex), might be used to advance the public health project of reducing harms from alcohol.
A push for a treaty on alcohol – a Framework Convention on Alcohol Control (FCAC) inspired by the success of the Framework Convention on Tobacco Control (FCTC) – has not yet been successful. But in early 2020, the Executive Board of the WHO did commit to the development of an action plan to improve the implementation of the “Global strategy to reduce the harmful use of alcohol” (Global Strategy).
Overview of articles included in the symposium
- The symposium opens with an article by Jürgen Rehm, Sally Casswell, Jakob Manthey, Robin Room and Kevin Shield analyzing how levels of alcohol use have been used as an indicator of progress in several global instruments covering alcohol, including the “Global Strategy”, the “Global Action Plan for the Prevention and Control of NCDs 2013–2020” and the “Sustainable Development Goals”.
- In the article by Robin Room, the history of alcohol’s handling by international institutions and its limited inclusion in international instruments reveals “good intentions, but little action”.
- The article by Trish Hepworth, Sarah Ward and Lisa Schölin and the article by Clare Slattery also explore how alcohol is treated by international institutions other than the WHO. Hepworth, Ward and Schölin discuss the developments by Codex to fill a “vacuum” around international labelling standards for alcohol products.
- In her article, Slattery strikes a positive note and argues that “the human rights agenda can be used to ensure accountability and mobilise action for alcohol control”.
- The article by Paula O’Brien compares how the Global Strategy and the FCTC have been used in discussions in the World Trade Organization’s Committee on Technical Barriers to Trade (TBT Committee).
- The article by Suzanne Zhou maps the differences between binding and non-binding legal instruments, drawing on experience from tobacco control and the FCTC.
- Gian Luca Burci considers that a FCAC would be “the most effective approach from a substantive and institutional perspective in terms of a global regulatory instrument”, he does not think such an instrument is feasible at the present time owing to political considerations and the absence of “norm entrepreneurs”.
- The symposium concludes with an article by Robin Room and Jenny Cisneros Örnberg, offering the first ever “concrete” proposal for drafting a FCAC, including a text that could be used as a starting point for discussions.