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THE GLOBE Issue 1 2016

Transnational Corporations are a Global Risk Professor Sally Casswell GAPA Chair The Globe Issue 1 2016 Contents

Editor: Derek Rutherford

Designer: Ellen Kelsey Contents Designed and Published on behalf of GAPA by SHORE & Whariki Research Centre College of Health, Massey University NZ

Chair: Professor Sally Casswell

Secretary: Oystein Bakke Transnational Alcohol Corporations are a Contact: [email protected] 4 Global Health Risk

Nicola Sturgeon: ’s First Minister 7 Opens GAPC15

Reducing the Harmful Use of Alcohol: A 12 Global Public Health Perspective

Mega Trade Treaties as Obstacles to Control 16 Policies

Protecting Children’s Right To Grow Up Free 26 From Alcohol Marketing

“Momentum for Change: Research and 29 Advocacy Reducing Alcohol Harm”

Tribute to Derek Rutherford Retiring Chair of 31 GAPA

World Health Assembly Side Event Discusses 36 Alcohol Marketing The Globe Issue 1 2016 Transnational Alcohol Corporations are a Global Health Risk

Alliance for Responsible Drinking (IARD) with offices in Washington and Data from the collaborative Transnational Alcohol Geneva. Many of the big global and international alcohol research project, spirits producers are also active in the the International Alcohol Control political arena nationally and globally. (IAC) study, show how much of the The recent amalgamation of two beer combined alcohol market from these Corporations are a giants, Anheuser Busch andAB INBEV, participating countries is consumed has resulted in a new active player in heavier drinking occasions. In one which recently launched a new initiative of these analyses we set the level of promising a one billion dollar investment heavy drinking at eight plus drinks for Global Health Risk to achieve ‘Smart Drinking Goals’. male drinkers and six drinks plus for women, as drunk on a typical drinking The frames itself as occasion (this is higher than the WHO Professor Sally Casswell a partner in reducing alcohol related ‘Heavy Episodic Drinking’ category). GAPA Chair harm. It then promulgates ways of Looking at the data from this perspective understanding the issue which lead makes the industry’s reliance on heavier directly to industry friendly solutions. A drinking occasions obvious and makes focus on the individual heavy drinker, the conflict of interest very apparent. rather than marketing, availability and Fifty percent of the alcohol market in affordability of alcohol, the drivers two high income countries was drunk he very successful GAPC15 in and legislation, and the increasing of heavy consumption, is found in all in these heavy drinking occasions and TEdinburgh last October, covered in importance of digital marketing and industry communications. A recent in three middle income countries it was this GLOBE, provided a clear picture social media. example is the statement by IARD’s new even more – sixty percent. of the strengths of the networks from To make policy change first we need Vice President (like the IARD President a NGO and government agencies around evidence that change will make a recruit from the NCD NGO sector) when These data show that effective action to the world who are working to reduce difference, which we have, second; announcing the opening of their Geneva reduce over consumption would cut into alcohol related harm in their home that it can be implemented, which office: ‘Alcohol is a normal part of an industry sales and profits. This conflict countries and worldwide. we have; but finally it needs to be enjoyable life for millions of people but of interest is at the heart of the issue we politically feasible and here is where for a minority, alcohol is associated with face and why GAPA is important. GAPA’s The stories told in the papers and the problem lies because politicians in harm’. mission ‘to reduce alcohol-related harm posters presented at GAPC15 reflect a many countries lack the political will to worldwide by promoting science-based common concern – alcohol is causing introduce effective policy… and why is From this, the argument goes, there policies independent of commercial harm in all our countries; levels are this? should be no policies which might interests’ is a recognition of this inherent unacceptably high and are growing affect moderate drinkers and we find conflict of interest. fast in the emerging alcohol markets. In each country there will be a mix of this echoed by political leaders around Presenters told stories of action at different reasons but in many countries the world when deciding against GAPA aims to support national and the community level to reduce harm, where alcohol policy is weak and implementation of effective policies. regional capacity building primarily by advocacy for national policy, and efforts contested, local people tell stories co-hosting biannual conferences and to look for regional and global solutions of the involvement of the alcohol It is important we use our evidence ensuring, by sponsorship, sizeable by making alcohol more visible in the industry in policy development and and advocacy skills to challenge and participation from low and middle intergovernmental global agenda. But close relationships between industry reframe the industry arguments. It is income countries where both consumers they also painted a clear picture of the and politicians such that less effective clear from all our epidemiological work and policy makers in the emerging barriers we face in reducing levels of policies are favoured. This influence and that there is a skewed distribution of alcohol markets are being targeted by harm: lack of adequate legislation and lobbying extends beyond the national alcohol use a minority drink more heavily the alcohol industry. GAPC provides taxation, minimal if any enforcement and provincial level to the regional and than the majority (although they don’t an opportunity to bring together the where legislation exists, and largely global and Big Alcohol funds a number of account for all the harm). But let’s turn government sector, civil society and unregulated marketing of commercial organisations internationally to promote this frame around and look at it from academia in a shared endeavour and we alcohol. Marketing was a conference their agenda. Two global organisations the perspective of the producers and have particularly appreciated the co- theme and presenters told of the extent active over the past two decades, retailers of alcohol. To what extent do sponsorship of WHO in GAPC meetings. of exposure to marketing, its effects, ICAP and the GAPG, have recently they depend on these ‘super-consumers’ We need this opportunity to meet violation of both voluntary codes amalgamated to form the International for their profits? together, learn from each other, transfer 4 5 The Globe Issue 1 2016 Nicola Sturgeon: Scotlands First Minister Opens GAPC15

successes from very different settings, new generation of economic agreements identify and make visible the workings which protect the interests of the global of a common enemy, build regional and corporations and have the potential to Nicola Sturgeon: global networks and, very importantly, chill national government attempts to decide on priorities for our strategic regulate their activities. At the same direction. Our next GAPC, in 2017, will be time there is a rapid expansion by the in , co-hosted by FARE and the transnational alcohol corporations into Scotlands First Australian Public Health Association. countries with high abstention rates, GAPA’s primary role is to provide a global youthful populations and growing voice to advocate for the development economies. of alcohol policy free from commercial Minister Opens interest. To achieve this we support It is imperative, therefore, we ensure the World Health Organization work Big Alcohol’s conflict of interest is allied with the Global Strategy to understood to be as compelling as Reduce Alcohol Related Harm, the that of Big and they should be GAPC15 UN’s NCD goals and the Sustainable excluded from these global governance Development Goals (SDGs) 2015 – arenas as is tobacco. 2030. Goal 3 of the new SDGs includes he Fourth Global Alcohol Policy targets to “strengthen the prevention Goal 3 of the SDGs also states the TConference was held in Edinburgh in and treatment of substance abuse, need to: ‘Strengthen the capacity of October 2015 by invitation of Alcohol including ... the harmful use of alcohol”. all countries, in particular developing Focus Scotland. It attracted 412 There is a growing focus on alcohol countries, for early warning, risk delegates from 60 countries. Nicola as a significant risk factor in NCDs reduction and management of national Sturgeon, First Minister Scottish (non communicable diseases) and the and global health risks’. Big Alcohol Government delivered the Opening inclusion of an alcohol target in the is, in its effects on people’s daily Speech to the Conference: SDGs is a major step forward in the lives and their subversion of efforts global governance arena. However, the to regulate their marketing activity, a world is also faced with a developing ‘global health risk’ and rather than being focus on partnerships between the represented as partners their conflict of private sector, governmental agencies interest needs to be recognised. Their “I want to thank the Global Alcohol Policy that Scotland has been chosen to and NGOs, as illustrated in current accountability is to shareholders’ profits Alliance and Alcohol Focus Scotland for host this conference. Scotland has a negotiations at WHO over the Framework and not to the public good. GAPA, with its all the work they’ve done to organise distinctive approach to tackling the for Engagement of Non State Actors and, civil society partners around the world, this conference. And I know that Derek harms caused by alcohol – but it’s unlike tobacco, alcohol is not currently will continue to speak this truth to power Rutherford is retiring later this month – one which has always been based on excluded from potential engagement. at every opportunity. after more than four decades of work on international evidence. Alcohol policy is also threatened by the alcohol policy. So I want to thank him for his contribution to a hugely important For example in our work on minimum area, and to wish him all the best for a pricing we have looked at Canada’s Professor Obott David Jernigan long and happy retirement. example. The Framework for Action Vice Chairman of GAPA Chair of the Scientific which we published in 2009 is closely Advisory Committee I’d also like to acknowledge the award aligned with the ten priorities set out of the fellowship to the late Dr Evelyn by the World Health Organization. And Gillan. Evelyn brought passion and now, as we look to refresh and revise enthusiasm to every cause she cared that framework in the coming year, we’re about. She was an exceptional Chief especially keen – not just to share our Executive of Alcohol Focus Scotland, knowledge and experience – but to learn and was especially inspirational as an lessons from others. So this is an ideal advocate of minimum unit pricing. She time for Scotland to host a conference is missed enormously by many people in which is attended by delegates from Scotland and far beyond. more than 60 countries around the The Scottish Government is delighted world. I warmly welcome all of you. 6 7 The Globe Issue 1 2016 Nicola Sturgeon: Scotlands First Minister Opens GAPC15

