During the 1980s with Western alcoholic drink markets reaching saturation, the international alcohol drinks companies started to focus their marketing strategies on the developing world and, in particular, the BRIC countries (Alcoholic beverages: dimensions of corporate power). They had also set about the establishment of their Social Aspect Organizations in an attempt to give the impression to Western governments that they were socially responsible companies. In 1989, as a counter to their European activities and to represent the interests of public health advocates to EU institutions, EUROCARE was established.
Also, in 1989, the United Nations Economic and Social Council had accepted a recommendation from the Commission for Social Development to carry out a study of the negative consequences of alcohol use, based on a report of an expert meeting. With the support of the United Nations Centre for Social Development and Humanitarian Affairs, the Norwegian Government brought together the representatives of ten governments and experts in research and policy making in Oslo in 1990 to discuss the issue. The Expert meeting made the following recommendations:
At international level, delegates recommended that the Secretary-General of the UN be urged to:
- Assign high priority to questions concerning the negative social consequences of alcohol use in the work programmes related to social development, advancement of women, crime prevention, youth, children and human settlement;
- Include the topic of negative social consequences of alcohol use in the follow-up of the guiding principles for development, social welfare policies and programmes;
- Initiate studies, and organize technical meetings, aimed at developing improved indicators of social problems related to alcohol use and at increasing understanding of prevalence and causes of such problems in order to facilitate prevention;
- Incorporate alcohol-use related themes in the preparatory work for the International Year of the Family in 1994;
- Initiate preparations to convene a global conference on the social, economic and environmental impact of alcohol production and consumption on development, preferably by 1994;
- Undertake studies, provide technical advisory services and organize technical and policy-oriented meetings targeted particularly towards developing countries’ needs in the field of alcohol control;
- Seek the assistance of donor countries and international funding agencies to provide the additional resources needed to undertake the above activities;
- Bring this report to the attention of the member states of the Commission for Social Development, the Commission on the Status of Women, the Commission on Human Settlements, the Committee on Crime Prevention and Control, and the Committee on Narcotic Drug Control;
- Bring the conclusions and recommendations of the meeting to the attention of the relevant specialized agencies, particularly the International Labour Organization and the World Health Organization, for their consideration and appropriate follow-up action.
At regional level, the Executive Secretaries of the UN regional commissions and the Secretaries-General of the regional intergovernmental bodies are requested to:
- Initiate regional level deliberations to examine the negative social consequences of alcohol use with a view to formulate appropriate policies, strategies and programmes, ameliorate the trend in industrialised countries and reverse the current trend towards deterioration in developing countries;
- Incorporate alcohol-related questions in their work programmes; and
- Seek the assistance of donor countries and funding agencies to provide the needed resources.
In April 1993, in order to build a coalition of alcohol policy advocates at international level, Derek Rutherford, then Chief Executive of the United Kingdom Temperance Alliance as well as being International Secretary of IOGT, travelled to the USA to enlist support for the venture. Thus began a period of extensive international travel to encourage support for a global alliance that was eventually established at an international conference at Syracuse USA in 2000. As a result of the travels two key figures joined the venture, Dr David Jernigan (USA) and Professor Sally Casswell (New Zealand), both of whom wholeheartedly supported and gave their time to the project.
Professor Casswell was one of the small group of researchers who, in the early 1980s, undertook a study of alcohol industry activity in less developed countries, under the auspices of the WHO. This project was brought to an abrupt end before its completion and from that point onwards, the level of attention appropriate to this crucial issue has been lacking.
David Jernigan was already planning to undertake an in-depth study of the social and health problems related to alcohol in developing countries and the activities of the Drinks Industry. The research proposal was presented to Helge Kolstad, President of IOGT International, who, in September 1993, accompanied Derek Rutherford to Washington. A meeting was also held with Dr James Mosher and David Jernigan to discuss the Marin Institute’s proposed international project. Helge Kolstad agreed to fund the project from IOGT International resources. In 1997 David Jernigan published his international health study on the alcohol industry and developing countries ‘Thirsting for Markets’. Press conferences were held in the USA and UK to launch the study. David Jernigan proposed a series of recommendations for global alcohol companies, national governments, international organisations and NGOs.
Recommendations for Global Alcohol Companies:
- Marketing of alcohol should be on the basis of price and quality only. This broad standard eliminates pointless debate over which images in alcohol advertising are attractive to children, offensive to various religions, show alcohol use in risky situations, or appeal to heavy drinkers.
- Companies should refrain from advertising alcohol on broadcast airwaves and in any other setting where large numbers of children are likely to be in the audience.
- Companies should not use coupon schemes, sweepstakes, and other “get something for nothing” come-ons that appeal to low-income drinkers.
