The penultimate part of this month's just-drinks management briefing sees Ben Cooper look at the alcohol debate around the rest of the world, especially in the European Union.

The alcohol debate is characterised by a considerable degree of antagonism between elements of the campaign and public health communities on one side and the industry. 

There are opportunities for discussion and even collaboration between different participants but the range of opinion among non-industry stakeholders means there are some who are more prepared to engage with industry than others. 

Eurocare

In the EU alcohol policy debate, Eurocare, or the European Alcohol Policy Alliance, is known to be highly sceptical of industry social responsibility efforts and its involvement in alcohol harm mitigation.

Eurocare comprises organisations from across the EU working on the prevention and reduction of alcohol through research and advocacy, as well as through the provision of counselling services and residential support for problem drinkers, workplace and school-based programmes and the provision of information to the public. It describes itself as an advocacy organisation but states that it advocates the prevention of alcohol harm through effective evidence-based policy. 

Mariann Skar, Eurocare secretary general, stresses that the group is a coalition, representing a range of views. She believes branding the organisation as 'anti-alcohol' is a tactic designed to "marginalise" the group in the debate. Skar says organisations advocating total abstinence from alcohol represent a minority of the membership and readily admits to being a social drinker herself. 

One reason why Eurocare is perceived as anti-alcohol comes down to its reluctance to engage with industry. Skar acknowledges that Eurocare is sceptical on this but adds that it is not Eurocare's role to engage with industry. Also, she adds, part of Eurocare's mission is to monitor what industry is doing and check that it is making good on social responsibility undertakings, which would be "really impossible" if the two were in partnership. 

However, Skar states that engaging with policymakers is most definitely central to the group's activities. Indeed, Eurocare's perceived rapport with bodies such as the European Commission and the World Health Organization (WHO) has concerned some industry representatives. Eurocare states that it "has received funding from the European Commission and WHO for various projects and publications".

The European Alcohol and Health Forum

While Eurocare is wary about engaging directly with industry, it was a founding participant in the EU Alcohol and Health Forum, a multi-stakeholder forum set up as part of the six-year EU Alcohol Harm Strategy which runs until 2012. 

Skar believes the Forum to have been important in raising alcohol up the policy agenda in Europe but stresses that it does not represent partnership with industry. 

Also, one of the two conferences on alcohol harm convened by the Swedish government in 2009 during its presidency of the EU included representation from both industry advocates and health campaigners. It has to be said that those hostile to industry efforts predominated, as might have been expected from a Nordic country with a tradition of tight control of alcohol. 

Nevertheless, the opportunity for those holding disparate opinions to discuss them must be positive, particularly as the next iteration of the EU alcohol strategy is now beginning to be discussed.

The European alcohol policy debate is often seen as the conflict between Nordic models of very tight alcohol regulation and the more relaxed southern European approach. Certainly, Eurocare is often portrayed as supportive of the Nordic model. Skar says this is true, though she also believes the French approach to alcohol regulation is a good model.

Eurocare is a member of the European Public Health Alliance (EPHA), an organisation representing some 100 NGOs across Europe. Although EPHA has a broader public health agenda, it does participate vigorously in the European alcohol debate and, like Eurocare, finds itself frequently at odds with industry. Like Eurocare, EPHA receives funding from the European Commission among other sources.

The World Health Organization 

As previously mentioned, Eurocare has received some funding from the World Health Organization (WHO) which is also sometimes portrayed as having an institutional bias against the industry. The WHO Copenhagen-based European office is considered by many to take a particularly sceptical view of industry engagement and errs towards the Nordic model of regulation.

Over the last few years, there has been a considerable amount of campaigning, by all stakeholders, focused on the WHO as it has been developing its global strategy to tackle alcohol-related harm. This was finally ratified at the World Health Assembly last May.

Whether the accusations of anti-industry bias are valid or not, WHO is ultimately accountable to the national governments of the member countries which, campaigners would counter, are susceptible to the significant lobbying resources of industry.

The strategy covers ten policy areas including health services' responses, community action, drink-driving policies, the availability and marketing of alcohol and pricing policies.

The final version of the strategy was broadly welcomed, suggesting that in the end neither side had an unfair influence over proceedings.

In February, WHO published its Global Status Report on Alcohol and Health (2011) and the first meeting in which WHO global counterparts discussed implementation of the global strategy was held in Geneva.

WHO Europe will have considerable autonomy in how it implements the global strategy, as do all WHO regional offices under its devolved structure and, given the perceived harder line taken by WHO Europe, this has caused concern to some industry advocates. 

In January, WHO Europe said its new European Action Plan on Alcohol, due to be launched in 2012, will be "based on both European and global alcohol strategies as well as the newest literature in the area of alcohol policy". Mariann Skar said Eurocare would like to be involved in that process.

Global Alcohol Policy Alliance

A prominent international campaign group during the discussions around the WHO global strategy was the Global Alcohol Policy Alliance (GAPA), of which Eurocare is a member.

Like Eurocare, GAPA is a membership organisation and, while it includes some groups that might be described as neo-prohibitionist, it also boasts members with more moderate positions.

Formed in 2001, GAPA says its mission is to "reduce alcohol-related harm worldwide by promoting science-based policies independent of commercial interests".

It aims to provide a forum for alcohol policy advocates in order to disseminate information on effective alcohol policies and bring to the attention of governments, international governmental and non-governmental agencies the social, economic, and health consequences of alcohol consumption and related harm.

Among other stated objectives, GAPA aims to encourage research on the social and health impacts of the actions of the multinational alcohol industry; promote research on the impact of international trade agreements on alcohol-related harm; and monitor the activities of the alcoholic beverage industry.

The GAPA secretariat shares offices with the Alliance House Foundation, formerly the UK Temperance Alliance, the parent company of the Institute of Alcohol Studies. One of its founding board members, Derek Rutherford, is chairman of the Institute of Alcohol Studies.

In its ten years of operation, GAPA has placed considerable emphasis on promoting alcohol policy reform in developing markets.

It states that it places "priority on research and advocacy regarding those parts of the world where alcohol problems are increasing" and aims to ensure that member groups in those areas have the technology and support capacity to participate in a global network for communication and action.

To that end, the Indian Alcohol Policy Alliance was launched in 2005 and the Asia Pacific Alcohol Policy Alliance in 2006.

To read part II of this briefing, click here.

The final part can be accessed here.