our policies. Scotland certainly isn't that it has reduced alcohol sales by Government has not heeded so far; but it unique in having a problem in terms 2.6%. is one which we will make as persistently of our relationship with alcohol. But and persuasively as possible. unfortunately we are unusual - certainly We’ve also increased investment in The second area - where we have among other western European alcohol treatment and care services. legislated, but are now awaiting the countries - in the severity and extent of We now deliver around 100,000 alcohol outcome of legal proceedings - is that problem. brief interventions every year. Those minimum unit pricing. We see this as an are short structured conversations – essential part of how we address alcohol Alcohol consumption in Scotland is based on evidence that they might be harm in Scotland. almost 1/5 higher than in and desirable – which encourage people to . Our rates of liver disease and think about and change their pattern There's some good evidence that the are the highest in western of alcohol consumption. They’re a low- other approaches we've adopted in the Europe. cost intervention which can have a big framework for action are having some impact. effect. During the three days of this conference, Scotland has seen a 9% fall in alcohol it is likely that approximately 300 people We’re now looking at refreshing our consumption since 2009. Rates of in Scotland will be admitted to hospital Framework for Action. As we do that, alcohol-related deaths, which doubled as a result of alcohol misuse. It is also we’re increasing the ability of health between 1981 and 2003, have fallen by likely that approximately 10 people will boards to deliver interventions in a wider more than a third since then. die. range of settings. For example we want Those consequences affect some to have more alcohol brief interventions It is possible, just possible, that we are sections of our population far more in places such as prisons and custody starting to shift individual behaviour severely than others. People in the most suites. By doing that, we can potentially and public attitudes. Scotland may deprived parts of Scotland are six times make further progress in tackling health be starting to develop a healthier more likely to die from alcohol misuse, inequalities – we’ll reach more of the relationship with alcohol. However, we than those in the most affluent areas. people who need help the most. also know that much more needs to be done. The evidence is very clear. The extent There are two other areas where we and nature of alcohol consumption in are keen to see progress as soon as In particular, alcohol-related deaths may Scotland damages individuals, , possible. be significantly lower than in 2003 – but businesses and communities across they have risen in each of the last two Nicola Sturgeon with Dr the country. It harms the poorest The first of those is – years. Mac Armstrong, Chair of families and communities most of all. particularly in relation to children. I know Alcohol Focus Scotland - No responsible government can ignore that’s an important part of tomorrow’s That provides strong evidence that many Conference Host an issue which has such devastating conference proceedings. of the changes we have seen in people's consequences. behaviour are heavily influenced by Broadcast advertising is reserved to the affordability. Our framework has helped That was the motivation behind the UK Government – it’s not something to reduce consumption, but so too did I want to spend my time this morning Framework for Action which the Scottish that the Scottish Government has the economic downturn. giving you a summary of the Scottish Government published in 2009. It set responsibility for. So we are arguing Government's priorities in relation out more than 40 proposals to reduce that the UK Government should protect As economic recovery continues – as to alcohol policy. I'll explain why it's consumption, promote a healthier children from on unemployment falls and living standards important to us, and I'll set out some of attitude towards alcohol, and improve television, in the cinema and online. rise - the improved affordability of the key approaches we're adopting. And treatment and support for people who We believe that one way of achieving alcohol seems to be causing an increase in doing that, as you might expect, I'll need it. that would be to prevent alcohol from in consumption. There's a danger that spend some time setting out our current being advertised before the 9pm much of the good work of recent years position on minimum unit pricing - since For example we introduced a ban on watershed. There is mounting evidence will be undone. I know that it’s an issue which has bulk discounts in shops, which had that alcohol advertising has an impact attracted international attention. previously encouraged people to buy on children and young people - and That's why reducing the affordability alcohol in greater volume. We estimate so we believe that their exposure to it of alcohol is the best way of reducing But I'll begin by setting the context for should be reduced. It's a case the UK the harm it causes. And in our view, 8 9 The Globe Issue 1 2016 Nicola Sturgeon: Scotlands First Minister Opens GAPC15

minimum unit pricing is more effective I’m just going to touch on those court and experiences of countries around after the SWA launched a campaign to than general taxation for doing that. proceedings very briefly. I’m not going to the world. That’s why I'm delighted to reduce alcohol duty on spirits. SWA’s It allows us to respond to changes in pre-empt the outcome, but I do want to welcome you here this morning. I wish action suggests that they put profit affordability – for example when they make two points clear. you all the best, for a constructive and above health. are a consequence of rising household enjoyable conference. "They are seeking to obstruct both the incomes. And it allows us to target the The first is that I welcome the opinion mechanisms that would reduce harm by strong-alcohol and low-cost products last month from the EU’s Advocate Latest News: MUP Returns to Scotland’s increasing the price of alcohol: minimum which are especially associated with General. He confirmed that minimum Court of Sessions. unit price and taxation. This despite the damaging drinking patterns. unit pricing is not precluded by EU law, Scottish Parliament and the courts in That’s why a Sheffield University study and stated that it is for domestic courts In December, the European Court of both Scotland and Europe accepting the - which looked at the impact of a 50p to take a final decision. He also found Justice stated that it is up to the Scottish clear link between price, consumption minimum unit price - indicated that it that the policy can be implemented, if it court to decide if minimum unit pricing and harm. would save 300 lives a year after 10 is shown to be the most effective public is more appropriate and proportionate "We are pleased the Court of Session years, and reduce hospital admissions health measure available. than other measures i.e. taxation, to is seeking further evidence. We remain by more than 6,000. protect health. The Court of Session in confident that the case for minimum And the second point, as you would Edinburgh held a procedural hearing unit pricing will be conclusive and look The case for minimum unit pricing expect, is that I can confirm that the on 28 January and agreed to hear forward to this much-needed policy initially met with widespread opposition Scottish Government continues to be further evidence, with a final hearing finally being implemented.” in Scotland. But steadily, hearts and absolutely committed to minimum unit provisionally scheduled for June. minds have shifted. They have been pricing. We believe that it is the best swayed by the overwhelming fact that way to reduce the harm caused to our Alison Douglas, Chief Executive of Scotland has a major problem; and communities by low-cost and high- Alcohol Focus Scotland, and Eric Carlin, the very clear evidence, such as the strength alcohol. We are convinced Director of Scottish Health Action on Sheffield study, that minimum unit that it will reduce damaging alcohol Alcohol Problems said: pricing is an important part of the consumption, improve health and solution. save lives – and that it will do so more “Today the Scotch Association As a result, in 2012 - when the effectively than any alternative measures (SWA) continued its efforts to prevent legislation providing for minimum unit available to us. the implementation of minimum unit pricing was passed - it received support pricing in Scotland. This comes the day from four of the five parties in the What Scotland is trying to do - through Scottish Parliament. minimum unit pricing and through more than 40 other measures in our Scotland’s position is now attracting framework - is to create a cultural Derek Rutherford, Maureen international endorsement and transformation. We want to change Watt Minister of Public recognition. A supportive study was Scotland's relationship with alcohol Health and Barbara published recently by the Organisation for good, and for the better. That's O’Donell, organiser of for Economic Co-operation and not simply about government action. conference. Development. Their Policy Brief Industry and the media have an on Tackling Harmful Alcohol Use, important role - and individuals also argues that raising prices will lower need to consider their own alcohol consumption. It also acknowledges that consumption, and their position as raising prices where they are cheapest parents, role models and friends. can be the most effective way of But the Scottish Government is reducing harmful drinking. determined to take a lead. Because we It was also heartening to see that when know that by doing so, we will reduce the took evidence inequality, increase prosperity, and on the court proceedings relating to improve the wellbeing of individuals and minimum unit pricing, Scotland's stance communities across the country. received support from five member states, and also the European Free Trade And as we work towards that aim, we will Association. always look to learn from the example 10 11 The Globe Issue 1 2016 Reducing the Harmful Use of Alcohol: A Global Public Health Perspective

