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Reducing the Harmful Use of Alcohol: Have International Targets Been Met?

Published online by Cambridge University Press:  06 October 2020

Jürgen REHM Open the ORCID record for Jürgen REHM [Opens in a new window] ,
Sally CASSWELL ,
Jakob MANTHEY ,
Robin ROOM Open the ORCID record for Robin ROOM [Opens in a new window]  and
Kevin SHIELD
Jürgen REHM*
Affiliation:
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada, M5S 2S1; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, Canada, M5T 1R8; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 3M7; Institute of Medical Science, University of Toronto, 1 King’s College Circle, Toronto, Ontario, Canada, M5S 1A8; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada, M5S 2S1; Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, D-01187Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation.
Sally CASSWELL
Affiliation:
SHORE and Whariki Research Centre, College of Health, Massey University, New Zealand.
Jakob MANTHEY
Affiliation:
Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, D-01187Dresden, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103Leipzig, Germany.
Robin ROOM
Affiliation:
Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria3086, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm106 91, Sweden.
Kevin SHIELD
Affiliation:
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada, M5S 2S1; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 3M7.
*
Correspondence to: Centre for Addiction and Mental Health (CAMH), 33 Russell Street/Room T420, Toronto, Ontario, CanadaM5S 2S1; email: jtrehm@gmail.com.
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Abstract

Alcohol use has been identified in major United Nations (UN) initiatives, such as the Sustainable Development Goals and the Non-Communicable Disease Action Plan, as a major contributor to the global burden of disease. As a result, levels of alcohol use serve as an official indicator of progress towards these UN-set goals. Given current trends, UN targets for reduced alcohol consumption are unlikely to be met. Moreover, in many countries, especially in low- and middle-income countries, the alcohol-attributable burden of disease continues to increase. Pressure will need to be exerted on national and international decision-makers to arrive at more powerful and normatively persuasive instruments, such as a treaty.

Type
Special Issue on the Global Governance of Alcohol
Information
European Journal of Risk Regulation , Volume 12 , Special Issue 2: Symposium on COVID-19 Certificates and Special Issue on the Global Governance of Alcohol , June 2021 , pp. 530 - 541
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

JR acknowledges funding from the Canadian Institutes of Health Research, Institute of Neurosciences, Mental Health and Addiction (CRISM Ontario Node grant no. SMN-13950).

References

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13 ibid; V Poznyak et al, “The World Health Organization’s Global Monitoring System on Alcohol and Health” (2013) 35 Alcohol Research 244–49; for a discussion of the use of per capita consumption as an indicator, see J Rehm et al, “What Is the Best Indicator of the Harmful Use of Alcohol? A Narrative Review” (2020, epub ahead of print) Drug and Alcohol Review, and the subsequent discussion in the same journal.

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22 World Health Organization, supra, note 10.

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24 World Health Organization, “Implementation of WHO’s Global Strategy to Reduce the Harmful Use of Alcohol During the First Decade since Its Endorsement, and the Way Forward. Assignment Given to the WHO Secretariat by the World Health Assembly” (World Health Organization, 2019) <https://www.who.int/substance_abuse/activities/globalstrategy/en/> (last accessed 20 August 2019).

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26 ibid; the draft decision was proposed by the delegations of Bangladesh, Bhutan, Indonesia, Iran, Sri Lanka, Thailand and Vietnam.

27 S Casswell and J Rehm, “Reduction in Global Alcohol-Attributable Harm Unlikely after Setback at WHO Executive Board” (2020) 395 The Lancet 1020–21.

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30 Most prominently, World Health Organization, supra, note 15.

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34 World Health Organization, supra, note 15.

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38 World Health Organization, supra, note 15; WHO Regional Office for Europe, supra, note 32.

39 World Health Organization, supra, note 11. The exact wording of the indicator even leaves loopholes: “At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context” (p 5).

40 United Nations Statistics Division, supra, note 12.

41 Our calculations are based on Manthey et al, supra, note 19.

42 ibid.

43 J Rehm et al, “Alcohol Use in Times of the COVID 19: Implications for Monitoring and Policy” (2020) 39 Drug and Alcohol Review 301–04.

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45 Manthey et al, supra, note 19.

46 Shield et al, supra, note 5.

47 DALYs are the main summary indicator for burden of disease. This indicator is composed of years of life lost due to premature mortality and years of life lost due to disability; see CJL Murray, “Rethinking DALYs” in CJL Murray and A Lopez (eds), The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020 (Cambridge, MA, Harvard School of Public Health 1996); J Rehm et al, “Steps Towards Constructing a Global Comparative Risk Analysis for Alcohol Consumption: Determining Indicators and Empirical Weights for Patterns of Drinking, Deciding About Theoretical Minimum, and Dealing with Different Consequences” (2001) 7 European Addiction Research 138–47.

48 ibid.

49 Our calculations are based on Shield et al, supra, note 5.

50 A Deaton, The Great Escape – Health, Wealth and the Origins of Inequality (Princeton, NJ, Princeton University Press 2013).

51 J Rehm and C Probst, “Decreases of Life Expectancy Despite Decreases in Non-Communicable Disease Mortality: The Role of Substance Use and Socioeconomic Status” (2018) 24 European Addiction Research 53–59.

52 KD Shield et al, “Parts 1 and 2: Alcohol Consumption and Alcohol-Attributable Burden of Disease and Injury” in WHO Regional Office for Europe (ed.), Status Report on Alcohol Consumption, Harm and Policy Responses in 30 European Countries 2019 (København, WHO Regional Office for Europe 2019).

53 Rehm et al, supra, note 13.

54 ibid.

55 See also MG Monteiro, J Rehm and M Duennbier, “Alcohol Policy and Coronavirus: An Open Research Agenda” (2020) 81 Journal of Studies on Alcohol and Drugs 297–99.

56 MCM. De Goeij et al, “How Economic Crisis Affect Alcohol Consumption and Alcohol-Related Health Problems: A Realist Systematic Review” (2015) 131 Social Science and Medicine 131–46.

57 Manthey et al, supra, note 19; JE Bennett et al, “NCD Countdown 2030: Worldwide Trends in Non-Communicable Disease Mortality and Progress Towards Sustainable Development Goal Target 3.4” (2018) 392 The Lancet 1072–88.

58 For the decision of the WHO Executive Board, see World Health Organization, supra, note 25; for an interpretation: Casswell and Rehm, supra, note 27.

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