The UK Alcohol Health Policy: Global Perspective - Essay Example

? UK ALCOHOL HEALTH POLICY GLOBAL PERSPECTIVES [Pick the of the UK Alcohol Health Policy: Global Perspective The Gin Epidemic of the Seventeenth century offers clear proof that a community has the susceptibility of falling victim to the psychoactive and sedating tendencies of alcohol (Valley, 2005). ‘Binge Drinking’ is becoming a culture in Britain, with its negative effects becoming clear and becoming a hot topic of debate when it comes to policy and public health (RGS & IBG, 2013). The World Health Assembly substantiated that problems related to and originating from alcohol consumption have gained the status of being the most significant health concern worldwide (Jernigan, Monteiro, Room & Saxena, 2000). The council of European Union in the June of 2001; concluded that alcohol acts as a major health determinant, for the community and people of Europe (Anderson & Baumberg, 2006). The Policy making process is based on the triangle of health policy; context, content and process (Steinbach, 2009). Context to the Alcohol Policy Excessive consumption of alcohol leads to significantly affecting the long-term health; and is found to be playing role as a significant factor in 40 to 60 diseases including terminal illnesses (RCP, 2013; WHO, 2011). In UK one of the leading preventable causes of death is alcohol consumption; and also during the last decade the NHS has been significantly burdened due to rising number of admissions into the hospitals (RCP, 2013). Over the past quarter of a century the rate of death in UK has increased to 9,000 people per year as a direct result of excessive alcohol consumption and that another 100,000 more could die over the next decade (RGS & IBG, 2013). Global Dimensions According to the World Health Organization (2011) 4% of all death in the world are caused by alcohol consumption, making it even more deadly than HIV/AIDS; with alcohol specially posing as a death threat for the males of 15-59. Globalization has pushed the concept of and debate over many issues out of the realm of the national and into the international; with a new concept of a global civil society under global governance (Castells, 2008). Till 2004 an estimated 2 billion people were considered as alcoholic drinks consumers (Greenfacts, 2012). Globally, alcohol is responsible for a significant disease burden: the consumption being responsible for 3.2% deaths annually with 4.0% DALYs (disability-adjusted life years) were owed to alcohol consumption in 2000 (Rehm, Room, Monteiro, Gmel, Graham, Rehn, Sempos & Jernigan, 2003). Alcohol attributes to most of the unintentional injuries when it comes to mortality burden; and neuropsychiatric diseases were found to be the most significantly contributing to the disease burden in ten large countries (Rehm, et. al, 2003) and this burden is expected to increase in future (Greenfacts, 2013). Social and Health costs of alcohol are more vivid in poverty stricken areas and bear strong relation to the people who are socially marginalized; financial costs are estimated to be above 1% of GNP in high and middle income countries, with social and health costs as leading factors (Rehm, Mathers, Popova, Thavorncharoensap, Teerawattananon & Patra, 2009). Content of the Policies The harm reduction policies at a national level aim to; create leadership, awareness and commitment with regards to alcohol consumption, alcohol availability, marketing, driving and alcohol consumption, policies regarding the pricing of alcoholic beverages, reduce the harmful and negative consequences that arise from consumption, and reduce the impact of illegally produced alcohol (WHO, 2010). Globally the harm reduction strategy by WHO aims at; Public health promotion and partnership, capacity building, increasing awareness and knowledge, and mobilizing resources (Who, 2010). All of these aims are focused on reducing harm from alcohol consumption even illegally manufactured alcohol, but none of the aims or policies are focused on reducing either alcohol consumption or eradicating illegal manufacturing, or trade (Endal). Process The policy formulation is a process led by the civil society, in which all the initial stages of the policy were determined by the civil society based on the harmful effects of alcohol (Chikhwana, 2011). From there on the involvement of strategic partners along with stake holders like public sector, civil society are involved (Chikhwana, 2011). Then the policy makers like MPA’s, District councils are involved (Chikhwana, 2011). Main Issues In UK the agenda and strategy the Government is following with regards to the ‘Alcohol Harm Reduction Strategy 2004’ is that of creating ‘voluntary improvement and regulation of drinking’ (Berridge, 2013). The Government believes in reducing the harmful impacts of consumption of alcohol