Reducing the Harmful Distribution of Alcohol – Attributable Burden of Disease Use of Alcohol: A

Global Public Health Figure 1

Perspective Net total = 3.3 million deaths Vladimir Poznyak, Dag Rekve Management of Substance Abuse, World Health Organization Globe Summary of the Presentation

summary of their presentation A In 2012 the global burden of disease Alcohol is consumed by 38.3% of the attributable to alcohol consumption world population aged 15-64 (1.9 billion was 3.3 million deaths and 139 million people). Of that number 7.2% of men DALYs (disability adjusted life years). and 1.3% of women have alcohol use The distribution of alcohol attributable disorders. The number of abstainers is to the burden of disease is outlined in 61.7%. The distribution of drinkers and Figures 1&2 abstainers in the world by WHO region is Figure 2 as follows:

Net total = 13.9 million DALYs

Source: WHO, 2014 12 13 The Globe Issue 1 2016 Reducing the Harmful Use of Alcohol: A Global Public Health Perspective

Proportion of alcohol-attributable deaths (%) of total deaths by age group 2012 (WHO 2014) Key messages

Vladimir Poznak and Dag Rekve concluded their presentation with the following Key messages:

• Harmful use of alcohol is among the top five risk factors for the global burden of disease

• Global policy frameworks for alcohol control include the Global strategy to reduce the harmful use of alcohol (WHO, 2010), WHO Global NCD Action Plan 2013-2020 and UN High Level Political Declaration on NCDs

• Harmful use of alcohol included in Source: WHO, 2014 the health target of the UN Sustainable Development Goals 2015 - 2030 The European region has the highest social determinants of health. Special number of alcohol-attributable deaths in attention needs to be given to reducing all age groups; among adolescents 1 in harm to people other than the drinker • Effective and cost-effective strategies to 4 and among young adults 20-29 years and to populations that are at particular reduce the harmful use of alcohol include: old 1 in 4. risk from harmful use of alcohol. pricing policies; restricting availability of The concept of the harmful use of The harmful use of alcohol is one of the alcohol; comprehensive restrictions or bans on alcohol is broad and encompasses key risk factors in the WHO Global NCD the drinking that causes detrimental Action Plan. alcohol advertisements; drink-driving policies; health and social consequences for the One of a number of targets of the NCD brief interventions for hazardous and harmful drinker, the people around the drinker global monitoring framework is a 10% and society at large, as well as the relative reduction in the harmful use of drinking. patterns of drinking that are associated alcohol. with increased risk of adverse health outcomes. Best buys to reduce the harmful use The burden from harmful use of alcohol can of alcohol are to regulate commercial Actions needed to reduce the harmful and public availability of alcohol; be effectively reduced and governments have use of alcohol? restrict or ban alcohol advertising and an obligation to intervene as appropriate for promotions; and to use pricing policies Global, regional and national actions are such as excise tax increases on alcoholic protecting the health of populations. required on levels, patterns and contexts beverages of alcohol consumption and the wider 14 15 The Globe Issue 1 2016 Mega Trade Treaties as Obstacles to Control Policies

Mega Trade Treaties as Three headed hydra Obstacles to Control TTIP TPPA TISA Policies

Professor Jane Kelsey

lcohol Control Policies and Trade investors, through economic penalties, Over time the GATT expanded to include As moves to expand the WTO stalled in Aand Investment Agreements whereas internationally mandated rules that targeted behind-the-border the late 1990s, a new wave of bilateral health policies are not. As a result, the laws and policies when they were and regional free trade agreements Public health policies on alcohol aim to autonomy of governments to determine deemed to pose barriers to trade, (FTAs) emerged that covered similar protect people from harm. Trade and their preferred public health policies, such as quarantine and food safety issues and, more notably, rules to investment agreements aim to maximise including a number of those promoted rules, product labelling requirements liberalise foreign investment and protect commercial opportunities for firms in the World Health Organization (WHO) or technical standards about product such investments3. These agreements that supply goods and services to, and Global Strategy to Reduce the Harmful content. vary depending on the countries invest in, other countries. Increasingly Use of Alcohol2, is jeopardised. involved, creating a complex and the two objectives collide1. Sometimes In 1995 the World Trade Organization sometimes inconsistent web that can a compromise can be identified. But What are ‘trade’ agreements and how (WTO) expanded the scope of global impose onerous obligations on countries as governments seek more effective do they vary? rules so as to facilitate global services with limited bargaining power. A separate alcohol control policies, on one hand, transactions, such as wholesale and category of bilateral investment treaties and commercial agreements expand in The number and scope of ‘trade’ retail distribution, health and social (BITs) between states creates rights and scale and scope on the other, conflicts agreements has expanded rapidly services, environment services, and protections for foreign investors, which seem set to intensify. International beyond what is traditionally seen as communications, through the General are increasingly integrated into new commercial treaties are enforceable by trade. The General Agreements on Agreement on Trade in Services (GATS). generation FTAs. Some countries have a other states, and sometimes by foreign Tariffs and Trade (1947) was limited to Governments were also bound to a new large number of BITS as well as FTAs4. restrictions on imported goods, such as intellectual property rights regime under 1 For earlier commentaries on this tension see discriminatory treatment, and reducing the Agreement on Trade-related Aspects 3 The WTO has an incomplete data base of FTAs: Grieshaber-Otto, Jim and David Jernihan, ‘Trade border taxes (tariffs) and import of Intellectual Property Rights (TRIPS) http://rtais.wto.org/UI/PublicMaintainRTAHome. treaties, alcohol and public health’, The Globe, Issue licensing, including on alcohol. that guarantees minimum monopolies aspx. A good source of multilingual information and 2, 2001; Kelsey, Jane, ‘The implications of new over medicines, technological commentary about FTAs under negotiation is http:// generation free trade agreements for alcohol policies’ innovations, copyright, brand names and www.bilaterals.org/ paper to the Global Alcohol Policy Conference, 2 WHO, Global Strategy to Reduce the Harmful Use other trade marks, and trade secrets. 4 The UNCTAD has a good database of BITS: http:// Bangkok, February 2012 of Alcohol, adopted May 2010 investmentpolicyhub.unctad.org/IIA 16 17 The Globe Issue 1 2016 Mega Trade Treaties as Obstacles to Control Policies