- Companies should refrain from sponsorship of sporting events and cultural activities.Such sponsorships only increase national dependence on alcohol. Alternative sources of funding need to be found. Anheuser Busch is currently challenging the French national ban on alcohol advertising, because it includes the World Cup soccer championship to be held in France in 1998. National laws regarding alcohol marketing need to be respected.
- Companies should not offer free sampling of alcoholic beverages. This is a training activity, designed to recruit new drinkers and to teach people to drink new and additional forms of alcohol, when the number and variety of alcoholic beverages already available are causing substantial health and safety problems.
- Companies should not make health claims, nor should they advertise alcohol on the basis of strength or effect. Strength claims amount to marketing alcohol as a drug of abuse, while health claims inevitably do not give a complete or balanced picture of alcohol’s health and safety effects.
- Companies should refrain from selling alcohol in food stores.This gives alcohol the image of being a normal commodity, which it is not.
- Companies should refrain from indirect advertising. Efforts to associate the product’s logo with other non-alcoholic services are another version of trying to make alcohol seem like a normal commodity, denying the unique and serious set of problems potentially associated with its use.
- Companies should refrain from using endorsements by celebrities and athletes. Such endorsements are an effort to associate the brand with the endorser, and again do not give an accurate picture of potential consequences of alcohol use.
- Companies should provide package labels that give full disclosure of ingredients, and that include specific, prominent and rotating warning labels. These warnings should appear in all advertisements as well. This fulfills a corporate responsibility to provide full disclosure about the risks inherent in using the product.
- Companies should not give incentives for heavy drinking, including volume discounts and rewards such as gifts or prizes for heavy consumption.
- Alcoholic beverage products should be packaged in forms distinct from nonalcoholic beverage packaging. Use of two-liter plastic bottles, cans designed to look like soft drink cans, pudding-type small plastic containers and the like are again efforts to blur the distinction between alcohol and other commodities without commensurate health risks.
Recommendations for national Governments:
- National governments should establish ongoing monitoring of alcohol problems, including drink-driving, alcohol-related trauma, poisoning, suicide, violence and crime, hospital admissions and long-term health consequences such as cirrhosis and chronic liver disease, alcohol dependence and alcoholic psychosis.
- Alcohol policies should be guided by an overall assessment of alcohol’s costs and benefits to the economy and the nation, and the public health agencies should be given the lead in designing policies appropriate to each national situation.
- Alcohol policies should encourage and support community involvement in monitoring and controlling alcohol problems, creating avenues for community voices to be heard, and supporting the development of community-based and consumer organisations dealing with alcohol problems.
- Governments should impose alcohol taxes based on the cost of the beverage and not on a flat rate – a tax based on alcohol content regardless of the type or origin of the beverage itself, and at the highest level at which control over illegal supply can be maintained. Duty-free sales of alcohol should be abolished.
- A portion of tax revenues from alcohol should be earmarked for a fund to support alcohol problems research, prevention and treatment and such funds to be administered by public health experts and citizen representatives without financial connections to the alcohol beverage industry.
- Government subsidies in the form of tax deductions for alcohol marketing as a cost of doing business should be eliminated.
- Governments should strictly enforce alcohol production, licensing, smuggling and counterfeiting laws.
- Limits should be placed on where and when alcohol may be purchased, together with limits on the number of retail, wholesale and production licenses, to assist in law enforcement and in control of the alcohol supply.
- If voluntary compliance with the marketing code as outlined is not forthcoming, countries should enact it into law, including provision for citizen review of all proposed alcoholic beverage products and advertising.
- Alcohol-related harm reduction measures, such as strict drink-sailing and drinking-sailing laws should be enacted and enforced.
- Human rights of people suffering from alcohol dependency should be respected and free access to treatment resources provided for them.
- Windfall tax provisions on alcohol beverage companies should be enacted into national tax codes.
- Priority should be given to developing alternatives to alcoholic beverage based sporting and cultural events and tourism.
- The use of alcohol as a form of payment for labour should be outlawed.
Recommendations for developed country governments
Corporate alcohol and the problems that it potentially brings are not issues solely for developing and post-community country governments. The big alcohol companies are mainly based in developed countries and the government of these countries need to take responsibility for the activities of the companies whose headquarters are in their soil. The following recommendations are steps towards taking on this responsibility:
- There should be no incentives, subsidies or tax breaks for overseas marketing or export of alcoholic beverages.
- Government subsidies for alcohol marketing in the form of tax deductions for alcohol advertising as a cost of doing business should be eliminated.
- There should be no use of trade sanctions to break down public health oriented local regulations regarding alcohol.
