Alcohol policy measures are an ignored catalyst for achievement of the sustainable development goals
Context and significance
The available information about alcohol harm and the sustainable development goals presents three main categories of scientific analysis of the intersection of the two areas:
- description of the problem by exposing the intersection of alcohol harm and the achievement of sustainable development;
- emphasis of the importance of policy coherence, including alcohol policy, for achievement of the sustainable development goals; and
- analysis of the reasons for inconsistency in policy making, such as conflict of interest and alcohol industry interference.
Although there are several papers that examine the link between alcohol and sustainable development, the focus lays solely on SDG 3, while a systematic overview of how governments currently utilize the potential of alcohol policy solutions for achievement of sustainable development goals does not yet exist.
By adopting the Agenda 2030, governments agreed to review and report on their approach and action for the achievement of the sustainable development goals annually through the High-Level Political Forum on Sustainable Development (HLPF). Health and well-being are at the heart of the United Nations Agenda 2030. Given the social and economic harm that can be caused by alcohol, reducing the consumption of alcohol is a pre-requisite to achieve the sustainable development goals.
The researchers explored how selected European countries have considered alcohol-related harm as an obstacle to the achievement of the SDGs and the extent to which they view alcohol policy as a solution to the achievement of sustainable development by analysing their voluntary national reviews (VNRs) submitted to the HLPF between the years 2016 and 2020.
The researchers developed a unique framework with 260 questions reflecting the three dimensions of alcohol-harm considerations: indication, action, and evaluation.
They analysed 36 VNRs of 32 European countries by first assessing them against the 260 questions to find out how they report on alcohol harm and whether they, in their action, refer to evidence-based, cost-effective alcohol policy solutions.
Afterwards the researchers used content analysis to assess the extent to which the countries addressed alcohol related harm, whether they refer to alcohol harm within SDG 3 (good health and well-being) or look beyond the health goal and consider alcohol harm having impact on goals other than the Goal 3.
Nine countries (28.1%) did not mention alcohol in their report.
Only eight countries (25%) mentioned one or more of the alcohol policy best buys among the actions they are taking to reduce alcohol related harm and only three (9.3%) explicitly elaborated on their impact on goals other than goal 3.
Only five countries referred to the agreed indicator 3.5.2 measuring alcohol per capita consumption in the adult population.
Many of the remaining countries used a range of terminology rather than alcohol per capita consumption, including “excessive use of alcohol”, “heavy use”, “too much alcohol “, “harmful alcohol consumption”, “use among young people”.
Alcohol use is, for example, associated with violence (SDG 5 and 16), it contributes to inequalities (SDG 5 and 10), it hinders economic growth (SDG 8), disrupts sustainable consumption (SDG 12) and it adversely impacts the environment (SDG 13 and 15).
The findings of this study show that these effects are not considered in the design of measures to achieve these goals.
Moreover, inaccurate language related to alcohol harm indicates a gap in understanding of the extent of the alcohol burden and the consequences for sustainable development. So does the choice of ineffective measures to reduce alcohol consumption. Education programs and awareness raising campaigns focusing on individual lifestyle are neither in line with the WHO Global Alcohol Strategy that all selected countries adopted in 2010, nor do they reflect the seriousness of the problems related to alcohol use.
Effective alcohol policy measures, the so called three best buys, are missing from the transformative action that the Agenda 2030 calls for and governments committed to.
Novel approach: examining countries’ UN reporting about SDGs progress
The SDGs are legally non-binding, and their effective implementation depends largely on the good will of national governments. Governments agreed to review and report on their approach and action for the achievement of the SDGs annually through the High-Level Political Forum on Sustainable Development (HLPF), which was mandated in 2012 through the United Nations Conference on Sustainable Development (Rio+20).
- One pillar of the Forum is an in-depth review of selected SDGs. The reviewed SDGs differ from year to year, and all 17 SDGs are covered within a three-year cycle set by a Resolution of the General Assembly.
- Another pillar follows up country action through voluntary national reviews (VNRs). Each country is expected to report at least once in a four-year cycle. Two hundred forty-seven VNRs were submitted to the Forum between 2016 and 2021.
