18 Nov, 2014

IOGT World Congress in Thailand advances cause of alcohol-free hotels

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Cha-am – Thailand may seem a most unlikely place to hold a convention on curbing the harmful consumption of alcohol. But that is exactly what happened between Oct 26-31 when the Regent Cha-am hotel in the seaside resort of Cha-am, about 200 kms southwest of Bangkok, hosted the largest worldwide community of non-governmental organisations committed to the cause of promoting “a lifestyle free from alcohol and other drugs.”

The quadrennial conference of the Sweden-based IOGT International was held for the first time in Asia as a warning to emerging countries whose growing population of young people is now the primary target of the increasingly aggressive global alcohol industry. It was organised in collaboration with Thailand’s Office of the Narcotics Control Board.

IOGT International claims to be the largest worldwide community of non-governmental organisations with a mission to promote a lifestyle free of alcohol and other drugs. Its work is guided by four principles: Invest in individuals; support families; strengthen communities; and develop societies.

According to the World Health Organization report Global status report on alcohol and health 2014, “Worldwide, every ten seconds, one human being dies because of alcohol. Alcohol kills more people in the world than AIDS, tuberculosis and violence combined. Every year we lose 3.3 million lives because of alcohol – because of alcohol-induced violence and abuse, because of a vast number of alcohol-related diseases and disorders (cancer, heart disease, HIV/ AIDS, tuberculosis, addiction etc.), because of road traffic accidents and injuries, because of workplace accidents and injuries. It all means that every 20th death is because of alcohol.”

According to IOGT International activists, “In Sweden, young people between the ages of 13 to 25 say that they use alcohol because it’s a way to socialise (67%), but less than half actually like inebriation (43%). 17% say that they only use alcohol because everyone else seems to be doing it. and 21% say that there’s really nothing else to do during leisure time.”

One primary focus of this year’s event was to expose the activities of the alcohol lobby. One blog by Katherine Robaina, MPH and Thomas F. Babor, PhD, MPH, posted on the IOGT International website said, “With non-profit classifications, deliberately confusing do-gooder names such as the International Center for Alcohol Policies and the Foundation for Advancing Alcohol Responsibility, and frequent name changes, it can be challenging to distinguish organizations with true public health motives from those with vested interests. Through their SAPROs and industry think-tanks, the Producers position themselves ingeniously and can confuse media outlets, policy makers, alcohol scientists and the public, which often assume the information is coming from an independent reliable source.”

The conference was of extensive relevance to the travel & tourism industry.

Alcohol sales are a major revenue-generator for hotels worldwide as well as sources of tax income for governments. However, because alcohol is more harmful than smoking, the anti-alcohol movement is gaining the same traction as the anti-smoking movement, and facing the same countervailing opposition as the tobacco lobby tried to mount.

Today, a smoke-free environment has become universal, and the anti-alcohol movement is gaining similar strength. This is borne out by alcohol-free hotels which are growing due to two reasons: 1) avoiding alcohol is a critical component of the entire health & wellness philosophy and 2) it is a bulwark of the Sharia-compliant hotels which are expanding rapidly across the Islamic world. As Buddhism also forbids the intake of intoxicants, Buddhist groups are also joining the bandwagon, especially in the wake of the huge annual casualty-count of road-traffic victims during Thai festive season long holidays.

“Alcohol is a ticking time bomb”

IOGT International President Sven-Olov Carlsson

An important policy and strategic overview of the event was provided by IOGT International President Sven-Olov Carlsson in his opening speech at the 68th World Congress. That is being reproduced here in full:

Four years ago, 2010, the 67th IOGT World Congress took place in Norway. I’m very happy that we now can hold the 68th IOGT World Congress in Thailand, the first ever. This wouldn’t have been possible without the hard work and support of IOGT Thailand, Stop Drink Network and the Office on Narcotics Control Board, Thailand.

Today our thoughts go out to all of those affected by Ebola in Western Africa, among them – many of our Members in the IOGT family. There are a lot of Orphans of dead Members and they need all the help they can get. Unfortunately the Ebola crisis has made it impossible for members from the region to attend and take part in this Congress. During this Congress we will start a fundraising activity to gather financial support for those members and families who are affected. Please help as much as you can.

Ladies and Gentlemen,

–       The harmful use of alcohol results in approximately 3.3 million deaths per year,

–       Alcohol is the World’s 3rd largest risk factor for disease and disability and it is the number one risk factor for middle-income countries,

–       Alcohol is a leading factor in 60 types of diseases and injuries and a component cause in 200 more,

–       Almost 4% of all deaths worldwide are attributed to alcohol – this is greater than deaths caused by HIV/AIDS, violence or tuberculosis.

