In response to the World Health Organisation web-based consultation on the first draft of the Global alcohol action plan 2022-2030, GAPA has developed the attached key points.Read more
GAPA was established at the Global Alcohol Policy Conference in Syracuse, NY, USA, in 2000. Over the years, the board has been male dominated, but from 2015 it was chaired by a woman. Gender balance in GAPA governing bodies and its activities (Global Alcohol Policy Conferences, GAPA delegations etc.) has been a prime consideration. At GAPC 2020 in Dublin the list of plenary speakers and panellist showed an almost 50/50 division with a small majority of women.
From the outset the GAPA Objectives included a Low- and Middle-Income Countries perspective in that it expressed the ambition to:
- Place priority on research and advocacy regarding those parts of the world where alcohol problems are increasing; and
- Ensure that member groups in those areas have the technology and support capacity to participate in a global network for communication and action.
Further the GAPA By-Laws outline that
- The Board of trustees shall consist of up to twenty members and shall be representative of all continents.
This Gender and Diversity Policy was passed by the GAPA Executive Board in March 2020 and includes what in many instances has been emerging practice over the years.
Gender equality and Diversity
GAPA recognises that gender is more than women and men, and that not everyone enjoys the same status, power or access to and control over resources. This situation is unacceptable. Principles of equity and social justice require us to ensure that everyone has equal opportunity for expressing and using their potential, irrespective of sex, gender identity and gender expression, age, race, colour, class, caste, religion, ethnic background, sexual orientation or disability. Likewise, there are great differences in the resources available around the world influencing to what extent voices and perspectives from these parts of the world come forward in the global arena such as the one GAPA is involved in.
Women are less likely than men to drink around the world. Still within this pattern there are big variations, and in some parts of the world the gender gap in the prevalence of alcohol use and heavy episodic drinking has become small or non-existent. However, elsewhere persisting cultural values still contribute to a general pattern of drinking in which men consume more alcohol and cause more problems by doing so than women. Alcohol is a causal contributor to intimate partner violence with disagreements more likely to become violent and injury to be worse if alcohol is involved. For women and children living in poverty the alcohol use by the husband and father may represent addition problems related to taking unproportioned part of the household expenditures, result in lack of income or catastrophic health expenditures.
GAPA recognises that by not equally involving every person or excluding certain groups in its work, talents will be underutilised, and important perspectives will be lost. GAPA’s work in the Global Health arena will be strengthened by bringing in voices from different backgrounds; women and men; different parts of the world; different age and professions; different cultures and religions; minority groups etc. GAPA fully commits to channelling energy, effort and resources into processes that create an organisation that values all people equally and take this commitment also into the values for the society that GAPA is promoting through its advocacy.
Following a decision at the World Health Organisation 146th Executive Board WHO started a two-year process to “accelerate action to reduce the harmful use of alcohol” . This includes a consultation towards an action plan 2022-2030 for the global strategy to reduce the harmful use of alcohol; development of a technical report on the harmful use of alcohol related to cross-border alcohol marketing; a call for more resources to be made available; and a review of the Global strategy in 2030. And updated timeline for the process is available on the WHO website here.
Civil society has an important role to play in contributing to consultations and communicating with decision makers about what such an accelerated action will entail. GAPA and its global network will participate actively in the two-year process and beyond. For the overall process GAPA issued the “GAPA Principles for Advocacy 2020 – 2022” (pdf, 20 June 2020).
In November 2020, WHO issued a ‘Working document for development of an action plan to strengthen implementation of the Global Strategy to Reduce the Harmful Use of Alcohol’ and started an online consultation until 13 December (extended deadline). For this consultation GAPA and Vital Strategies have issued a joint statement underlining three key points to strengthen the draft Plan. GAPA has also issued some key advocacy points for the consultation and made the following submission.
Joint statement from GAPA and Vital Strategies regarding WHO consultation on the development of an action plan to strengthen implementation of the Global Strategy to Reduce the Harmful Use of Alcohol.
On 16 November WHO released a Working document for development of an action plan to strengthen implementation of the Global Strategy to Reduce the Harmful Use of Alcohol. The document is open for consultation until 6 December. Without a clear Action Plan, the Global Strategy will remain unrealized and the health and economic harms of alcohol consumption will remain high and continue to be an obstacle to achieving the Sustainable Development Goals. The following are three key points to strengthen the draft Plan, agreed by Global Alcohol Policy Alliance and Vital Strategies and offered for consideration for your own submissions.
Role of economic operators:
In the current document the “economic operators” – i.e., alcohol industry entities (producers, distributors, retailers, etc) – are listed as stakeholders in equal standing alongside civil society and other UN organisations. This is inappropriate, given their inherent conflict of interest and long record of influence undermining effective alcohol policies, including in low- and middle-income countries (LMICs). The alcohol industry should, instead, be addressed in a separate section with due regard to conflict of interest toward safeguarding public health.
More regular reporting on implementation:
We are concerned about the lack of specific time intervals for review and reporting of the implementation of the Action Plan. Given the importance of intergovernmental collaboration to reduce alcohol harm, we recommend that the Director-General be requested to report to the World Health Assembly biennially on the progress of implementing the Global Action Plan. This should include any challenges faced by Member States and the nature and extent of collaboration between UN agencies.
Prior to the review of the SDGs and Action Plan in 2030, a progress report and recommendations for the way forward for reducing alcohol harm through alcohol policy should be submitted to the WHO governing bodies by 2028 at the latest to ensure there is no further delay to proportionately addressing any persistent barriers to progress identified through the course of the Action Plan.
