5 th NCD Seminar 6 th September 2011
5 th NCD Seminar 6 th September 2011 Lausanne, Switzerland The WHO global strategy to reduce the harmful use of alcohol in a national context l Mr Dag Rekve l l Technical Officer Management of Substance Abuse Department of Mental Health and Substance Abuse World Health Organization
The WHO global strategy to reduce the harmful use of alcohol endorsed by the 63 rd WHA resolution …the global strategy for reducing the harmful use of alcohol is a true breakthrough. This strategy gives you a large and flexible menu of evidence-based policy options for addressing a problem that damages health in rich and poor countries alike. The strategy sends a powerful message: countries are willing to work together to take a tough stand against the harmful use of alcohol. Dr Margaret Chan Director-General World Health Organization Closing speech at WHA 63
Policy making Policy implementation
WHO governing structure l UN specialized agency l 193 Member States l The World Health Assembly l Executive Board l HQ in Geneva l 6 Regional Committees l Consensus driven l Mostly non-binding 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
minar , ber 2011, Lausanne, Switzerland
WHO`s research strategy l measuring the problem; l understanding its cause(s); l elaborating solutions; l translating the solutions or evidence into policy, practice and products; and l evaluating the effectiveness of solutions. 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Too big burden to be neglected 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Global distribution of alcohol-attributable deaths and DALYs Deaths 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland DALYs
Percent of total Different perspectives Risk factor 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Distribution of alcohol-attributable male deaths (of all male deaths) 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
minar , ber 2011, Lausanne, Switzerland e positive effects of alcohol consumption and ssible implications for policy decisions tential movements in abstention rates and chan ale drinking patterns ohol exposure and harms to others including S/FASD ohol exposure and incidence and clinical course ectious diseases Critical issues
Effective counter measures exist Effective measures: l regulating the marketing of alcoholic beverages, (in particular to younger people); l regulating and restricting availability of alcohol; l enacting appropriate drink-driving policies; l reducing demand through taxation and pricing mechanisms; l raising awareness and support for policies; l providing accessible and affordable treatment for people with alcohol-use disorders; and l implementing screening programmes and brief interventions for hazardous and harmful use of alcohol 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Important milestones l October 2002: World Health Report 2002 l May 2005: WHA 58. 26 l May 2007: WHA 60 l May 2008: WHA 61. 4 l May 2010: WHA 63. 13 Plus numerous regional resolutions, strategies and frameworks 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
minar , ber 2011, Lausanne, Switzerland Consultation with economic operators Consultation with NGOs and health profes Consultation with UN agencies and IGOs l l l Regional technical consultations with Me States (February – May 2009) in 6 WHO r Draft development by the Secretariat in collaboration and consultation with Memb States (May – October 2009) 126 th session of the Executive Board WHA 63 l l Stage II. Draft strategy development Web-based consultation l Stage I. Broad consultation process The development of the strate
The content of the strategy The global strategy: – complements and supports public health policies in Member States; – gives guidance for action at all levels; – sets priority areas for global action; – contains a portfolio of policy options and measures that could be considered for implementation and adjusted as appropriate at the national level 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
WHO global strategy: Five objectives (a) raised global awareness of the magnitude and nature of the health, social and economic problems caused by harmful use of alcohol, and increased commitment by governments to act to address the harmful use of alcohol; (b) strengthened knowledge base on the magnitude and determinants of alcoholrelated harm and on effective interventions to reduce and prevent such harm; (c) increased technical support to, and enhanced capacity of, Member States for preventing the harmful use of alcohol and managing alcohol-use disorders and associated health conditions; (d) strengthened partnerships and better coordination among stakeholders and increased mobilization of resources required for appropriate and concerted action to prevent the harmful use of alcohol; (e) improved systems for monitoring and surveillance at different levels, and more effective dissemination and application of information for advocacy, policy development and evaluation purposes. 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Achieving the objectives of the global strategy Requires global, regional and national actions on – – levels of alcohol consumption patterns of alcohol consumption contexts of alcohol consumption wider social determinants of health Special attention needs to be given to reducing harm to people other than the drinker and to populations that are at particular risk from harmful use of alcohol 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Global strategy: recommended ten target areas for policy measures and interventions 1. Leadership, awareness and commitment 2. Health services' response 3. Community action 4. Drink-driving policies and countermeasures 5. Availability of alcohol 6. Marketing of alcoholic beverages 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland 7. Pricing policies 8. Reducing the negative consequences of drinking and alcohol intoxication 9. Reducing the public health impact of illicit alcohol and informally produced alcohol 10. Monitoring and surveillance
Global action: key components l Public health advocacy and partnership l Technical support and capacity building l Production and dissemination of knowledge l Resource mobilization 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
minar , ber 2011, Lausanne, Switzerland WHO global counterparts netw 1. meeting 8 -11 February 201
The role of WHO national counterparts for implementation of the global strategy l establish the working mechanisms and plans for the global network; l elaborate priority areas and implementation plans for reducing the harmful use of alcohol at the global level; l discuss priority areas and plans for implementing the global strategy at the regional level; l discuss monitoring and reporting on the implementation of the global strategy at different levels; 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Chairs of regional networks Task force on Technical support and capacity building WHO Secretariat minar , ber 2011, Lausanne, Switzerland Public cy and ip e Global network of WHO counterparts Task force on Production and dissemination of knowledge Coordinating council Task force on Resource mobilization WHO Secretariat Techni group(s target are a Chairs of task forces International partners and ot stakeholder mplementation structures for the Global st to reduce harmful use of alcohol
Challenges of Monitoring l Unreliable or invalid data l Incomparable data l Establishing uniform definitions l Need for historical data l Resources 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
minar , ber 2011, Lausanne, Switzerland Framework for monitoring and evaluation
The implementation of the global strategy to reduce the harmful use of alcohol l Strong global and regional leadership l Effective mechanisms for coordination and collaboration between all levels l Appropriate engagement of relevant stakeholders l Sufficient recourses available 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Issues to consider in policy formulation l Replicability - can the intervention be implemented in different contexts and circumstances? l Sustainability - are the required human, technical and financial resources such that the interventions can be continued for long enough to have the desired and lasting effect? l Scalability - can the interventions be expanded to the scale required to be meaningful? l Political feasibility - can the intervention be implemented in different political circumstances, e. g. , with respect to timing, values, power structure, etc. ? l Economic feasibility - what are the required investments and are these reasonable? How can the finances be made available? What has to be given up by other sectors? l Technical feasibility - are the tools required to make the intervention happen available or can they be made available? 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
Level of involvement l Informing: To provide stakeholders with balanced and objective information to assist them in understanding the problem, alternatives, opportunities and/or solutions l Consulting: To obtain feedback from stakeholders on analysis, alternatives and/or decisions l Involving: To work directly with stakeholders throughout the process to ensure that public concerns and aspirations are consistently understood and considered l Collaborating: To partner with stakeholders in each aspect of the decision including the development of alternatives and the identification of the preferred solution 5 th NCD seminar , 6 th September 2011, Lausanne, Switzerland
minar , ber 2011, Lausanne, Switzerland aluating the ectiveness of solutions. nslating the solutions or idence into policy, ctice and products; and borating solutions; derstanding its use(s); asuring the problem; WHO`s research strategy
Exit the maze of harmful use of alcohol for better global health Thank you for your attention! http: //www. who. int/substance_abuse
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