The fourth and final part of this month's management briefing sees Ben Cooper consider how the future looks for the drinks industry's attempts to deal with alcohol harm and responsible consumption.

In executing the WHO's Global Strategy to Reduce the Harmful Use of Alcohol, the WHO's Secretariat is bound to support member states by "promoting and facilitating international coordination, collaboration, partnerships and information exchange to ensure the needed synergies and concerted actions of all relevant parties".

As in most areas of policy discussion today, whether in national government or international governmental agencies, a strong emphasis is placed on pluralist, multi-stakeholder discussion of issues and how they should be addressed.

Leaving aside the question of how the WHO Secretariat balances this particular aspect of its alcohol harm reduction strategy with protection from what it describes as "distortion by commercial or vested interests", the principle of multi-stakeholder collaboration is clearly enshrined in the strategy.

Engagement with NGOs and government

As previously noted, some NGOs and public health advocates take an extremely sceptical view of industry engagement, though there is a spectrum of views. 

The authors of the GAPA Statement of Concern, a response to the Beer, Wine and Spirits Producers' Commitments by a coalition of health NGOs and academics, are at the extreme edge of that spectrum but do not speak for all NGOs or third-party stakeholders.

While Mark Leverton, director general of the Global Alcohol Producers Group (GAPG), accepts there is not much hope of cross-collaboration with GAPA", he stresses that there are many other external stakeholders in public health and other fields willing to partner with industry, as shown by recent partnerships with third-party organisations included in the Global Actions programme. 

"They [GAPA] are not the only stakeholder out there; there are others in public health and others in  alcohol-related areas which would be relevant," Leverton continues. "I think industry has already shown it has been able to work in partnership over many years. GAPA's not willing [to collaborate], but others will be, and we will be delighted to work with those who wish to work with us and who share common goals."

The point that the GAPA coalition members are not the only NGOs in town is also underlined by the experience with the Public Health Responsibility Deal in the UK. 

While it was notable that six extremely prominent NGOs withdrew their support from the UK government's Public Health Responsibility Deal in 2011 on the grounds that it was "all carrot and no stick", many other third parties remained onboard.

Speaking in a recent article in the British Medical Journal (BMJ), Dr Nick Sheron, head of clinical hepatology at the University of Southampton, and an oft fierce critic of the alcohol industry, defended his decision to remain within the Responsibility Deal Alcohol Network Group (RDAN), which in fact he co-chairs with the Portman Group. 

Underlining Sheron's own scepticism, he says he does not disagree with anything in the GAPA Statement of Concern, and shares concerns over what he perceives as industry's inherent conflict of interest when discussing alcohol harm mitigation. However, he says that does not mean companies cannot be persuaded to make "profit neutral" business choices which can benefit public health.

For governments simply not to speak to industry is not a "pragmatic reality", Sheron says. He adds that it is "really important to talk to people who totally disagree with you".  He says he gets criticised from both sides but industry representatives would certainly welcome his inclusive position on engagement, even if he is often berating them.

"We believe that all stakeholders need to come together, preferably under auspices of government," says Leverton, "and irrespective of the Statement of Concern from GAPA that will not in any way detract from us continuing to promote multi-stakeholder collaboration."

Even if multi-stakeholder forums like the RDAN and the European Alcohol and Health Forum (EAHF), set up as part of the EU's alcohol harm strategy, are viewed sceptically by some NGOs, those taking a more pragmatic view see them as an opportunity publicly to hold industry to account. Interestingly, at the EAHF, Sheron represents the Royal College of Physicians, one of the NGOs that withdrew from the RDAN. 

The European Alcohol and Health Forum

The European Alcohol and Health Forum (EAHF), while it has had its detractors, is precisely the type of forum where NGOs can potentially take industry to task. But, while few would go as far as refusing to support the forum, some would still question whether industry representatives have a legitimate place there.

However, cross-stakeholder dialogue was viewed by the European Commission as critical to the EU's alcohol harm strategy  industry from the outset.