as it proves to be hazardous on employment by lowering the ability to work and function technically. In England the economy suffers the cost of ?1.7 billion per year just to treat alcohol misuse and an estimated number of work days that face alcohol related absences are around 17 million (FPH, 2008). The policy resulted from the need to enlighten the public to the adverse effects of adverse drinking, identification of misuse of alcohol and its treatment, the prevention and management of crime resulting from intoxication, and collaboration with industry to counter the harms induced by alcohol (Cabinetoffice, 2004) In 2010, WHO issued the ‘Global Strategy to Reduce Harmful Use of Alcohol’, which had five objectives regarding use of alcohol and the control and treatment of effects resulting from it (WHO, 2011). The ‘Global Strategy to reduce the harmful use of alcohol’ is meant to be a guidance action for policies and policy makers at national, international and Global levels (WHO, 2010). The alcohol policy also signifies which priority areas with regard to alcohol consumption that need to be addressed worldwide, and combines all options and preventive measures and techniques which can be employed to alcohol consumption (WHO, 2010). Critique of the Policy The key stake holders in the ‘Alcohol harm reduction strategy for England’ are the political parties, the national and international investors, the NHS, and the public sector. The pubic do not have a say in the policy making processes. The purpose of the act is to pave avenues for legislation and laws, which will be based on the premise of reducing harm that arises from alcohol consumption (Allyn & Bacon, 2010). The 2004 report on alcohol-related harms stated that the licensing Act of 2003 would lead to an increase in the harm induced by alcohol but at the same time notified that alcohol was a ?30 billion industry (Haydock, 2013). Of course if the NHS spends ?1.7 billion on alcohol misuse treatments, it is nothing as compared to the ?30 billion that the economy receives. The key stake holders in the policy are the political parties, the national and international investors, the NHS, and the public sector. The pubic do not have a say in the policy making processes. The policy also does not focus on controlling the drinking habits of children and youth as this is also becoming a critical situation in Britain. In 2004 a survey was conducted in England with secondary school students as subjects; the survey reported that 11% of 11 to 12 year old boys and girls and 61% of 15 year olds reported being drunk; with girls having three times more chance of being intoxicated (FPH, 2008). A recent study analyzing the documents from the alcohol industry related how the industry through their building up of relations which are institutional and financial, manipulated the policy formulation process and shaped the legislations to suit their convenience and thus avoiding any regulations against them (Kelland, 2013). Ian Gilmore of the Britain’s Royal College of Physicians and the special adviser on alcohol believes that this arrangement cannot work and should not be trusted to work in the future, the conflict of interests are quite obvious and the industry should be divorced from the workings of the public health sector (Kelland, 2013). The key stake holders in the ‘global strategy to reduce the harmful use of alcohol’ and its implementation are the member states of the WHO, the international partners, the civil societies, private sector and the public health and research institutions (WHO, 2011). The WHO director general, Dr. Margaret Chan was recently issued a statement which clearly highlighted the conflict of interest that is arising between the global public health community and the alcohol industry elite (Endal, 2013). The statement clearly iterates that alcohol industry is pursuing its own ends and creating hurdles in the alcohol harm reduction policy implementation (Endal, 2013). The alcohol producers have a conflict of interest when it comes to public health and making huge profits; they are making documents produced by centers like ICAP (International Centre for Alcohol Policy) as an excuse, which is also sponsored by the alcohol industry (Endal, 2013). According to ICAP the alcohol industry has gained the status of equal stake holders in light of the WHO strategy, and thus they are playing significant roles in influencing alcohol policy formulation in African and Asian states (Endal, 2013). For example the recent conflict in South Africa over the banning of Alcohol advertisements highlight the industries conflict of interest (Endal, 2013). Companies like SAB Miller and Diego at one hand declare participation in the WHO harm reduction strategy whereas on the other hand declare Africa as a growing market and influence the policy formulation in those countries (Endal, ‘FORUT’). Global health governance was the child of WHO until recently, but with Global Health Initiatives which were results of efforts of multiple stake holders the governance has gone into the hands of new actors (Kruk, 2010). Foundations like Bill and Melinda Gates hold a primary seat in the scenario but issues regarding accountability are becoming a concern (Kruk, 2010). WHO has also issued a legislation guide, “addressing the harmful use of alcohol”, to guide governments to develop, implement, monitor and enforce alcohol use policies: the legislation incorporates the necessary measures like sale of alcohol, taxation, age restrictions, marketing and driving (Bakke, 2011). Apart from commercial alcohol non-commercial alcohol has very high percentages, like it is two thirds of the alcohol consumed in Indian subcontinent, 50% in Africa, and a third of alcohol consumed in Europe and Latin America is non-commercial or illicit (WHO, 2004). Agreements like ‘free trade’ tend to reduce hurdles in alcohol trade, intensify competitiveness, promote lowered prices and most importantly encourage consumption; whereas the policies aim at controlling all these factors, this also in turn sometimes gives rise to illegal trade (Zeilger, 2009; Zeilger, 2006). Impact of the Alcohol Policy These policies are supposed to be for the benefit of the public but there are those who argue that the effects of these policies do not trickle down fast enough and the benefits and advantages are enjoyed by the elites who invest in the alcohol economy and the disadvantages, risks and problems are faced by the rest of the world’s population and ‘localized communities’ (Bauman as cited in Lee, et. al., 2002). The concept of global health originated from this inequality (Coburn as cited in Lee, et. al., 2002), but the advantaged and disadvantaged in the long-run still is still a great dispute (Lee, et. al., 2002). The focus on reducing harm induced by alcohol consumption has led to the incorporation of the codes of harm reduction in about 50 of global initiatives; improving the marketing strategies of alcohol (Thompson, 2013). The ASA regulates all forms of alcohol marketing in the UK; the adverts cannot target youngsters under the age of 18 and also they cannot show that alcohol consumption is in any form related to social or sexual success (Thompson, 2013). The advertisement panel is independent and hence ensures that no pressure from politicians, industry or other concerned parties is exerted; any product that does not follow the packing, advertising code is removed from the market as has been done to about 70 products (Thompson, 2013). The current policies seem incapable of tackling the alcohol problem. When viewed with relation to other implemented policies they are not acting in favor of reducing crime and harm induced by alcohol. In a recent survey, Alcohol has also been proven to be a major instigator and catalyst to ‘violent crimes’, 44% of victims believed that they were attacked by an intoxicated person (RGS & IBG, 2013). According to Berridge (2013), the Government policy with regards to alcohol is at odds with the society policy, as through the 24 hour licensing the government has authorized longer hours for the outlets to stay open and in turn allowed the public with a license to drink 24 hours. This gained favor with the youth and ‘night-economy’ but was ill received by the older generation who are opposed to both and are part of the local political, resident and amenity groups (Berridge, 2013). Where the Government believes in reducing alcohol related harms, the contradicting 24 hour licensing policy has given a rise to community disorder and violence resulting from drinking during the early hours (BBC, 2008; Stewart, 2008; Measham, 2006). David Davis, who is the shadow home secretary, also believes that current approached is a failed policy and a significant 50% increase in anti-social alcohol based behavior is clear proof of this (BBC, 2008). Alcohol trade is illegally carried in many parts of the world to an extreme case with the consequences also becoming a harsh reality with every passing day (Quinn, 2010). Recommendations Current policies although named otherwise; focus more on the treatment of the disorders produced from the consumption rather than focusing on reducing the consumption (Anderson & Baumberg, 2006). The municipal will act as the relevant actor in the changing and implementation of the policy locally and foundations like Bill and Melinda Gates can act significantly to introduce change on the Global level. 1. 24 hour licensing should be nullified and appropriate Laws for sales and licensing should be implemented through the municipal committees 2. Restrictions should be placed on the number or bars and pubs which can be built in an area. 3. 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