There is no template for VNRs, although common reporting guidelines are issued by the Secretary General recommending concrete chapters.
- Most countries examine actual progress on all targets (and indicators). In an analysis of 20 European VNRs, it was concluded that whilst robust numerical data on progress might be presented, information on the actions that countries have taken to achieve the goals is often lacking.
- Another approach to reporting is to document potential interactions between different SDGs, and to consider the positive and negative effects of these, including the ways to enhance and reduce the effects respectively.
Since failure to address alcohol-related harm impedes progress towards the SDGs, the aim of this paper is to explore how selected European countries have considered alcohol-related harm as an obstacle to achieving the SDGs and the extent to which they view alcohol policy as a solution for promoting sustainable development.
The researchers hypothesis is: In their reporting process to the HLPF (VNRs), governments do not consider the impact of alcohol policy solutions on the achievement of the SDGs.
The researchers ask the following questions:
- Do governments mention alcohol harm in their VNRs to the HLPF?
- Do governments mention alcohol policy solutions in their VNRs to the HLPF?
- Do governments address the impact of alcohol policy on the achievement of the SDGs in their VNRs to the HLPF?
[O]mitting the alcohol policy best buys and their impact on the achievement of the SDGs from VNRs means a missed opportunity not only to share experience, insights, and knowledge about how to use them as a catalyst for sustainable development but also to start building a collective understanding that these solutions could be a part of a basic action package for sustainable development.”Sperkova K, Anderson P, Llopis EJ (2022) Alcohol policy measures are an ignored catalyst for achievement of the sustainable development goals. PLoS ONE 17(5): e0267010. https://doi.org/10.1371/journal.pone.0267010
The analysed countries are often not precise in their definition of alcohol harm. This contributes to insufficient alcohol policy action and often to the choice of ineffective measures
Considering the enormous potential that implementing the alcohol policy best buys and reducing overall alcohol consumption can have on achieving the SDGs, the number of countries that considered the effects of the alcohol policy best buys in their VNRs is very low.
These findings show that very few countries reflect on the adverse effects of alcohol related harm on the society and sustainable development that they have committed to in 2015.
The findings also show that very few countries use a population level approach to alcohol related harm and most of the countries expect their citizens to take personal responsibility for their alcohol consumption. Overlooking population-wide solutions can mean a missed opportunity to implement highly cost-effective (and in the case of alcohol taxation even domestic resources mobilising) solutions and facilitate transformative change to shift the world on to a resilient and sustainable path.
Only 8 countries mentioned one or more of the alcohol policy best buys among the actions they are taking to reduce alcohol related harm. Only five countries (15.6%) wrote about the impact of one or more of the three alcohol policy best buys on the achievement of the SDGs and only three (9.3%) explicitly elaborated on their impact on goals other than SDG 3.
- Hungary referred to restricted alcohol availability in order to contribute to improved nutrition among children and youth (SDG 2);
- Finland referred to alcohol availability and its impact on social inclusion and poverty (SDG 10);
- Estonia highlighted the importance of the alcohol policy best buys for the creation of safer environments (SDG 11) and mentioned the importance of effective alcohol policy for the reduction of economic harm caused by alcohol that could be interpreted as enabling of economic growth (SDG 8).
Although health is at the centre of Agenda 2030 and despite the strong relationship between health, wellbeing, and inequalities, consideration of this connection was rare. The choice of words indicates that governments continue to underestimate the full extent of alcohol harm and limit it to “alcoholism” and “excessive drinking”. Limiting alcohol harm to “alcoholism” can be a partial explanation for the missing attention to the most cost-effective population level alcohol policy measures. Instead of utilizing the overall reduction of alcohol use as a catalyst for development, countries reported rather vague approaches to alcohol harm such as ineffective lifestyle campaigns or placing responsibility for alcohol harm solely on the individual. This framing prevents governments from seeing the broad impact of alcohol harm on education, equality, economic growth, and the environment. Governments are thus missing an opportunity to utilise the potential of alcohol policy best buys to accelerate progress towards multiple SDGs in a cost-effective and synergistic way.