- Development funding from governmental or quasi-governmental agencies should not be used to support increased alcohol production, distribution or promotion.
- Like developing country governments, if voluntary compliance with the marketing code is not forthcoming, countries should enact it into law, including citizen review of all proposed alcoholic beverage products and advertising.
- A special tax should be levied on alcoholic beverage exports to pay for public health research and technical assistance partnerships with developing countries.
- Developed countries with resources to invest in developing and post-communist countries need to understand the negative role that alcohol can play in development and fund special projects and initiatives to study and prevent alcohol-related problems in those countries.
- International health bodies should receive full funding to conduct global monitoring, technical assistance and training to developing and post-communist countries regarding prevention and treatment of alcohol problems.
Recommendations for international organizations:
- World trade agreements need to make special provision for alcohol, to ensure that these agreements may not be used to weaken health and safety regulations regarding alcohol.
- Economic advice regarding the structure of the alcohol supply needs to build on a comprehensive assessment of the health and other costs of alcohol to the economy.
- Economic development money should not be used to support increased alcohol production, distribution or promotion.
- Illegal alcohol should be included in all global collaborative efforts and consultations regarding control of drug trafficking.
- Alcohol should be included in all efforts by the United Nations Drug Control Program (UNDCP) and other international bodies to reduce drug demand.
- The World Health Assembly and the World Health Organization should put a high priority on alcohol as a health issue, and promote and provide technical assistance and training in monitoring and controlling alcohol problems.
- The World Health Organization, the International Labor Organization and other appropriate bodies should fund positions dedicated to the monitoring, prevention and treatment of alcohol-related problems and in other ways support a public health response in developing countries with extremely limited resources for public health
- International organizations such as the World Health Organization and the International Labor Organization whose briefs include prevention of alcohol-related problems should support the convening of periodic meetings among non-governmental organizations working on alcohol issues to exchange information and experience and pool resources.
- Developed countries should work with developing country governments and airline companies to eliminate free alcohol in air travel. Non-drinking passengers should not have to subsidize those who drink.
Recommendations for non-Governmental organizations:
- NGOs at the national level working in health or development should understand how alcohol problems and alcohol industries can influence development, and should include special consideration of these issues in development planning and technical assistance.
- NGOs from all the arenas affected by alcohol problems – families, women, children, workplaces, health, safety, and so on – should build coalitions with each other to mount a coordinated response to alcohol problems
- NGOs should network at regional and international levels to exchange information and experience and to pool resources to promote effective responses to alcohol problems. In particular, there should be opportunities for information and experiences from the developing countries to be shared with and inform those working in developed countries.
- NGOs with international missions or constituencies should contribute to global awareness of alcohol problems, and support research and advocacy to address them.
In February1994, after one of the meetings with USA alcohol policy advocates, the following statement was issued:
GLOBAL ALLIANCE – FOR THE PREVENTION OF
ALCOHOL RELATED HARM INTERNATIONALLY
Several meetings have taken place in Washington USA with the following organisations:
American Council on Alcohol Problems
ARIS – Alcohol Research Information Service,Michigan
Centre for Science in the Public Interest
General Board of Church & Society, United Methodist Church USA
Marin Institute (California)
National Council on Alcoholism & Drug Dependence USA
The outcome of the discussion was the adoption of the following agreement for the need to establish a Global Alliance for the prevention of alcohol-related harm with the following aims:
- To monitor the activities of the multi-national drinks industry
- To provide a forum for alcohol policy advocates through meetings, information sharing and publications.
- To disseminate information on international alcohol policies
- To promote international research on the social and health impact of the multi-national drinks industry.
- To monitor and promote research on the impact of international trade agreements on alcohol-related harm.
- To bring to the attention of international governmental and non-governmental agencies the social, economic and health consequences of alcohol consumption and related harm.
- To encourage and support international and national governmental and non-governmental efforts to ameliorate alcohol related-harm internationally.
United Nations Drug Control Programme
In order to facilitate the aim of placing alcohol on the international agenda, the opportunity was taken to attend the UNDCP NGO World Forum on Drug Demand Reduction in Bangkok in December 1994.
However, the draft final communication of the meeting omitted references to alcohol or tobacco. Consequently a group of participants met and drew up an alternative. The group included David Crosbie (The Alcohol and Other Drugs Council of Australia), Kushlani Amarasuriya (ADIC Sri Lanka), Johnson Edayaranmula (ADIC India), David Jernigan and Derek Rutherford.
Overnight they collected 67 delegate signatories from 30 countries for the alternative statement. The Policy Statement Committee in their second redraft merely paid lip service to the alternative statement. Consequently, immediately before the final plenary session, all delegates were given a copy of the alternative statement. When the adoption of the statement came before the session the alternative statement was put forward as an amendment. After discussion, the Chairman agreed that the alternative statement should be incorporated. The conference agreed to coopt David Jernigan to the redrafting committee.
