Alcohol-related problems deplete the human and financial resources of many nations. In both developed and developing countries, they reduce life-expectancy, lower productivity, require substantial expenditures for health and other services, and ravage family and community life. These effects (which are described in detail in other publications of the World Health Organization) are experienced, in many nations, by the nation as a whole. Often, they interfere with attainment of important national goals. But it is also true that national actions affect the development of alcohol-related problems. In every country, government influences the production, trade, and distribution of alcoholic beverages in a manner which affects their price, the conditions under which they are available, and public attitudes towards their consumption. These, in turn, influence the nature and level of alcohol-related problems experienced within the country. That such influence is generally unintended makes it no less powerful. Other governmental actions (for example, with regard to drinking and driving, alcohol-related violence, provision of health care, and alcohol-related accidents in the workplace) define for a nation the limits of "acceptable" alcohol-related damage. And the efforts of families, communities, non-governmental organizations and other levels of government to prevent alcohol-related problems are profoundly affected (either constrained or supported) by actions at the national level. These matters have long been of concern to WHO. In 1979, for example, the World Health Assembly affirmed that problems related to alcohol, and particularly to its excessive consumption, rank among the world's major public health problems. The Assembly also noted the serious social and economic consequences of alcohol problems. In 1982, the Assembly convened Technical Discussions on alcohol consumption and alcohol-related problems in which delegates from more than a hundred countries participated. These discussions were marked by a high degree of consensus on the need for national programmes and policies to prevent alcohol-related problems, including the alcohol dependence syndrome. Delegates expressed keen interest in learning from each other’s experiences in this area and appealed for sound data on which to base national decisions, especially information about the relative effectiveness of different prevention and treatment strategies. In 1983, the Assembly observed that rising alcohol consumption and alcohol-related problems are incompatible with achieving the goal of the Member States of the World Health Organization: health for all by the year 2000. Taking note of the Technical Discussions, the Assembly recommended that Member States formulate comprehensive national policies, with prevention of alcohol-related problems as a priority, within the framework of their strategies for health for all. In keeping with the expressed concerns and priorities of the World Health Assembly, WHO supports Member States in their efforts to reach decisions on prevention of alcohol-related problems which are consistent with their national needs and circumstances. In recent years, for example, it has conducted a series of studies and workshops relating to development of national alcohol policy. These efforts have been carried out at headquarters and regional levels, with collaborating governments and research institutions, and have produced a valuable body of reports and publications. This document summarizes current scientific knowledge regarding the effectiveness of various policy measures which governments can take to prevent alcohol-related problems. It is drawn from the documented experience of Member States, primarily as reflected in scientific and professional publications over the last fifteen years. So far as possible, examples of preventive measures have been drawn from both developing and developed countries. It is apparent, however, that more documented evidence exists in some developed countries than elsewhere in the world. It is hoped that one effect of issuing this document will be to encourage others, particularly developing countries, to make available the fruits of their experience in seeking to prevent alcohol-related problems. The main purposes of the document are, however, much wider. It is hoped that it will help inform the political debate about prevention of alcohol-related problems; that it will support Member States in their efforts to develop effective national policies; that it will encourage careful evaluation (and wide dissemination) of the results of future policy decisions; and that it will confirm Member States in their expressed desire to learn from one another's experiences in this important area of public health policy. Accordingly, it is addressed to scientists, policy-makers (both politicians and civil servants), and individuals and organizations seeking to influence national policy decisions. (Author/publisher)
Samenvatting