Most recently, a number of mainly border services8 (advertising, , the same products to different countries. Third, domestic regulation that involves developed countries have been telemedicine, radiography, e-retail, Domestic regulations are seen as trade licensing (eg. outlets) or technical negotiating three new mega-regional water supply and sanitation); investment barriers even when they appear non- standards (eg. zoning, advertising agreements: the 12-country Trans- (alcohol or tobacco production, mines, discriminatory. Because of that country standards or limits on retail displays) Pacific Partnership Agreement (TPPA)5, coal fired power plants, wholesale and specific rules on alcohol products, are required to be based on ‘objective the Transatlantic Trade and Investment retail chains, aged care franchises, including restrictions on the chemical criteria, such as competence to supply Partnership (TTIP) between the US trademarks); international movement composition or the permitted alcohol the service, and not more burdensome and EU6, and the Trade in Services of persons (health professionals, content, or large and graphic health than necessary to achieve ‘quality’ of Agreement (TISA)7. Collectively, they consultants, brand ambassadors); and labelling9, have been challenged as the service. Quality is undefined, but aim to impose far more extensive environment (international environment technical barriers to trade10. implies a consumer, rather than public substantive constraints on participating agreements, climate change), among policy, focus. Licensing procedures governments’ laws and policies than many others. Services: The global supply chain for cannot in themselves restrict the any previous agreements, including new alcohol relies on a sophisticated strategy supply of the service. Administration of chapters in areas like e-commerce and How specifically might these for marketing and distribution, across these regulations must be ‘reasonable, state-owned enterprises. In addition, agreements restrict alcohol control borders, through the local presence of objective and impartial’; decisions that chapters on transparency, regulatory policy? foreign firms and by electronic delivery. respond to local community objections, coherence or regulatory cooperation and The FTAs impose three main rules for for example, may be challenged as domestic regulation of services provide A number of chapters dictate the regulation of services at central and subjective, unreasonable or biased. more opportunities for foreign states substantive rules that governments local government levels. and corporations to influence a nation’s must follow; these rules are becoming While governments can usually protect policy and regulatory decisions. progressively more restrictive of First, any government measure (meaning various measures, including alcohol regulatory autonomy in the new a law, regulation, policy, decision, action, policies, from these rules, agreements What do these commercial agreements generation FTAs. There is almost always or anything else) must not close off the increasingly require them to list what have to do with public health? provision for state-state enforcement, size and growth of the market in that will be protected rather than what will be supported by commercial penalties, service by imposing a ban (eg internet covered. That ‘negative list’ approach is Many chapters of contemporary FTAs and increasingly investor-state dispute sales), operate monopolies, or limit the especially problematic where the alcohol have implications for health policy and settlement that allows foreign investors quantity of suppliers (eg liquor outlets) industry is using rapidly developing services, ranging across intellectual to enforce rules against states. or service operations (eg advertising) technologies and new opportunities that property (affordability of medicines and nationally or in specific locations. were not foreseeable when these lists medical devices); financial services Goods: The traditional area of trade in were created. There are also moves to and investment (health and accident goods, including alcohol products, seeks Second, local services and suppliers lock in any new liberalisation, making it insurance); government procurement to eliminate quantitative restrictions must not get any better treatment than difficult or impossible to re-regulate such (public-private partnership (PPP) and reduce border taxes or tariffs. What ‘like’ foreign services and suppliers; services or activities11. hospitals, blood services); cross- level of tariffs a country can impose ‘like’ may mean the service they provide depends on its tariff schedule in a (selling or advertising alcohol) even if the Mutual recognition agreement: particular agreement. Internal taxes suppliers are very different (small local Exporters want the same rules to apply 5 Australia, Brunei Darussalam, Canada, Chile, on alcohol products must also be non- shops and mega-retailers). to their products in different countries. Japan, , Mexico, New Zealand, Peru, discriminatory, and not act as disguised Rather than harmonisation, which is , USA, Vietnam. The final text is available at barriers to imported products. Like 9 Thailand’s proposals for alcohol labelling and politically difficult to achieve, mutual http://tpp.mfat.govt.nz/text products must be treated the same, restrictions on messaging have been the subject of recognition means a product that can 6 For EU’s commentary on negotiating texts see irrespective of which country they come ongoing challenges in the WTO; see, for example, lawfully be sold in one country must http://trade.ec.europa.eu/doclib/press/index. from. the discussion in the WTO Committee on Technical be allowed to be sold in the importing cfm?id=1230 Barriers to Trade meeting on 17-18 June 2014, G/ country. That restricts the ability of the 7 Australia, Canada, Chile, Chinese Taipei (Taiwan), Technical barriers to trade (TBT): TBT/M/66 pp.37-39; ‘Thailand’s new alcohol labelling importing country to take a different Colombia, Costa Rica, , Iceland, Israel, Exporters, including of alcohol, and message requirements’, Bangkok Post, 18 approach on public health grounds, Japan, Liechtenstein, Mexico, New Zealand, , increasingly use global brands, September 2015 for example the amount of alcohol Pakistan, Panama, Paraguay, Peru, South Korea, marketing strategies and distribution 10 The US Trade Representative’s 2015 National permitted in a ready-to-drink product or Switzerland, Turkey, the , and the networks that assume they can export Trade Estimate Report on Foreign Trade Barriers European Union. Singapore, and recently Uruguay provides a useful indication of the kinds of TBT issues 11 See the discussion of the draft core text and Paraguay, have withdrawn. Many draft texts and 8 Cross-border includes foreign establishments that arise in relation to alcohol policy: https://ustr.gov/ and chapter on domestic regulation in the TISA analyses are available at https://wikileaks.org/tisa/ inside the host country. sites/default/files/2015%20NTE%20Combined.pdf negotiations, https://www.wikileaks.org/tisa/ 18 19 The Globe Issue 1 2016 Mega Trade Treaties as Obstacles to Control Policies

the kind of labelling required12. that affect a foreign investment’s value and procedural safeguards17. equally effective, but less burdensome, or future profits. New regulations that policy option available. Intellectual property (IP): Names, have a significant impact can also Process rules: In more recent logos, images, colours, words are all be challenged as a direct or indirect agreements, chapters on transparency The general exception does not important to branding, marketing and expropriation. and regulatory coherence/cooperation necessarily apply to the investment sales of products, including alcohol. The set out the required decision making chapter, where specific provisions intellectual property chapters of new Investment chapters empower states processes and criteria, obligations on provide possible protections for public generation FTAs confer more extensive and investors to allege a breach through governments to provide information, policies. The inclusion of a specific and longer monopolies on those who ad hoc offshore tribunals rather than and rights of other governments and option to deny the use of ISDS for register them. Moves by a country to the domestic courts. Investor-state ‘interests’ to participate in developing tobacco control policies in the TPPA limit promotion of alcoholic products dispute settlement (ISDS) is especially new policy or regulation and to challenge implies that other public health policies, through labelling and marketing may be controversial, as is involves ad hoc decisions. including for alcohol, are at risk19. said to breach the intellectual property tribunals with arbitrators drawn mainly chapter13, as well as expropriation of from a small group of investment The same policy or law is likely to be How might the Global Strategy to unfair treatment of an investment, being litigators and academics, without any affected by a number of chapters Reduce the Harmful Use of Alcohol be the intellectual property right itself14. effective conflict of interest rules, no across a number of agreements. The most affected? consistent system of precedents, no cap cumulative effect across public health Investment: An investment is very on the level of monetary awards and no policy is to pose multiple barriers to The strategy identified 10 target areas, broadly defined in BITS and the appeal15. an integrated and coherent strategy to which should be treated as supportive investment chapters of FTAs. It might, address non-communicable diseases. and complementary. It is clear from the for example, be a factory, shop or Challenges to tobacco control policies rules outlined above that policies and sports promotion business, or shares show how public health policies can be Exceptions: Agreements will provide interventions that target the availability in such a business, a franchise, a undermined by foreign investors16. The some general exceptions and some of alcohol, marketing of alcoholic contract held by a foreign advertising state or investor that threatens or brings that are specific to individual chapters. beverages, and pricing policies are company or a trade mark. In addition a dispute may have little interest in the In most cases these must be argued most at risk from these agreements. to being treated no less favourably country it is challenging, but is primarily as defences to a dispute. The general In addition, they constrain general than domestic counterparts, investors concerned to prevent precedent setting exception in Article XX of the GATT preventive public health measures and secure special rights and protections innovative policies. Even where the and Article XIV of the GATS appears affect access to affordable medicines, not available to nationals. These include investor’s legal arguments are weak, to provide protection for public especially the new biologics drugs to a ‘minimum standard of treatment’, threats of disputes may be intended to health measures, but is overlaid by treat cancer. which investors commonly interpret as have a ‘chilling effect’ so governments numerous requirements that are so a stable regulatory environment from drop proposed measures. difficult to satisfy that the exception Are health officials involved in trade the time of investment – for example, has fully succeeded only once in the agreements and what can they do to tighter regulations related to alcohol The need to reform the ISDS mechanism 44 times it has been pleaded in the have a voice? has been vigorously debated, with WTO18. Measures that are innovative 12 The Australian industry challenged proposals some governments withdrawing from or precautionary may find it especially Trade ministries run trade negotiations. from New Zealand to limit the alcohol level of RTDs as investment agreements or arbitral difficult to satisfy requirements that The presumptions that drive negotiations in breach of the Australia-New Zealand Trans-Tasman facilities, others proposing new legal they are evidence based and there is no are economic and commercial, and Mutual Recognition Agreement, see ‘Liquor law forums for pursuing such disputes, and preclude an approach that treats health changes could breach CER, committee told’, National yet others proposing new substantive 17 See ‘Official Government Statements and Actions objectives as paramount. Those seeking Business Review, 11 March 2011: http://www.nbr. against Investor-State Dispute Settlement (ISDS)’, to defend health policies carry the co.nz/article/liquor-law-changes-could-breach-cer- 15 The United Nations Conference for Trade and Public Citizen, Washington DC, December 2014 burden of proving they are justifiable committee-told-nn-88142 Development (UNCTAD) has been playing a leading http://www.citizen.org/documents/isds-quote-sheet. exceptions. Trade negotiators work 13 This is one of the grounds for the challenge in the role in this debate; see http://investmentpolicyhub. pdf from existing templates that reinforce WTO to Australia’s tobacco plain packaging legislation: unctad.org/IIA/KeyIssueDetails/42 18 ‘Only one of 44 attempts to Use the GATT that bias. Even if health officials are Australia – Certain Measures Concerning Trademarks 16 Investment disputes brought by Philip Morris Article XX/GATS Article XIV “General Exception” has consulted or invited to negotiations, and Other Plain Packaging Requirements Applicable to against Uruguay and Australia are prominent Ever Succeeded: Replicating the WTO Exception the dynamics and technical language Tobacco Products and Packaging, DS435 examples; Matthew Porterfield and Christopher Construct will not Provide for an Effective TPP General makes it very hard for them to engage, 14 Tim Lince, ‘The international implications of Byrnes, ‘Philip Morris v Uruguay: will investor-State Exception’, Public Citizen, Washington DC, August let alone to intervene effectively. The the Philip Morris branding battle in Uruguay’, World arbitration end restrictions on tobacco marketing up in 2015, https://www.citizen.org/documents/general- Trademark Review, 19 September 2014 smoke?’, Investment Treaty News, 12 July 2011; exception.pdf 19 Article 29.5 20 21 The Globe Issue 1 2016 Mega Trade Treaties as Obstacles to Control Policies

