Academic journal article Alcohol Research

The Road to a World Health Organization Global Strategy for Reducing the Harmful Use of Alcohol

Academic journal article Alcohol Research

The Road to a World Health Organization Global Strategy for Reducing the Harmful Use of Alcohol

Article excerpt

Harmful alcohol use and the related health effects are a global problem and therefore need to be addressed not only by individual nations but also on an international level. For example, the World Health Organization (WHO) noted that harmful alcohol use is the third leading risk factor for premature deaths and disabilities in the world, accounting for approximately 2.5 million deaths worldwide (corresponding to 3.8 percent of all deaths) in 2004 (WHO 2010). Moreover, harmful alcohol use was considered responsible for 4.5 percent of the global burden of disease as measured in disability-adjusted life-years lost in the same year. Given this scope of the impact, the WHO initiated a series of efforts that culminated in the development of a global strategy for reducing the harmful use of alcohol. This article reviews the alcohol-related activities of the WHO over the years and summarizes the central issues addressed by the global strategy.

Historical Overview of WHO Activities Focusing on Harmful Alcohol Use

As early as 1979, the WHO initiated a program focusing on alcohol-related problems. This program assessed the impact of alcohol consumption in developing and developed societies and has coordinated dozens of projects and activities that have helped build the evidence, awareness, and support necessary for the development of a global alcohol strategy.

In 1997, the WHO also created the Global Information System on Alcohol and Health (GISAH) (http://apps.who.int/globalatlas/default.asp), which currently is hosted and maintained by the Centre for Addiction and Mental Health in Toronto, Canada. This information system is compiling the most reliable and updated information in the world on alcohol consumption and related harm by country. It includes and regularly updates data on recorded alcohol production, on alcohol consumption and related health effects based on national surveys and estimations of unrecorded consumption, and on national alcohol policies and interventions. The database has information from most countries around the world, although many gaps in the validity and reliability of the information remain.

In 1999, the WHO published its first Global Status Report on Alcohol, which relied on a combination of national and regional estimates, industry data, and data from the United Nations (UN) Food and Agriculture Organization and UN Statistical Office to generate estimates of adult per capita consumption for most countries (WHO 1999). Subsequently, three additional reports have been published, including the Global Status Report: Alcohol and Young People (WHO 2001), the Global Status Report: Alcohol Policy (WHO 2004a), and the Global Status Report on Alcohol 2004 (WHO 2004b), and a new global report was published at the end of 2010.

A subsequent study conducted in 2000--the WHO Comparative Assessment of Risk Factors for the Global Burden Disease--demonstrated that alcohol consumption ranked as the fifth most important risk factor worldwide (Rehm et al. 2003; WHO 2002). Furthermore, alcohol was identified as the leading risk factor in developing countries with low mortality rates and the third-leading factor in developed countries. These findings clearly indicated a need for global action regarding alcohol's harmful effects.

The Global Strategy to Prevent Alcohol's Harmful Effects

In 2005, the World Health Assembly (WHA) approved a resolution on public health problems caused by harmful use of alcohol (WHA 58.26), thus recognizing that alcohol has a worldwide impact and that strategies exist to reduce such an impact. This resolution led to intensified work on reviewing the evidence on alcohol policies through an expert committee meeting and report. In addition, among other initiatives, the information in the global alcohol database was updated, followed by new estimates of the burden imposed by alcohol on global health. However, when presented at the WHA in 2007, these additional data still were insufficient to reach a consensus on a global alcohol strategy. …

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