The strategy came to the end of its initial six-year term last year but a decision has been taken by DG Sanco to extend the strategy on a rolling basis, along with the EAHF.

And as the EU strategy moves forward, DG Sanco clearly remains firmly committed to those multi-stakeholder precepts. "The EU alcohol strategy calls for actions from all stakeholders to reduce alcohol relate harm," DG Sanco states in a response to just-drinks. "This also includes alcohol companies. Alcohol producers are for the Commission key stakeholders and have a role to play in this respect."

This decision is supported by Spirits Europe which represents spirits producers in the EU. "We support the continuation of the forum," says director general Paul Skehan. "We view it as a positive mechanism. It is a forum where people come together and something we'd like to see continue."

As for industry-sponsored events attracting representation from public health, the challenge is even harder. At the ICAP conference there was representation from outside industry, though attendance from the NGO community was lower than the organisation would have wanted and ICAP stresses that this was "not through want of trying". What the ICAP conference certainly did underline, however, was that discussion, cooperation and partnership within the industry is increasing around these issues. The conference was the first major ICAP conference for some years but the organisation  is already tentatively planning another for late 2014 or 2015. 

Partnership within industry

In fact, Spirits Europe itself bears witness to this trend as it was formed by the merger of CEPS and the European Forum for Responsible Drinking (EFRD) last November. Skehan points out that one of the virtues of the merger is bringing together the complementary strengths of large alcohol producers and national industry associations which formed the membership of CEPS.

As EFRD's sole focus was responsible drinking , the merger has a particular relevance to the continuing mission around these issues. Indeed, Skehan says of the four "pillars" of work at Spirits Europe, it is the responsible consumption/alcohol harm piece which takes up most time.

Skehan also points out that cooperation between the different drinks trade bodies in Europe on alcohol harm has been stepped up. He has instituted monthly meetings with José Ramón Fernández and Pierre-Olivier Bergeron, his respective counterparts at Comité Européen des Entreprises Vins (CEEV) and Brewers of Europe. "On this whole question of spirits and society, health aspects and so on, we work extremely closely," Skehan says. 

Concluding comment

So intra-industry partnership and collaboration is definitely on the increase. In fact, the Beer, Wine and Spirits Producers' Commitments can themselves be viewed as part of that trend. Indeed, they represent both partnership between major multinationals and, with the inclusion of two Japanese trade associations, collaboration between corporate players and industry bodies.

With the open-door policy towards incorporating new signatories and the broad industry interest being shown in the Commitments mentioned in the second section of this briefing, this greater collective focus might give the more standoffish NGOs something to ponder.

The likes of Diageo, Anheuser-Busch InBev, Pernod Ricard and SABMiller are powerful political players individually. As a collective, united behind specific shared commitments, they will be an even more daunting force, and as major employers and economic contributors to national economies will be listened to by member governments, however aloof the WHO Secretariat may remain. That aloofness also appears to extend to responding to any questions posed by just-drinks to the WHO press office in the course of researching this briefing.

GAPA rails against industry lobbying but a continued position of trying to freeze industry out of debates only makes a greater emphasis on the dark arts of lobbying more likely.

It is simply unconscionable for companies as powerful as this not to seek somehow to involve themselves in policy discussions on issues which affect their commercial activities. The new commitments and other activities at least suggest that they do so also with a strong awareness of what governments and the public expect of them from an ethical perspective. 

That is the way the wind is blowing and NGOs in other sectors of industry woke up to this some time ago. The health NGOs represented by GAPA focus on the parallels with tobacco and believe the alcohol harm debate and drinks producers will go the same way as tobacco companies, and ultimately will not be welcomed as co-stakeholders in the same way seen in other industries. GAPA may be right but evidence in the UK, the EU and elsewhere suggests they are not.

If the academics and NGOs in GAPA feel that such industry-sponsored corporate responsibility activities, pledges and commitments are so much greenwash, there are forums where industry can be directly and publicly challenged. However, to imagine that powerful multinationals with revenues far in excess of the GDP of many WHO member states are simply going to give up and slip away is fanciful in the extreme.