secrecy of many negotiations means to trade, regulatory coherence) privilege for alcohol control. The FCTC gives measures are, of necessity, not that health policy advocates outside light-handed, least-burdensome legitimacy to a raft of measures, supported by empirical evidence – a government have no access to the text regulation, with a preference for no, including plain packaging of tobacco problem encountered with innovations or tabled documents and are unable to self or co-regulation ahead of directive products26, and to the need to such as plain packaging of tobacco provide independent and critical advice. regulation23. quarantine the industry from influencing products. It is also important to Calls from UN special rapporteurs20 national policy debates and decisions recognise the potential for official and international health leaders21 for Lessons from tobacco under Article 5.327. Even if an equivalent documents that promote compromise, human rights impact assessments of instrument was possible for alcohol, balance, and less directive measures agreements before they are concluded There are some important lessons and that would come too late given the pace in the hope of greater acceptance have been ignored. points of reflection from the experience at which new FTAs are being signed by governments and industry to be with tobacco control policies, which and the far-reaching mega-agreements cited as evidence that there are less How do these agreements empower have gained much more traction than that are being negotiated. This reality burdensome alternatives that could the alcohol Industry? alcohol policies in the critique of trade check makes unequivocal statements achieve the health policy objectives. agreements. from international health agencies Again, such opinions have been used Because these agreements are designed and leaders that alcohol causes as to challenge tobacco control policies, to meet the needs of commercial First, a lot of research has been much harm as tobacco and calls for including internal disagreements within interests, corporate lobbyists have a lot conducted on the trade-tobacco nexus the industry to be excluded from the governments disclosed through freedom of influence in shaping a government’s that can be transposed to the context policy and regulatory arena all the more of information laws28. position. Frequently they operate of alcohol control policies and adapted important. through broad groupings, such as to provide educational and advocacy Fourth, governments have stronger the Global Services Coalition, or resources24. Third, the ambivalence towards commercial interests in alcohol bilaterally, for example, the Transatlantic restricting alcohol consumption is production and sale than for tobacco, Business Council. Sometimes industry Second, the Framework Convention rarely evident today for tobacco. As a including as exporters. The World representatives play a formalised role at on Tobacco Control (FCTC)25 provides result, it is easier for the industry to Trade Group, for instance, is described a national level22. a more concrete reference for push for soft policies like education and as an informal group of government governments’ competing obligations voluntary industry codes rather than and industry representatives from Agreements increasingly require than general international human rights graphic labeling or bans, even though various wine-producing countries. It governments to provide opportunities and health obligations or strategies the evidence shows they are largely was founded in 1998 with the aim to for affected interests to have prior ineffective. The robustness of research ‘facilitate international trade in wine notice of proposed regulations, the 23 Jane Kelsey, ‘The Trans-Pacific Partnership is crucial because it will be strongly through information sharing, discussion opportunity to comment and submit Agreement: A Gold-Plated Gift to the Global Tobacco contested throughout the domestic of regulatory issues in wine markets, evidence, to provide explanations for Industry?’, American Journal of Law and Medicine, policy process, as the industry is likely to and joint actions for the removal of trade government decisions, and sometimes 39,(2-3) p237-264, 2013, although this was written counter with its own ‘expert evidence’, barriers’29. The industry section’s ‘vision’ to review. Various chapters (domestic before the final TPPA text became available; see also and when governments rely on it to is ‘a successful, competitive and growing regulation of services, technical barriers the analysis of the draft TISA Transparency chapter, defend policies against challenges global wine industry, characterised by https://wikileaks.org/tisa/transparency/04-2015/#a. brought under the trade and investment social responsibility, sustainability and 20 ‘UN experts voice concern over adverse 24 eg. Jane Kelsey, International Trade Law and rules. That will be especially focus on consumer interests, operating impact of free trade and investment agreements Tobacco Control: Trade and investment law issues hard when innovative or precautionary in a climate free of trade-distorting on human rights’, 2 June 2015, http://www. relating to proposed tobacco control policies to factors’30. Given that governments and ohchr.org/FR/NewsEvents/Pages/DisplayNews. achieve an essentially smokefree Aotearoa New 26 Article 11.1(b) mandates large and graphic their industry partners deem many of the aspx?NewsID=16031&LangID=E Zealand by 2025’, Tobacco Control Research Turanga, health warnings and messages. Para 46 of the most effective alcohol control policies to 21 Joshua Freeman and others ‘Call for Auckland NZ, 2012, http://www.turanga.org.nz/sites/ Guidelines for Implementation of Article 11 of the be ‘trade-distorting’ there are intrinsic Transparency in New Generation Trade Deals’, The turanga.org.nz/files/Kelsey%20Trade%20Law%20 WHO Framework Convention on Tobacco Control Lancet, 385, 9968, 604-605, 14 February 2015, Tobacco%20Control%20Report.pdf; Andrew Mitchell (packaging and labelling of tobacco products) 28 Jane Kelsey, ‘The Trans-Pacific Partnership http://dx.doi.org/10.1016/S0140-6736(15)60233-1 and Tanya Voon, Legal Issues in Tobacco Control, encourages parties to consider the adoption of plain Agreement: A Gold-Plated Gift to the Global Tobacco 22 The US, for example, maintains a system Transnational Dispute Management,5, 2012; Benn packaging. Industry?’, American Journal of Law and Medicine, of industry trade advisory committees, including McGrady, Trade and Public Health: The WTO, Tobacco, 27 Guidelines for Implementation of Article 5.3 of 39,(2-3) p237-264, 2013, pp.257-258 on distribution services and intellectual property, Alcohol and Diet, Cambridge University Press, New the WHO Framework Convention on Tobacco Control 29 World Wine Trade Group: http://ita.doc.gov/td/ and cleared advisers who have the opportunity to York, 2012 on the protection of public health policies from ocg/wwtg.htm comment on negotiating proposals; http://ita.doc.gov/ 25 http://who.int/fctc/treaty_instruments/adopted/ commercial and other vested interests in the tobacco 30 World Wine Trade Group Industry Section: http:// itac/ en/ industry. www.wwtg-gmcv.org/ 22 23 The Globe Issue 1 2016

