CHAPTER 3 The cost of harmful alcohol use in South Africa ... - ARA

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Chapter 3 │ Cost of harmful alcohol use in SA and policy measures by mitigating the effect of alcohol abuse. The estimates by DNA Economics also include the intangible, non-financial costs of the trauma associated with alcohol-related illness, injury and violence. By doing so, they go some way towards indicating how much value South Africans place on any intervention that would help to mitigate this trauma. Proposed policies by the World Health Organisation (WHO) to curb the harmful use of alcohol 9 Death and injury through the harmful use of alcohol, as well as the resultant economic and social cost of this harmful use, can be reduced through prevention and treatment policies – if it is enforced properly. As early as 1979, the World Health Assembly (WHA) called on WHO Member States to develop “intensive preventive programmes” and “appropriate legislation and other measures enabling effective action to be taken” to reduce the harmful use of alcohol. In 1983, the World Health Assembly recommended that Member States “formulate comprehensive national alcohol policies, with preventive measures as a priority”. In 2005, the World Health Assembly again called on Member States to “develop, implement and evaluate effective strategies and programmes for reducing the negative health and social consequences of harmful use of alcohol”. The WHO reported to the World Health Assembly on ten ‘best practices’ identified by the research (WHA54/18): …minimum legal age to buy alcohol, government monopoly of retail sales, restrictions on hours or days of sale, restrictions on the density of sales outlets, taxes on alcohol, sobriety checks, lowered limits for blood alcohol concentration, administrative suspension of licences for driving under the influence of alcohol, graduated licensing for novice drivers (i.e. issuing licences with initial limitations on driving privileges, such as a zero limit for blood alcohol concentration), and brief interventions for hazardous drinkers. Prevention strategies, such as education and persuasion, although perhaps the most widely applied, are not necessarily effective. Recent evidence suggests that population-based policy measures such as taxation are the most cost-effective public health response to the alcohol-related disease burden in countries with moderate and high levels of alcohol consumption, whereas measures targeted at high-risk or harmful drinkers, such as brief interventions, appear to be more effective where the rates of hazardous consumption of alcohol are lower. In 2010, the World Health Assembly endorsed a global strategy on the harmful use of alcohol (see Box 7). Box 7: The Global Strategy to Reduce the Harmful Use of Alcohol The Global Strategy to Reduce the Harmful Use of Alcohol was endorsed by the Sixty-third World Health Assembly in May 2010. The consensus reached on the global strategy and its endorsement by the WHA is the outcome of close collaboration between WHO Member States and the WHO Secretariat. The process that led to the development of the global strategy included consultations with other stakeholders, such as civil society groups and economic operators. The global strategy builds on several WHO global and regional strategic initiatives and represents the commitment by WHO Member States to sustained action at all levels. The strategy contains a set of principles that should guide the development and implementation of policies at all levels; it sets priority areas for global action, recommends target areas for national action and gives a strong mandate to WHO to strengthen action at all levels. The Global Strategy to Reduce the Harmful Use of Alcohol includes ten recommended target areas for national action: 9 Main sources for this section: “Global Status Report on Alcohol and Health”, World Health Organization (2011); “Addressing the Harmful Use of Alcohol, A guide to developing effective alcohol legislation”, World Health Organization (2011); “Global Strategy to Reduce the Harmful Use of Alcohol”, World Health Organization (2010) Economic Impact of Advertising Ban on Alcoholic Beverages│ ARA Page | 42
Chapter 3 │ Cost of harmful alcohol use in SA and policy measures 1. leadership, awareness and commitment - leadership is exemplified by the existence of national policies as well as awareness campaigns. 2. health services’ response 3. community action 4. drink–driving policies and countermeasures - these include blood alcohol concentration (BAC) laws and random breath-testing. 5. availability of alcohol - these include age limits for the purchase and consumption of alcohol, monopoly or licensing systems for alcohol distribution, bans on the sale of alcohol at petrol stations, and limits on the hours and days that it can be sold. 6. marketing of alcoholic beverages - these policies include how much marketing is permitted, the existence of self-regulatory systems within the alcohol industry, bans on product placements and sports sponsorships, and limits on retail sales below cost. 7. pricing policies - these focus on alcohol tax revenues as a percentage of total government revenues, and the existence of dedicated alcohol taxes. 8. reducing the negative consequences of intoxication 9. reducing the public health impact of unrecorded alcohol 10. monitoring and surveillance. Not all the policy options and interventions will be applicable or relevant for all Member States and some may be beyond available resources. As such, the measures should be implemented at the discretion of each Member State depending on national, religious and cultural contexts, national public health priorities, and available resources, and in accordance with constitutional principles and international legal obligations. The implementation of the global strategy will require active collaboration with Member States. The WHO Secretariat will report back to the WHA in 2013 on progress in implementing the strategy. In 2010, the WHO has identified the policy measures (within the ten recommended target areas as mentioned in Box 7) that they view as the most effective. These are: 1. To reduce affordability through price; 2. To reduce availability of alcohol by restricting and/or regulating the sale of alcohol to the public; 3. To reduce alcohol consumption by children and young people by setting the minimum age for sale and purchase; 4. To deter drinking and driving; 5. To monitor and enforce legislation; and 6. To reduce exposure to alcohol marketing. In light of the WHO global strategy, many countries are developing national alcohol policies and action plans, and considering legislation to give effect to these policies - South Africa has been one of the countries actively supporting the WHO’s strategy. An overview of the effectiveness of the various policies will be summarised in Chapter 5. South Africa’s response to the WHO’s proposed policy measures The publication of the WHO’s reports, “Global Strategy to Reduce the Harmful Use of Alcohol”, and the ““The Global Status Report on Alcohol and Health” galvanised governments worldwide to adopt the proposed WHO policy measures, including South Africa, who is highly supportive of the WHO strategy; Professor Melvyn Freeman (Department of Health) co-chairs the Global Network to support the global implementation of the strategy. Economic Impact of Advertising Ban on Alcoholic Beverages│ ARA Page | 43
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CHAPTER 3 The cost of harmful alcohol use in South Africa ... - ARA

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