Management of substance abuse

Report by the Secretariat to the Executive Board 121st Session (EB121/10) on the Second Report of the WHO Expert Committee on Problems Related to Alcohol Consumption

Main recommendations

The Committee reviewed the health and social consequences of alcohol consumption and disease burden attributable to alcohol in the context of mechanisms of alcohol-related harm and recent trends in alcohol consumption worldwide. After reviewing available evidence, including the latest data on the contribution of alcohol consumption to the global disease burden the Committee made several recommendations emphasizing WHO’s role in coordinating a global response, and the need for global action to reduce alcohol-related harm through effective mechanisms for international action and country support.

The Committee also recommended a range of strategies and policy options that have a sound evidence base and global relevance for reducing alcohol-related harm, emphasizing that their adaptation and implementation at the national and sub-national levels should take into account specific cultural and legal contexts and the local configuration of alcohol problems. The Committee recommended that WHO should support governments, particularly in low- and middle-income countries, in developing, implementing and evaluating national and sub-national evidence-based policies, action plans and programmes.

In reviewing the disease burden attributable to alcohol worldwide, the Committee recommended that comparative assessment of alcohol as a risk factor to health should continue, and emphasized the need for a sustainable global information system on alcohol based on comparable data, agreed definitions, and country-based counterparts to monitor progress in reducing public health problems caused by harmful use of alcohol. The Committee also recommended that data on policies, laws, regulations and their effectiveness should be integrated into this information system and that practical experiences in the implementation of alcohol policies in different societies should be collated and disseminated.

Significance for public health policies

The disease burden attributable to alcohol consumption is significant and, in many countries, public health problems caused by harmful use of alcohol represent a substantial health, social and economic burden. Reduction of the alcohol-attributable burden is becoming a priority area for international public health. Alcohol-related harm can be reduced through the implementation of proven alcohol strategies, including at the global level. The Committee’s conclusions and recommendations have significant implications for future developments in this area.

Although substantial progress has been made in quantifying the disease burden attributable to alcohol, some areas of alcohol-related harm have not received sufficient attention at the global level. The Committee identified several priority areas for further work, including the measurement of alcohol-attributable social harm and contributions of harmful use of alcohol to infectious disease morbidity and mortality.

The Committee emphasized the important role of health workers in supporting and implementing effective public health policies and interventions for reducing alcohol-related harm, within and outside the health sector, and recommended several strategies and programmes for further support and development.

As the formulation and implementation of alcohol policies involves sectors other than health, collaboration between different national and international agencies and organizations is necessary in tackling public health problems caused by harmful use of alcohol. An example of this would be the need to assess the potential implications of trade and trade agreements for alcohol policies and alcohol-related harm.

Implications for the Organization’s programmes

Resolution WHA58.26 on Public health problems caused by harmful use of alcohol requests the Director-General to draw up recommendations for effective policies and interventions to reduce alcohol-related harm. The conclusions and recommendations of the Expert Committee will be used by WHO in preparing recommendations and programme activities at the global and regional levels to reduce the disease burden attributable to alcohol consumption worldwide.

WHO should continue and strengthen its support to low- and middle-income countries in implementing, evaluating and monitoring alcohol policies. A framework of regional and global supporting mechanisms should be developed in consultation with Member States, international organizations and other relevant stakeholders.

The global information system on alcohol and public health, to be based on the WHO Global Alcohol Database, regional information systems on alcohol and regular reports from Member States, as recommended by the Expert Committee, will enable the Organization to monitor progress in reducing the public health problems attributable to alcohol worldwide and to disseminate information on the implementation and effectiveness of alcohol strategies and interventions in different societies and settings.

Implementation of strategies to reduce public health problems caused by harmful use of alcohol requires coordination with different programmes within and outside the Organization and increased collaboration and interaction with other United Nations agencies, international organizations, nongovernmental organizations and other stakeholders. This may require appropriate coordination mechanisms.

WHO will continue its interaction with trade, hospitality and alcohol-industry sectors in order to encourage implementation of strategies and interventions in the areas of production, distribution and marketing of alcoholic beverages. Concerns regarding the potential implications of the international alcoholic-beverages trade and trade agreements for alcohol-related harm and alcohol policies will be addressed by the Secretariat within the framework of resolution WHA59.26 on International trade and health.