barriers that do not exist for tobacco. A do not have even that level of putative dispute forums in future agreements36. number of governments and industry protection. lobbyists have opposed strong tobacco Another partial protection is through What NGOs can do? control exceptions out of concern for a annexes that preserve the right to ‘slippery slope’ that this may extend to maintain measures that do not conform Alcohol industry messaging use of alcohol and beyond. to certain rules on cross-border services advertising, sponsorship, brand or investment. But these only apply to association with popular sporting events Is it possible to protect alcohol policies some rules, and are very hard to add to both attracts enthusiastic supporters from trade agreements? in the future. Increasingly these annexes and engenders skepticism about the do not list what the rules cover, but sales pitch. Health professionals also The only way to fully protect public health what they do not, either by freezing the have intrinsic credibility. It seems more policies is through a total carveout from existing state of policy and regulation, important for alcohol than tobacco an agreement. The clearest example or only preserving future policy space that research and stronger advocacy is the reported proposal from Malaysia where a government has the foresight builds on this reputational advantage. to exclude tobacco control policies, and negotiating ability to do so. Given Academics, local public health groups, aside from tariffs, from the Trans-Pacific shifts in thinking about alcohol policy community organisations, and churches Partnership Agreement31. Malaysia was that ‘negative list’ approach is very among others, need to develop a basic apparently supported by only one or problematic. Even more problematic are level of literacy about these agreements two other countries. The compromise, moves in the TISA to automatically lock and organize to stop their expansion promoted by the US, was an option to in every new liberalisation. and/or demand an effective alcohol exclude tobacco control measures from carevout. investor-state dispute settlement32. That Can free trade and investment does not protect policies from state- agreements be reversed? 36 European Union, ‘Commission proposes new state disputes in the investment or other investment court system for TTIP and other trade and chapters, and exposes governments to It is much easier to stop these investment negotiations’, 16 September 2015, http:// pressure from the tobacco industry not agreements being concluded because europa.eu/rapid/press-release_IP-15-5651_en.htm to exercise that option. Even that the political price is too high, and there compromise is under pressure from are numerous examples where that members of US Congress from tobacco has occurred. Once an agreement is Glossary of terms producing states33. It is easy to imagine signed it is difficult to withdraw, and a much more intense debate over an once it is ratified and the agreement BIT Bilateral Investment Treaty equivalent exception for alcohol. comes into force it is binding on the FCTC Framework Convention on Tobacco Control state. Withdrawal is usually technically FTA Free Trade Agreement Yet the main alternative is the general possible but carries with it reputational GATS General Agreement on Trade in Services (in WTO) exception provision that governments and economic harm. That said, a growing GATT General Agreement on Tariffs and Trade often cite, misleadingly, as providing number of countries are withdrawing SPS Sanitary and Phytosanitary Measures protection for legitimate public health from their international investment TBT Technical Barriers to Trade policy. As noted above, the exception is agreements, replacing them with more TISA Trade in Services Agreement weak and has failed almost every time balanced agreements34 or offering TPPA Trans Pacific Partnership Agreement it has been invoked. The investment remedies in the host country’s domestic TRIPS Agreement on Trade-related Aspects of Intellectual Property Rights chapter in some FTAs and many BITs courts35, or proposing alternative WHO World Health Organization WTO World Trade Organization 31 ‘Will Malaysia’s tobacco carveout be adopted in 34 Luke Eric Peterson, ‘ invites comments Pacific trade deal?’, http://www.fctc.org/media-and- on draft model investment treaty; text offers radical References available. publications/fact-sheets/industry-interference/1096- departure, and calls to mind Norway’s past efforts at will-malaysia-s-tobacco-carve-out-carry-in-pacific-trade- revision’, International Arbitration Reporter, 24 March deal 2015 32 Article 29.5 35 Promotion and Protection of Investment Bill, 33 ‘Reichart says about 15 Republicans will oppose following a Cabinet decision of the South African TPP over tobacco’, Inside US Trade Daily News, 3 government in July 2010 to withdraw from South December 2015 ’s bilateral investment treaties. 24 25 The Globe Issue 1 2016 Protecting Children’s Right to Grow Up Free From Alcohol Marketing

For example do these rights mean in in this regard? Early that marketing should not be aimed at drinking is associated with increases Protecting Children’s children or that children should never be in motor vehicle crashes and other exposed to alcohol marketing? There is unintentional injuries. Young people tend quite a difference between these. to drink to high risk levels when they do drink and tend to be less risk averse. Right To Grow Up A few important points on alcohol related harm and children/youth The 2014 WHO Global Status report on explains that children Child or adolescent alcohol consumption and adolescents are more vulnerable Free From Alcohol is very closely linked to adult alcohol to alcohol related harm from a given related harm. There is substantial volume of alcohol than are adults. The overlap between marketing that report states that early initiation of specifically targets children and alcohol use (before 14 years of age) is a Marketing alcohol advertising more generally. predictor of impaired health status. Early Alcohol consumption affects children drinking is associated with increases without them ever touching any alcohol in motor vehicle crashes and other Melvyn Freeman themselves, for example through Foetal unintentional injuries. Young people tend Chief Director Non-Communicable Disease Alcohol Syndrome or through being to drink to high risk levels when they innocent victims of alcohol related traffic do drink and tend to be less risk averse National Department of Health, South Africa crashes or alcohol related violence – so and engage in reckless behaviour while marketing to adults may infringe on drunk. the right of the child to protection against harm. The status report does not go into the damage caused by alcohol to From a health point of view and from the the developing brain but this is well point of view of what is right for children, documented elsewhere. The damage is rights based approach is somewhat legislative, administrative, social and there is more than a strong case to be probably worst in the developing uterus Adifferent from both a scientific educational measures, to protect made for protecting children from all where as we all know Foetal Alcohol evidence based approach or a moral/ children from illicit use of narcotic drugs alcohol marketing through a total or near Syndrome may result, but the impacts ethical approach and may indeed and psychotropic substances as defined total marketing ban. Less than this will can also be quite severe at other stages assist in moving the marketing issue in the relevant international treaties. mean that children will grow up being on the developing brain in children and forward globally – if combined with the States parties shall encourage the exposed. adolescents. Research now suggests former two approaches. development of appropriate guidelines that the brain is still developing into the for the protection of the child from It is definitely “right” to protect children twenties. In 1989, governments worldwide information and material injurious to his from marketing even if may be still promised all children the same rights or her wellbeing. The child, by reason in question whether it is or is not an A number of studies, mainly from by adopting the UN Convention on the of his physical and mental immaturity, internationally binding legal right. higher income countries, show that Rights of the Child. The Convention needs special safeguards and care, harmful drinking generally begins changed the way children are viewed including appropriate legal protection, Why do we need to protect children during adolescence and persists into and treated – in other words as human before as well as after birth. from alcohol consumption? adulthood. It is estimated that the odds beings with a distinct set of rights. of future or dependence These rights describe what a child needs This convention has been ratified by 195 Why should we protect adolescents and are 7% greater for each year of age to survive, grow and live up to their countries and signed by another two children from alcohol marketing? Does below age 21 that alcohol consumption potential in the world. They apply equally and is binding on countries that have advertising that is directed at adults begins. The risk of adult alcohol to every child, no matter who they are or ratified it. Whether or not these clauses (or ostensibly directed at adults) also dependence is two to three fold greater where they come from. oblige us as countries to protect children impact on adolescents and children? for individuals who begin drinking by age from alcohol marketing is debatable What strategies on marketing would best 12 compared to those who begin at age Article 33 states that:- “Parties shall and if indeed it does, it is not quite prevent the harmful impacts of alcohol 19. take all appropriate measures, including clear (to me) what exactly this means. on children? What has been happening 26 27 The Globe Issue 1 2016 Momentum for Change: Research and Advocacy Reducing Alcohol Harm

