B4955.Pdf (2.457Mo)
Total Page：16
File Type：pdf, Size：1020Kb
REDUCING HARM FROM ALCOHOL USE: GOOD PRACTICES Mental Health and Substance Abuse Unit Department of Sustainable Development and Healthy Environments Contributing Authors BHUTAN DR RAJAT RAY MR TANDIN CHOGYEL Professor and Chief National Drug Dependence Program Officer for Mental Health Treatment Centre and Department of Public Health Head, WHO Collaborating Centre Ministry of Health All India Institute of Medical Sciences Thimphu New Delhi MR TSHERING DORJI SRI LANKA District Health Officer Mongar District DR SAJEEVA RANAWEERA Epidemiologist and Director MR KARMA WANGCHUK Public Service Delivery and Social Welfare Evaluation District Health Officer Presidential Secretariat Lhuentse District Colombo INDIA MR PUBUDU SUMANASEKARA Alcohol and Drug Information Centre DR VIVEK BENEGAL Colombo Professor of Mental Health National Institute of Mental Health and Neuro Sciences THAILAND Bangalore DR CHITLADA AREESANTICHAI MS.ANITA CHOPRA Lecturer and Researcher Scientist, College of Public Health Sciences National Drug Dependence Treatment Centre Chulalongkorn University All India Institute of Medical Sciences Bangkok New Delhi DR USANEYA PERNGPARN DR G. GURURAJ Drug Dependence Research Center Professor & Head College of Public Health Sciences Department of Epidemiology Chulalongkorn University National Institute of Mental Health and Neuro Sciences Bangkok Bangalore DR THAKSAPHON THAMARANGSI DR RAKESH LAL Center for Alcohol Studies Professor and Officer-in-Charge International Health Policy Programme National Drug Dependence Treatment Centre Ministry of Public Health All India Institute of Medical Sciences Bangkok New Delhi MS ORRATAI WALEEWONG DR GIRISH N RAO Specialist in Alcohol Policy Associate Professor International Health Policy Programme Department of Epidemiology Ministry of Public Health National Institute of Mental Health and Neuro Sciences Bangkok Bangalore 2 REDUCING HARM FROM ALCOHOL USE CONTENTS Preface Executive summary 1. Introduction 1.1 Historical note 1.2 The alcohol industry 1.3 Promotion and sale of alcohol 2. Spectrum of alcohol use in the South-East Asia Region 2.1 Practice of alcohol use 2.2 Alcohol consumption: volume and pattern(s) 3. Information on alcohol use 3.1 Myanmar and Sri Lanka 3.2 Nepal 3.3 India, Indonesia and Thailand 3.4 Findings 4. Harm from alcohol use in the South-East Asia Region 4.1 Morbidity and mortality 4.2 Psychosocial harm 4.3 Economic harm 5. Reducing harm from alcohol use 5.1 Initiatives of the WHO South-East Asia Regional Office 5.2 Policies on control of alcohol use: global and national 5.3 Priority areas for action to reduce harm from alcohol use 5.4 Programmes to reduce harm from alcohol use: community action: • Bhutan, Sri Lanka, Thailand 6. Conclusion 7. References Annexes: 1. Resolution of the 59th Regional Committee, 2009, (SEA/ RC59/ R8) 2 Recent information on alcohol from India. GOOD PRACTICES 3 PREFACE Documented evidence The impact of globalization, Alcohol use results in suggests that fermented industrialization, migration approximately 2.5 million beverages existed at least and the media on the lives deaths each year, which as early as 10 000 BC. of people is palpable. The is greater than the global Ancient references to shift from agrarian to number of deaths caused by alcoholic beverages can be modern societies has led to HIV/AIDS, tuberculosis or found in literature from psychological, cultural and violence. Approximately 4.5% China, Egypt, Greece, India, social change. People are of the global burden of disease Iran, Italy, pre-Colombian embracing new lifestyles, and injury – more than 60 America and sub-Saharan cultures and practices, major types – is attributable Africa. Use of alcohol has a leading to emerging problems to alcohol use. Alcohol place in the rituals of many such as the increased use and consumption is the world’s cultures around the world, abuse of alcohol. third largest risk factor for including in some South- disease and disability. In East Asian communities. Traditionally, alcohol use has addition, it is also associated Throughout history, alcohol been considered a matter of with many serious social has been regulated through personal choice, and harm issues, including gender- social control whereby its from alcohol use seen as an based violence, child neglect use is permitted, and abuse issue to be addressed by the and abuse, and absenteeism at discouraged. But today, individual and the family. the workplace. things have evolved. In recent years, awareness about harm from alcohol Harm from alcohol use has South-East Asian societies use has increased, not only been clearly detailed in the are experiencing changing with regard to the user but “Alcohol Control Series” stages of growth and also harm to the family, the developed by experts from the development due to macro- community and the entire South-East Asia Region of the and micro-level influences. nation. World Health Organization. 