The alternative statement:
- All international and national efforts against drug use should adopt a definition of drugs that includes alcohol, tobacco, solvents and other legally available drugs of abuse.
- UNDCP, WHO, and other international organisations should combine forces to address the major socioeconomic and health threat posed by all drugs in both their licit and illicit form of production, trade and promotion.
- The United Nations Drug Control Programme (UNDCP), UN specialized agencies, other international, inter-governmental, regional organisations and governments should involve NGOs in planning, implementing and evaluation of alcohol and other drug demand reduction programmes.
- NGOs involved in the area of social and economic development should recognise the impact of legal and illegal drug misuse and integrate demand reduction into their programme development and develop effective working relationships with drug specialist NGOs.
- UNDCP, UN specialised agencies, other international inter-governmental, regional organisations and governments should assist and support NGOs in planning, implementing and evaluating the use of multi-disciplinary approaches to licit and illicit drug problems, keeping in view the role of the family, the community, religion and/or spirituality wherever and whenever applicable.
- People experiencing alcohol, tobacco and other drug problems should be treated with dignity and respect within the framework of human rights.
- The mass media should cooperate with NGOs in providing accurate information and consistent messages to the general public regarding drug use and problems. Legislative or other limits should be placed on demand stimulation for legal drugs through advertising and other forms of promotion of drug use. Scare tactics and the glamorisation of drug use, including alcohol and tobacco use, should be avoided.
- Formal or informal regional and national networks focused on demand reduction for all drugs should be established or further strengthened, in collaboration and with the support of appropriate organisations whenever possible.
- Progress towards the achievement of the above recommendations should be monitored and reported by UNDCP to all participants on an annual basis. Follow-up meetings of NGOs should be held at national, regional and international levels within the next four years to assist with the implementation of these recommendations, and development of new goals and objectives for the future.
Eurocare NGO Meeting and USA Advocates, London, September 1995
USA advocates were invited to attend and participate in a three-day workshop to prepare Eurocare’s Statement for the WHO Europe Ministerial Conference to be held in Paris, December 1995.
Statement of Non-Governmental Organizations to the WHO European
Ministerial Conference Health Society and Alcohol, Paris, September 1995
Meeting with USA Advocates, London 1995
Following on from the workshop, a meeting of the Global Alliance was held. The agenda covered world developments, the Drinks Industry and international health, the Global Alliance and international action priorities and the structure and development of the Alliance. It was agreed that the name of the Alliance would be the Global Alcohol Policy Alliance for the prevention of alcohol-related harm internationally. A feasibility study regarding the establishment of the Alliance was to be undertaken by the Marin Institute in the USA. However, lack of resources meant that this study would not be undertaken.
‘The Globe’ has played an important part in promoting the work, mission and advocacy of GAPA during its formative years.
Towards the inauguration of GAPA
It was not until 1999 that a group met in Chicago and took the decision to arrange an inaugural conference in Syracuse. The Marin Institute had secured promises of funding from the Robert Wood Johnson Foundation. Alliance House Foundation also agreed to contribute. IOGT International was also going to hold its congress in Syracuse and delegates interested in GAPA were expected to stay on to take part. The World Health Organization agreed to co-sponsor the meeting and offered a small grant to bring some representatives from developing countries. More than 200 participants from over 30 countries attended, including Dr Shekar Saxena and Dr Maristela Monteiro from WHO.
August 2001 – GAPA INAUGURATED
GAPA (Global Alcohol Policy Alliance) emerged from the Conference held in Syracuse, New York, in the summer of 2000. Experts and advocates from all over the world came together to share their views and to find a way to co-ordinate their efforts. It became quite clear that there was a community of interest and an urgent need to match the measures being taken by the global alcohol industry to increase sales and circumvent health promotion policies. Although it would, of course, be impossible to match the financial resources of the international drink companies and the “social aspect” groups which speak for them, there was no doubt that, if properly organised, the dedication and scientific knowledge displayed at Syracuse would be a formidable tool in helping governments around the globe to counter the health problems created by alcohol consumption.
Roy Grantham, Chairman of the Alliance House Foundation, in his Chairman’s Annual Report in December 2000 observed: “Only with the passage of time will we be able to assess the success of this venture, but I am delighted to say that so far it looks extremely promising.”
The Globe archive; the events undertaken by GAPA over the past 15 years; and the adoption of the WHO Global Alcohol Strategy to reduce the harmful use of alcohol demonstrates that GAPA’s early promise continues to be effective.