“Momentum for Change: Research and Advocacy Reducing

Most countries understand that drinking do not possess a promotional item and in children is harmful and even the do not have a favourite alcohol brand. Alcohol Harm” alcohol industry tends not to challenge restrictions on having an age limit for Does it really matter whether alcohol sales and consumption. In marketing is specifically aimed at fact a lot of their responsible alcohol children? David Jernigan use interventions and campaigns are Conference Statement targeted at protecting against underage The Cochrane Review Edinburgh, Scotland, 7-9 October, 2015 drinking. Obviously no “good guy” would want to target a child. The industry does The absence of available evidence though have views on what this age cannot be interpreted as evidence that should be! alcohol advertising restrictions do not work. There simply has not been enough A review of seven cohort studies that high quality research undertaken in followed up more than 13 000 young the field to draw conclusions in one ECLARATION we note the importance of a specific people aged 10-26 concluded that there direction or another (and this is the D indicator of alcohol consumption or is an association between exposure case as regards restrictions on tobacco We, the participants of the fourth Global harm in monitoring progress towards to alcohol advertising or promotional advertising as well). Notwithstanding Alcohol Policy Conference "Momentum achieving the Sustainable Development activity and subsequent alcohol there is a growing evidence base for Change: Research and Advocacy Goals. consumption in young people. The effect from observational data to show an Reducing Alcohol Harm", gathered in was consistent across studies and a association between advertising and Edinburgh, Scotland on 7-9 October In light of the close relationship between dose response between the amount of early initiation of drinking and drinking 2015, to reaffirm our commitment alcohol consumption and alcohol-related exposure and frequency of drinking was greater amounts in young people. to evidence-based actions to reduce harm, rising alcohol consumption and demonstrated. Every additional alcohol alcohol-related harm worldwide. alcohol industry marketing activity advertisement seen by youngsters A study conducted in Zambia examined We recognise that alcohol consumption in populous and rapidly growing increases the alcohol consumption with the associations between alcohol causes 3.3 million deaths per year, is economies, and the clear evidence 1%. Youngsters who are highly exposed marketing strategies, the fifth leading cause of death and of effectiveness of population-wide to alcohol commercial will drink more including knowledge about dangers disability worldwide, and is the leading measures to curb alcohol consumption alcohol when they are in their twenties. of alcohol and refusal of alcohol, and cause of death and disability for young in reducing harm, we call on all parties However, alcohol consumption stabilises drinking prevalence, problem drinking, people ages 15 to 24 in much of the to support global action to implement for youngsters who have been lightly and drunkenness. It was found that world. We also recognise the harms those measures. exposed to alcohol commercials. Non- alcohol marketing, specifically through alcohol use causes to non-drinkers, drinking 12 year olds who possess providing free alcohol through a including violence and injury, alcohol- We recognise the rights of children to a promotional item from an alcohol company representative, was associated related birth defects, and impact on grow up safe from alcohol-related harm, producer, or would like to have one, have with drunkenness and problem drinking budgets. Given the adverse and call upon national governments to a 77% higher chance of drinking one among youth after controlling for consequences of these and other implement their commitments in the year later compared to children who are demographic characteristics, risky alcohol-related harms for development, United Nations Convention on the Rights not sensitive to alcohol marketing who behaviours, and alcohol education. 28 29 The Globe Issue 1 2016 Tribute to Derek Rutherford: Retiring Chair of GAPA

of the Child and other human rights health, safety and quality of life. agreements, to ensure that children are protected from alcohol-related harm We call attention in particular to the Tribute to Derek and that alcohol control policies and urgent need to restrict alcohol marketing legislation reflect those commitments. in all its forms. The evidence is clear that exposure to alcohol marketing increases Specifically, we call on governments and the likelihood and quantity of young Rutherford Retiring civil society around the world to support people’s drinking. It normalises alcohol and implement WHO’s global strategies consumption and encourages the loss on alcohol and on non-communicable of abstention in growing economies and diseases, focusing on the most effective populations where drinking prevalence Chair of GAPA and cost-effective actions, including has historically been low. the three “best buys” – increasing the Professor Dr Stephen Orchard price of alcohol, reducing its physical We also strongly recommend the availability, and restricting its marketing implementation and evaluation of Chairman Alliance House Foundation Former – as well as effective implementation minimum pricing for alcohol where Principal Westminster College Cambridge and enforcement of proven strategies for appropriate. We call on Member States, reducing drink-driving. in setting and implementing their public health policies with respect to alcohol We note with concern the ramifications control, to act to protect their alcohol of global and regional trade agreements policies from commercial and other for evidence-based public health policies vested interests of the alcohol industry. regarding alcohol, and call on all parties to explore mechanisms for protecting We call on the global philanthropic Sally Casswell speaking at the dinner to the ability of governments at all levels to community to recognise alcohol’s honour Derek Rutherford’s retirement at implement these policies, through the significant role in injuries, in infectious The Royal College of Physicians Edinburgh strengthening of existing instruments diseases such as HIV and tuberculosis, hosted by Alliance House Foundation or the negotiation of a public health- in cancer and a wide range of non- oriented global agreement to address communicable diseases, and in mental alcohol-related harm, independent of health and social harms, and to provide commercial interests in alcohol, that funding to national and international erek Rutherford and I first met as much about winning commitment could be binding on its signatories, and NGOs and research organisations Dyoung men in the 1960s as student to a cause as sharing information, be effective in preventing and reducing commensurate with alcohol’s burden on leaders at the National though information was available, from the global toll of alcohol use on human health worldwide. Summer School. The schools were authoritative and attractive sources. held annually at Eastwood Grange, Ashover, Derbyshire, sponsored by the The Summer School did not make Derek Maureen Watt welcomes British National Temperance League Rutherford a Temperance advocate delegates to the Scottish under the leadership of Herbert Jones. – he was already committed through Governments reception at It provided a sophisticated approach his association with the International Edinburgh Castle to Temperance education - a country Organization of Good Templars. It did house holiday for young people from confirm him in his views and strengthen urban terraces, in which they were his contacts with the then national expected to take responsibility for leaders in the field and future allies. running much of the programme Although trained as a teacher, Derek themselves. had political ambitions and was on short lists for the Labour candidacy in at least Herbert Jones gave bursaries to young two constituencies. Parliament’s loss people he wished to cultivate as was public health's gain. Indeed, Derek’s potential leaders of the movement. professional life has been spent in a The residential experience was as period when those who chose to work in 30 31 The Globe Issue 1 2016 Tribute to Derek Rutherford: Retiring Chair of GAPA