Alcohol is a ticking time bomb in terms of its impact on health of world population. The true scale of the impact of alcohol on health systems, policing, budgets and lost productivity is only starting to be understood. The effect on individuals, families and communities is even greater and as alcohol consumption increases, so does the harm. Governments need to have a strong public health approach to alcohol in place in developing countries before alcohol use patterns start to be copied from those of the developed world. This is the critical lesson to be learned from the European region for the rest of the globe.

Now, then why are we not talking about alcohol in the way we are talking about tobacco? We are told that:

–       The evidence is less clear than on tobacco i.e. low/minimal risk levels of alcohol do exist,

–       It is a legally consumed food item that should be seen just as another product and be allowed to be marketed to adults and sale without restrictions,

–       In addition, many different government departments deal with alcohol, for instance trade, taxation, food standards, health, agriculture, licensing, policing, transport and more.

Most of these departments view alcohol differently, often as something to be promoted and supported. This makes it hard for the public health voice to be heard. What is needed is a strong cross-government approach to alcohol, linking together all policy areas in a consistent way. However, we are up against a very large economic industry that aggressively protects existing markets while seeing new markets to grow.

What do we mean by ‘Big Alcohol’?

First of all, lets understand just how big they are. Solid data is hard to find on the alcohol industry but in 2012, some estimates put global alcohol sales at $1,163 billion. And most of that market is controlled by a few key global players. Profits from the leading six companies were estimated at $480 billion dollars. To put that in perspective, let me tell you about two other sectors with strong global markets and leading European companies: the cosmetics and the pharmaceutical industry. The cosmetics sector has overall sales of about $160 billion and the global pharmaceutical industry has sales of $300 billion. The alcohol industry is huge. But bear in mind that just the social cost of alcohol consumption in the EU is €156 billion per year. So there is no question that alcohol is big business and that big business has a big impact on society and economy.

What are the prospects for Big Alcohol?

The future of Big Alcohol looks better than the future of Big Tobacco.

– The global alcohol industry sales are projected to grow and exceed $1 trillion in 2014.

– Volume of consumption is predicted to reach almost 210 billion liters in 2014 this is an increase of 10% in five years.

– The EU represents almost 57% of the world alcohol beverage market.

Big Alcohol is learning from the playbook of Big Tobacco. Big Alcohol is following similar patterns and tactics that were used by the tobacco companies. Such as:

– Deny there is a problem.

– Limit product liability and transfer responsibility to consumers.

– Claim behaviour cannot be regulated.

– Undermine independent scientific research.

– Insist on being part of the solution, while denying responsibility for the problem.

– Create additional organisations , so called social aspect organisations, to fill the policy space.

But what I would like to stress here is that, the Big Alcohol is also learning lessons from the battlegrounds about Tobacco. Just as the public health community seeks to be inspired from the successes against tobacco and adapt tactics for alcohol, so does the industry. So the path towards a strong alcohol control framework will be similar but not identical to the efforts on tobacco. This is not to say that we should not learn from Big Tobacco but that we should do it with imagination and be even better.

For a long time, the industry has denied that there were problems linked to their products. As the evidence of harm has built up and demand for political action has grown, they acknowledge that a small minority of people ‘misuse’ their products. This small minority represent the 6 % of alcohol users who are clinically addicted to alcohol – the easily stereotyped ‘alcoholic’ who can be pitied and ignored in a policy context. Once this message has been accepted, the industry is extremely good at framing any attempt to regulate or control their product as a disproportionate response to a small problem.

For us as an NGO:

–       We need to keep on insisting on total population consumption approach to alcohol – cutting overall alcohol intake helps everyone – including the heaviest alcohol users.

–       We need to keep the focus on the overall societal aspects, looking beyond the individual. We can use injuries, accidents, crime and violence data to support our arguments. When talking about the impact on health, link alcohol to health problems that are well established as a concern for the whole population – for example, depression or cancer.

The alcohol industry wants to limit the product liability. This tactic is familiar from gun manufacturers and tobacco companies. The message is that the product itself is a legitimate and legal consumer product that is not inherently harmful. It is the behaviour of the consumer that is at fault. The result of this message is that the product is distanced emotionally, legally and financially from the harm that it causes. And the manufacturers are not held responsible for the actions of the individual consumer, despite having spent large amounts of money to influence the behaviour of that consumer!