Focus on best buys/SAFER
The numerous and sometimes overlapping recommendations in the draft document tend to obscure a focus on the most cost-effective policies to reduce alcohol-related harms. The Action Plan should be strongly framed around every country implementing the 5 most effective, science-based interventions, as articulated in the SAFER guidance: Strengthening restrictions on alcohol availability; Advancing and enforcing drink driving counter measures; Facilitating access to screening, brief interventions, and treatment; Enforcing bans or comprehensive restrictions on alcohol advertising sponsorship, and promotion; and raising prices on alcohol through excise taxes and pricing policies. The monitoring indicators should include specific metrics of SAFER implementation, and countries’ reporting of the implementation of SAFER policies should be facilitated, especially in LMICs, which currently lack adequate resources and are subject to interference from commercial interests.
24 October 2020 GAPA issued a position paper on the implementation of WHO’s global strategy to reduce the harmful use of alcohol during the first decade since its endorsement, and the way forward. In this paper the GAPA highlights important elements for consideration and encourages its own network and the wider the global health community to take part in a web-based consultation conducted by the World Health Organization. The World Health Assembly in May 2019 requested the WHO Director-General “to report to the Seventy-third World Health Assembly in 2020, through the Executive Board, on the implementation of WHO’s global strategy to reduce the harmful use of alcohol during the first decade since its endorsement, and the way forward”. Comments from the consultation will be taken into consideration in the process of developing the above-mentioned report.
Read the GAPA position paper here:
The inappropriate partnership between the Global Fund and Heineken was the topic of discussion between Marijke Wijnroks, Interim Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and representatives of IOGT International, the Global Alcohol Policy Alliance, and NCD Alliance last Friday in Geneva. During the meeting the civil society representatives underscored concerns over the partnership expressed in a public letter on 1 February.
Close to 100 organisations endorsing the letter, prominent global health and development experts and representatives of Global Fund donor governments Norway and Sweden are resolute that a partnership between the alcohol industry and a global health fund is entirely incompatible with our shared vision of health for all and sustainable development.
Comments made by incoming Executive Director Peter Sands in the days since the meeting however underscore remaining concerns that the Global Fund does not see this partnership with Heineken as incompatible with public health and sustainable development goals.
While partnerships can indeed be positive, Sands’ latest comments to The Lancet indicate that he doesn’t sufficiently heed the concerns voiced in the health and development sector about partnering with a harmful commodity industry, particularly relating to benefits realised by these businesses, such as implied endorsement and access to high level decision makers.
To date no decision has been taken on whether or not the Global Fund will end its partnership with the Dutch brewer, but civil society remains hopeful that the Fund’s board will review and agree to end the partnership
“In the meeting we elaborated on a host of key issues the Global Fund had clearly missed in their due diligence and review of partnering with an alcohol company. Therefore, the decision to discontinue the partnership is imperative. We are committed to supporting the Global Fund in both crafting better risk assessment guidelines and in tackling alcohol as major risk factors for people and communities affected by TB and HIV/AIDS,” explained Kristina Sperkova, International President of IOGT International.
Øystein Bakke, Secretary of the Global Alcohol Policy Alliance, reiterated in the meeting that the partnership was assisting Heineken in building their corporate image and indirectly facilitating increased sales and the subversion of effective alcohol policy in Africa going counter to public health objectives, including Global Funds own focus on HIV/AIDS and TB.
Promoting health and sustainable development is fundamentally in conflict with the alcohol industry’s aim of increasing sales of a product which is a recognised risk factor of disease and injury to increase profit margins. The alcohol industry uses these types of partnerships for access to the public health policy making process in order to obstruct and derail high-impact, evidence-based alcohol policies – a familiar strategy from the tobacco industry, which alcohol companies are closely connected with.
The civil society representatives present at the meeting welcomed the frank and constructive nature of the discussions and the Global Fund’s openness to review its criteria and due diligence processes for partnerships in light of concerns and evidence raised. The Global Fund also expressed interest in joining a dialogue on commercial determinants and (in-)compatible partnerships among global health and development agencies and international organisations.
“The challenge posed by commercial determinants of health is massive, and the question of what does and does not constitute compatible health partnerships in the SDG era is a critical issue that calls for urgent dialogue among the health and development community. We call on the World Health Organisation and the UN Interagency Task Force on NCDs to convene a high-level dialogue among UN entities with the aim of making concrete recommendations on dealing with the industry interference impeding progress on improving global health,” said Katie Dain, Chief Executive Officer of the NCD Alliance.
In advance of the United Nations High-Level Meeting on NCDs later this year, the UN Secretary General’s report on prevention and control of NCDs published last week noted concerns around industry interference in policy making, and that while multi-stakeholder partnerships are important to reach the ambition of the Sustainable Development Goals, provisions need to be established to address the commercial determinants of NCDs including to safeguard against industry interference.
Commonalities between the tactics of unhealthy commodity industries, such as the tobacco and alcohol industry, and coherent public health strategies to address commercial determinants of health were among the issues discussed during the World Congress on Tobacco or Health taking place in Cape Town this past week.
IOGT International is the premier global network combining evidence-based policy solution with community-based interventions to prevent and reduce alcohol harm.
Global Alcohol Policy Alliance is a network of non-governmental organisations and people working in public health agencies who share information on alcohol issues and advocate evidence-based alcohol policies, “free from commercial interests.”
The NCD Alliance is a unique civil society network uniting 2,000 civil society organisations in more than 170 countries dedicated to improving non-communicable diseases (NCD) prevention and control worldwide.
The international public health community responds to the global alcohol producers’ attempts to implement the WHO Global Strategy on the Harmful Use of Alcohol.