Photo: Helena Goldon

Debate

Sweden should lead the fight against global alcohol harm

Alcohol kills about three million people every year and many more fall victim to violence and ill health. Despite this, there is no global framework for effectively preventing the negative effects of alcohol. Jens Rosbäck, head of the international department in the IOGT-NTO movement, believes in a debate article that it is time to do something about the problems.

Sweden has the ambition to play a significant role in better global health. Earlier this autumn, the report "Sweden's work with global health - for the implementation of Agenda 2030" was presented by the Ministry for Foreign Affairs and the Ministry of Social Affairs. It is an excellent and in many ways an impressive document. Working preventively with the most important risk factors behind ill health is one of three priority areas in the work.

Alcohol kills about three million people every year. There are more than those who die of HIV and tuberculosis combined. Alcohol is also an important risk factor behind over 200 medical conditions, causing accidents and contributing to violence. The poorest in the world are disproportionately hard hit.

Our partners around the world constantly meet people who have been severely affected by alcohol. Women who are exposed to violence, men who have gotten drunk and who can no longer contribute to the family, children who can no longer go to school, or have even ended up on the streets because too much alcohol is drunk in the family.

Although the problems caused by alcohol are well known and well documented, efforts to prevent the problems are small on a global level. The World Health Organization has admittedly adopted a strategy that includes a lot of good things, but since it was hammered out in 2010, the resources to implement it have been drastically reduced.

Many countries - especially low- and middle-income countries - today completely lack an effective, evidence-based alcohol policy. This leaves the field free for an expansive and sometimes directly aggressive alcohol industry, which invests enormous resources in conquering growing markets in, for example, southern Africa, South and Southeast Asia.

Relatively simple initiatives that we are well aware of in Sweden, such as higher prices, limited availability via age limits, opening hours, etc., and heavily regulated marketing, are the most effective ways to prevent problems from alcohol. When countries today turn to the WHO for technical assistance to develop this, they all too often get no. The resources do not exist.

Now it's time to fill strategies and goals with concrete content. Sweden can and should do many things, here are three suggestions:

# Open health assistance for alcohol prevention work. WHO and other UN institutions have good initiatives in this area, all of which are severely underfunded. Aid should also be channeled through civil society organizations, which are already making good efforts at both local and global levels - with far too few resources.

# Work for a global framework convention on alcohol, similar to the one in the field of tobacco. The Tobacco Convention has made a big difference, not least in low- and middle-income countries, and a similar solution is needed in this area. Alcohol is today the only psychoactive and addictive substance that is not regulated in any international convention.

# Monitor the WHO's commitment to the issue closely. It is both about how budget funds are distributed and about ensuring that alcohol is not forgotten when strategies and action plans are drawn up. Sweden should also work to ensure that the alcohol industry does not have the opportunity to influence WHO's work - this is unfortunately not the case today.

Alcohol may always be present, but a large part of the problems can be prevented. It is not a natural law that millions die every year, or that many more suffer from ill health, violence, accidents or poverty due to alcohol. Let's do something about the problems.

This is a debate article. The author is responsible for analysis and opinions in the text.

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