It is also a way of minimising the perception of the impact of alcohol – by placing blame on a few misusing individuals rather than recognising the systemic and toxic harm to families and communities.

Separating the harm from the product allows companies to reject any regulatory limits on their operations by claiming the right to free speech and the right to market their product. The public health community needs to draw on expertise from the environmental community which has established the principle of ‘polluter pays’ and a ‘lifecycle approach’ to products.

For us as an NGO:

–       We need to seek people/ organisations with expertise and build alliances with them that would allow us to place alcohol as a health problem in those debates talking about alcohol just as a product.

The alcohol industry says: “alcohol consumption behaviour cannot be regulated, so don’t try.” Once the message has been taken on board that the issue is not the product but individual behaviour, the next message from the industry is that it is impossible to regulate behaviour through legislation. The prohibition era in the US is used as an example of this failure. Instead, they push for measures like education and awareness campaigns as a way of influencing behaviour.

For us an an NGO:

–        We need to bring the debate back to the example of tobacco where legislation was used to shape behaviour (not regulate it) and build on the most recent examples of behavioural economics (known as nudge theories) now increasingly used in government practice.

As a reminder, the WHO has described the most effective policy tools or ‘best buys’:

– Raise taxes on alcohol

– Restrict access to retailed alcohol

– Enforce bans on alcohol advertising

The alcohol industry also undermines independent scientific research.

– They provide funding for academics for research that supports the industry position, e.g highlighting positive aspects of the product from a social, cultural or health perspective.

– They demand higher and higher levels of proof for scientific evidence before it can be taken into account for policy making.

– They identify ‘friendly’ academics that can write papers that challenge the findings of independently funded research.

This can be called our weakest link: we have plenty of evidence about the harm from alcohol but we are not effective at ensuring that these messages can be properly heard amid the noise generated by the industry with their version of scientific evidence. So the common misconceptions about the health benefits of one glass of wine a day or safe alcohol intake amounts during pregnancy keep being repeated. What we need to do is to link researchers with communication specialists and get smarter about getting our messages across. We need to work more with researchers and empower them to become strong advocates for our cause.

Typical is that the alcohol industry insist on being part of the solution while denying responsibility for the problem.

– The alcohol industry encourages multi-stakeholder processes that discuss the issue and potential policy responses.

– And they use these processes to establish the industry as an equal and legitimate stakeholder in health discussions.

– They delay, block or challenge proposed policy actions that are based on a public health rationale.

For us as an NGO:

–        We need to be better at exposing industry hypocrisy.

Big Alcohol has managed to position itself as a strong part of the health debates. This space needs to be reclaimed by the NGOs. Let’s be very clear about what the alcohol industry is: it makes money for its shareholders through the manufacture, distribution and sale of alcohol. The companies are legally required to act in the interests of those shareholders by maximising sales and profits. This is a legitimate role but it means that they are NOT a stakeholder in health or societal wellbeing.

We should not have to debate our case in the health forums. It is understandable we have to defend it when talking about trade related matters but having to defend it in health settings is an enormous defeat for all of us.

Big Alcohol creates additional organisations to fill the policy space. These are designed to act as counterweight to NGOs and they are both advocacy and corporate social responsibility bodies. They help ‘balance’ out a policy debate so that industry messages can be passed by seemingly independent organisations.

For us as an NGO:

–       We need to expose these entities on every possible occasion. The industry can only represent the industry.

But we can draw on researchers, consumer and family groups, education organisations, policing and justice reform organisations, patient groups and rehabilitation sector, doctors and medical professionals, trade unions and employers, health insurers etc.

Let us build strong coalitions!

For that we need to encourage:

–       A shift in attention to, and understanding of alcohol. Alcohol is bad for health – a carcinogenic, toxic, addictive and teratogenic.

–       A shift in governments ‘frame’ to understand alcohol comprehensively. It is a health issue and Health Departments should have the biggest say.

–       We need to establish that alcohol prevention makes economic sense. It is an investment in future savings. Evidence plays a key role in the process which means acceptance of the unequivocal scientific evidence that alcohol is harmful.

We are going through an evidence battle that should not even be taking place. We need to work closer with researchers and promote the best evidence in the field.

Working against Big Alcohol is difficult and can be extremely frustrating at times. But it is undeniably worth every single life saved!

With this I declare IOGT International’s 68th World Congress for opened.

Further information about the IOGT International congress including its various blogs and position statements can be found by clicking here: iogtworldcongress68.org/english/.