Alcohol misuse: tackling the UK epidemic - London

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BMA Board of Science
International cooperation on alcohol control
It is evident that different countries have adopted markedly varied policies for reducing the burden
112, 234, 238-240
of alcohol misuse. This reflects the differences in alcohol consumption and related harm
between countries, as well as the diverse political climates and objectives. International
cooperation on alcohol control is essential for several reasons including: the significant global
burden of alcohol; the commonality of problems faced by different countries (eg underage
drinking, alcohol-related road deaths); trans-border factors such as global advertising and
production, formal and informal trading, and smuggling; and the difficulty countries have in
dealing with alcohol problems in isolation.
Reducing alcohol-related harm across the EU has been facilitated by the adoption in 2006 of an
EU Alcohol Strategy with five priority themes:
to protect young people, children and the unborn child
to reduce injuries and death from alcohol-related road deaths
to prevent alcohol-related harm among adults and to reduce the impact on the workplace
to inform, educate and raise awareness on the impact of hazardous consumption
to develop and maintain a common evidence base at EU level. 241
In 2007, an EU Alcohol and Health Forum was set up to assist implementation of the strategy and
to provide a common platform for relevant stakeholders who pledge to increase their actions to
reduce alcohol-related harm. Other initiatives include the adoption of the EU Road Safety Action
Programme 2003/08, the EU Community Public Health Programme 2003/08, and Audiovisual
Media Services Directive (previously known as the Television Without Frontiers Directive). 241
In 1995,
the WHO European Charter on Alcohol – which was endorsed by all Member States of the EU –
set out 10 key areas of health promotion that need to be addressed in reducing the burden of
alcohol in Europe (see Appendix 5). 242
This has since been re-enforced by the 2000 WHO European
Alcohol Action Plan, 243
the 2001 WHO declaration aimed at reducing alcohol misuse among young
people, 244
and the 2005 WHO Framework for Alcohol Policy in the European Region. 245
While the introduction of agreements such as the WHO European Alcohol Action Plan and the
EU Alcohol Strategy provide a useful platform for action, their effectiveness has been questioned
because of the influence of the alcohol industry on their development. 246-248
These questions focus
on the omission of key policies from the 2006 strategy such as those that affect price and
246, 247
availability. This represents a significant shortcoming in the promotion of public health by
EU member states. It is vital that the UK Government strongly supports EU initiatives and policies
aimed at reducing alcohol-related harm to individual and public health. Strong support for
WHO and World Health Assembly (WHA) initiatives on alcohol is also necessary.
A further drawback of EU-level action and agreements is the fact that they are non-binding. 240
Existing international agreements and treaties on trade also serve to weaken the ability of national
and sub-national governments to restrict the alcohol market. 240
It is therefore important that a
legally binding international treaty on alcohol is developed and implemented to reduce the global
burden of alcohol. There is no pre-existing international framework or convention under which
alcohol could easily be incorporated. w
An alternative approach would be to introduce a legally
binding treaty similar to the WHO Framework Convention on Tobacco Control (FCTC) that came
w The 1971 Narcotics Convention may provide a feasible international convention under which alcohol could be incorporated;
however, resistance from the alcohol industry and from the general public is likely to make this unrealistic.
Alcohol misuse: tackling the UK epidemic