4 REDUCING HARM FROM ALCOHOL USE In trying to reduce this practices, provides policy their participation, harm harm, we are confronting a options taking into account from alcohol use can be formidable enemy. There are diverse national, religious minimized. The impact an estimated 600 factories, and cultural contexts. To be evaluation of the community- 1582 distributors and locally relevant, the strategy based programmes in Bhutan, thousands of retail outlets also considers the differences Sri Lanka and Thailand involved in alcohol production in Member States’ resources, has shown very positive and retailing in the Region. capacities and capabilities. results. Other Member States Over four million people are Similarly, at its Fifty-ninth may wish to analyse these involved in this industry. session in 2009, the Regional pilot studies with a view to Committee for South-East adapting them in their own We now realize that only a Asia requested the Regional countries. coordinated, multisectoral Director to support Member approach can address the States in building and I am confident that experts complex issues of prevention strengthening institutional and governments working of harm from alcohol use, and capacity to develop to promote the welfare governments are increasingly information systems, policies, of their communities by taking measures to protect action plans and programmes reducing harm from alcohol their citizens from the on the prevention of harm consumption will find this dangers of alcohol abuse. from alcohol use. document useful. The Sixty-third World In response to these high- Health Assembly in May 2010 level resolutions, experts in endorsed the Global Strategy the South-East Asia Region to Reduce the Harmful Use have carried out significant DR SAMLEE PLIANBANGCHANG of Alcohol. This strategy, studies to show governments Regional Director based on evidence and best and communities that, with GOOD PRACTICES 5 EXECUTIVE SUMMARY Communities around the of diseases and injuries and world have been consuming a component cause in 200 alcohol for centuries. others. Indeed, alcohol use Although alcohol use is represents approximately acceptable in society, its 4.5% of the global burden abuse is strictly controlled of disease and is the world’s by societal norms. More third largest risk factor recently, alcohol use has for disease and disability. shifted from its original It is also associated with ritualistic and symbolic many serious social issues, purposes to recreational and including gender-based excessive use in many parts violence, child neglect and of the world. Widespread abuse, absenteeism at the alcohol use, leading to harm work place and economic loss. not only to the user but also to the family, the community The formal alcohol industry, and the entire nation is now which has emerged during recognized as a public health the last few decades, strives to problem in many countries. increase alcohol consumption through many means, and Globally, alcohol use results uses vast resources to do so. in approximately 2.5 million It is estimated that in the deaths each year. This figure South-East Asia Region of the is greater than the number of World Health Organization, deaths caused by HIV/AIDS, over 600 factories, 1582 tuberculosis or violence. distributors, thousands of Alcohol is a causal factor in retail outlets and over 4 more than 60 major types million people are involved 6 REDUCING HARM FROM ALCOHOL USE in alcohol production, retail which includes evidence- and other elements of the based measures to address industry. use and consequent harm. Similarly, at its Fifty-ninth The community and policy- session in 2009, the Regional makers in the Region Committee for South-East should be made aware of Asia requested the Regional issues related to alcohol Director to support Member consumption such as States in building and increasing use by women and strengthening institutional the youth, the earlier age of capacity to develop initiation, availability of illicit information systems, policies, alcohol, and the targeting action plans and programmes of markets in developing on prevention of harm from countries by multinational alcohol use. manufactures. The experience of selected The global community has SEAR Member States realized the harm from in reducing harm from alcohol use and is taking alcohol use through policy measures to reduce it. In development and community May 2010, the World Health action is documented in Assembly, representing this book. In particular, all 193 WHO Member the impact evaluation States, approved resolution of community-based WHA63.13 endorsing the programmes in Bhutan, Sri Global Strategy to Reduce Lanka and Thailand has the Harmful Use of Alcohol, shown very positive results. GOOD PRACTICES 7 1. INTRODUCTION 1.1 THE ARCHAEOLOGICAL DISCOVERY of late Stone Age jugs has Historical note established the fact that fermented beverages existed at least as early as 10 000 BC. Ancient references to alcoholic beverages can be found in literature from China, Egypt, Greece, India, Iran, Italy, pre Colombian America and sub-Saharan Africa. The Babylonians as early as in 2700 BC worshipped a wine goddess and other wine deities. Use of alcohol has a place in the rituals of many cultures around the world.