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WHO - Italy participates in the consultation on the implementation of the Global Strategy to reduce the harmful use of alcohol

Date:

11/05/2019


WHO - Italy participates in the consultation on the implementation of the Global Strategy to reduce the harmful use of alcohol

The WHO has opened a consultation, extended to Member States and all interested stakeholders, on results and challenges in implementing the "Global Strategy to Reduce Alcohol Abuse", almost ten years after its launch, with a view to a renewed commitment towards horizon 2030 and the attainment of the “Sustainable Development Goals” in the field of health.

While fully sharing the objectives of the Strategy, Italy has put forward a series of considerations and proposals in relation to the methodology and the specific measures proposed by the WHO, which risk having penalizing effects on those Countries, like Italy, which are engaged in combating alcohol abuse while safeguarding a healthy and varied dietary balance, as embodied in the Mediterranean Diet.

Here are the comments presented by Italy to the WHO:

Italy would like to thank the WHO for opening a consultation on the implementation of the global strategy to reduce the harmful use of alcohol.

Italy steadfastly joined the international consensus at the time the strategy was launched, and it remains convinced that reducing the harmful use of alcohol and its associated health and social burden still constitutes a public health priority.

Against the background of the evidence and different sets of data available after 10 years of implementation of the strategy, the efforts of the international community and of all stakeholders involved should now be focused towards those actions having proven effects in contrasting improper use or abuse of alcohol.

In this regard, Italy would like to convey some concerns and suggestions pertaining to the methodologies proposed by the discussion paper to this end.

The report emphasizes the lack of reduction of per capita alcohol consumption in the whole world as the main parameter to judge the effects of the strategy so far, and the basis to push for further collective efforts in the way forward to 2030: however, such a generic reference to consumption on a global scale risks to overshadow the results achieved in specific Regions and Countries of the world -e.g. Europe, including Italy- which undertook serious and effective efforts to tackle alcohol abuse in the last decade, with specific regards to consumption by minors and excessive episodic consumption, while tackling alcohol related mortality and illnesses.

The proposed targets (total reduction in the number of active drinkers / reduction in the consumption of alcohol per capita) do not seem to take into account the fundamental distinction between moderate drinkers and alcohol abusers.

This distinction would correctly reflect available scientific evidence which indicates that, while alcohol abuse produces serious implications for human health, moderate consumption does not imply particular risks, and can even produce positive effects.

All efforts of public authorities should therefore be directed towards tackling alcohol abuse with a targeted, evidence based approach towards specific populations (in particular minors, vulnerable groups) and fully taking into account national contexts, cultural traditions and consumption partners, especially when alcohol consumption by adults makes integral part of balanced, healthy and sustainable diets and it is associated to normal, active lifestyles.

Across the document, the paper advocates three “best buys” as a means to reducing alcohol consumption (regardless of issues such as quality, context, age, health conditions of the drinkers, etc.): restricting availability of alcohol, reducing marketing of alcoholic beverages, raising prices.

The document’s approach towards the private sector in general appears very critical, as it states, inter alia:

-“Increased awareness of the commercial determinants of health provides another opportunity to strengthen development and implementation of alcohol control measures by effective counteraction of the industry interference in the alcohol policy development. A growing focus on the actions of the tobacco, unhealthy food and alcohol industries signals increased recognition of commercial drivers of harm and the importance of conflicts of interest and industry interference as barriers to effective policy adoption and implementation”

Italy believes that, while safeguarding health oriented policies from all undue interference from interest groups, the engagement of producers of alcoholic beverages in a constructive dialogue should be pursued as a means to contributing to responsible drinking and combating alcohol abuse.

Proliferation of low quality and even illegal production of alcohol should be instead the main reason of collective concern and would require decisive counter-action.

In these years, Italy has achieved encouraging results in limiting average per capita consumption through a set of actions focusing on prevention and health promotion, taking into account its national and cultural context, and empowering individuals towards responsible lifestyle patterns and drinking choices.

In the way forward to 2030, exchange of good practices among Member States should therefore be broadened and encouraged (e.g. through the National Counterpart Network) in order to enrich the scope of possible of policy options.

While keeping firm the objective of tackling health and social effects of alcohol abuse, in line with SDGs, all proposed actions within the Global Strategy should be reformulated as a "menu" from which each Member State could select those deemed most consistent with its national policies, without focusing only on the existing "best buys", which have proven to be reductive and inadequate in specific contexts, failing to take into account the variety of national and regional backgrounds.
Focus should therefore shift towards involving all areas of expertise (with Health Ministries on the front line) who can contribute to renewing preventive actions, specific to their role, and to feed national prevention plans consistent with public health objectives.


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