non-governmental agencies have often information centres at a local level in of its property in a new educational historic advocacy of , in the achieved more in shaping national life England and Wales, commissioned charity, the United Kingdom Temperance belief that going along with the idea of than a backbencher can ever do. by the Department of Health. The Alliance, with an educational and moderate drinking would bring them Rutherford style was being formed. advocacy programme, rather than a closer to the public. The churches The young teacher was not called to the Challenge people with new information, political agenda. The UKTA became the wished to avoid being regarded as House of Commons but to set up a new infect them with your enthusiasm and owners of the Alliance’s freehold offices censorious and seemed to forget why organization, TACADE, the Teachers’ trust them to carry forward the project. in Caxton Street, Westminster, they had taken up in the first Advisory Council on Alcohol and Drug By the time he left the National Council, By 1982 it was evident to some place. Derek was confirmed in the view Education in 1969. This provided an in 1982, there were 40 such centres to members of the board of the UKTA that that those who forget their history are outlet for Derek’s varied interests. The testify to its effectiveness. all was not well in the organisation. They doomed to repeat it. He was determined extension of the school leaving age, first then invited Derek Rutherford to return to avoid this negative scenario for the to fifteen and then sixteen had created He became a confidant of the Chairman and take on the role of Chief Executive. future and to take an evidence-based an opportunity for religious education of the Council, the late Sir Bernard approach, with a view to changing public syllabuses to move beyond the scriptural Braine MP, and briefed him extensively He now found himself in charge of an perceptions. He and Andrew developed curriculum of earlier years to engage when relevant legislation was before organisation that represented a cause the Institute of Alcohol Studies to collate with issues affecting young people, Parliament, both during this time and which was dear to him but was in and disseminate information about the often characterised as “sex, drugs subsequently. In his time at the National need of restructuring and redirecting. harmful effects of alcohol in individuals and rock’n’roll.” There were also new Council the training of voluntary alcohol His position was strengthened by his and society. Within that broad remit opportunities in health education and counsellors had been established, recruiting a colleague from the National the limited resources of the Institute the extension of the science curriculum. together with alcohol and workplace Council, Andrew McNeill, to be his were devoted to particular issues as The provision of material and training for programmes for trade unions, industry deputy, and by rallying old friends from opportunity arose. teachers in these new areas was a new and commerce. He was also a member Eastwood Grange to take up vacant opportunity for a campaigner like Derek. of the Government’s Advisory Committee positions on the board. The one new restriction on drinking in on from 1975-1979. an era when regulations were eased TACADE, with backing from the United Part of the work was administrative; was the introduction of the breathalyser Kingdom Temperance Alliance, was This solid professional development the office building, which was the major for drivers. It took a brave politician, launched and grew. In 1973, having prepared Derek for the remainder of his capital asset, needed programmes Barbara Castle, to introduce it amid a demonstrated his commitment and life's work. The of modernisation and more efficient chorus of disapproval from libertarians competence, Derek was recruited as was the old political vehicle for the management, in order to generate and vested interests. The new Institute the Director of the National Council . In the period income. This was fundamental to the sought to work with the Campaign on Alcoholism. He travelled widely, after the Second World War the Alliance real work of the charity and Derek put Against Drinking and Driving to establishing a network of alcohol took the tactical decision to vest much part of his energies into ensuring all support the new law and to push for this came to pass. However, his real tougher penalties for those who broke genius came in the reinvention of the it. Along with the drink-drive legislation UKTA to meet the changes in the public came the “responsible drinking” Professor Sally Casswell, views on alcohol. Consumption rose message from government. Derek was Chair of GAPA, presenting steadily through this period, as alcohol instinctively against this because it Derek Rutherford became both more affordable and assumed drinking to be a normative outgoing Chair with a more available. Broadening off-licence activity and ignored an abstaining life- commemorative plaque provision to supermarkets was to have style by implication. For a while the a long-term effect on drinking patterns new Institute ran a campaign for young in the home and amongst the young. people, in conjunction with the National Drinking became prevalent in a wider Union of Students called “Stay Dry”. The range of social contexts. Achilles heel of this initiative was that, however much student welfare officers Derek took no delight in his Cassandra- wished to limit the potentially harmful like role, pointing out that increased drinking of students, a large proportion consumption would lead inevitably to of student union funds were and still are greater harm to public health and public derived from takings. order. He was particularly concerned that many churches dropped their The artwork for this campaign also 32 33 The Globe Issue 1 2016 Tribute to Derek Rutherford: Retiring Chair of GAPA

served to illustrate Derek’s book, “A is dominated by international Lot of Bottle”, a popular exposition of conglomerates, with powerful lobbies GAPA Closing Ceremony: the questions alcohol raises for society. well beyond their notional host countries. The flag is handed to the After a few years it became evident that next host, Australia. there was no groundswell for a popular What was true in Europe was true for movement against alcohol consumption the world as a whole and Derek began that might compare with those of the to wonder if national non-governmental early twentieth century and the UKTA organisations around the world might be and the Institute began to consider new brought together to share information tactics under Derek’s leadership. and promote healthier policies. Once more, having made initial enquiries What presented itself as a problem, and contacts, Derek masterminded a the proposed harmonisation of duty on conference at Syracuse, in New York alcohol across the European Community, State, to consider the formation of a leading to further comparative Global Alcohol Policy Alliance. reductions in the price of alcohol, was turned into an opportunity; the founding Historically this was an apt place to of Eurocare. Having once conceived begin, for this part of New York State had this rather bold idea of taking the fight seen and Methodists launch to Europe rather than accepting any emancipation movements for women middle-class country walker has also Good Templars. This is not because of adverse effects of European legislation, and slaves, linked with the advocacy of gone by default, when landlords have any shortcomings in his administrative Derek brought to the task the same gifts temperance. The meeting was timely in chosen not to open when there is little skills. However, over his time in office that had characterised his development another sense, as it began to dawn on trade about, not to mention the social he developed a vision for the future of of the National Council on Alcoholism. development agencies that changing and economic forces which are driving the organisation, which he wished to This time he travelled Europe looking for indigenous cultures to accommodate the the cosy country pub of popular myth see relaunched under a new name. The possible allies and openings. The result worst of Western drinking habits would into extinction. The IAS did its best critical international meeting to bring was the first consultation at Parceval undermine progress. GAPA became a to prophecy the possible negative about these changes failed to reach Hall, in the Yorkshire Dales, which retirement project for Derek, which he consequences of the legislation and the necessary two thirds majority in its planned the structure and programme now hopes to hand on in a developed remains in touch with its former partners favour. Disappointed at the time, he has for Eurocare. state comparable to that of Eurocare. against the day the legislation is revised. since done his best to maintain contacts with his former colleagues and to draw The growth of Eurocare was not without Meanwhile, back at base, the UKTA The IAS has also recruited some of them into the other developments in its problems and not everyone agreed decided to give a measure of autonomy the country’s top specialists in various which he is now involved. with all that Derek proposed but, to the Institute of Alcohol Studies to aspects of the alcohol problem to act by sheer dogged determination and enable it to develop as a primary source as consultants to its board. This has All this might suggest Derek is wholly hard work, he carried it forward. Quite of information on alcohol issues. The sharpened the focus of its activities and driven by his work. This would be to early in the growth of Eurocare Derek skilful use of project staff in meeting allowed it to follow the growing concern underestimate his pride in his family and identified the need for a presence in particular requirements of clients was amongst the medical establishment love for his grandchildren. It would also Brussels to facilitate contact with the part of this. The Institute played a key concerning the rising price of alcohol- ignore the many years he has served Commission and persuaded the UKTA role in bringing together a disparate related illness to the National Health as a magistrate and in his local church. to buy premises there. At a time when group of opponents or critics of the Service. Derek, as a long-time However, Derek would be the first to the British government seemed to listen legislation to change the licensing participant in the public debate around admit that his life had been driven by his more to the industry than to the health system. In the end the libertarian, drinks alcohol issues, has made his experience concern to open the eyes of the world to professionals the contact with the wider industry and tourist lobbies prevailed and insight available after his retirement the dangers inherent in our consumption European scene, including the European in persuading legislators to loosen from his executive role. He is also taking of alcohol. Some people work for the Region of the World Health Organization, up the licensing system and to all but on experimental work in seeing if a new material rewards they accumulate. Derek was crucial in keeping the IAS in tune abolish opening hours. The promised generation of abstainers can be formed. has always counted himself fortunate with developing trends in alcohol policy. end of closing-time brawls has never to be in the paid employment which materialised – we have mayhem going Derek would probably regard as failure coincides with his vocation. No one, even Europe was not enough for Derek. on into the night in some city centres. his period as International Secretary those who disagree with him, can doubt Alcohol production and sale The promised leisure drink for the of the International Organization of the genuineness of his commitment. 34 35 The Globe Issue 1 2016 World Health Assembly Side Event Discusses Alcohol Marketing

and user generated content, which of digital alcohol marketing. She often portrays a culture of intoxication pointed out that it is not long since it World Health and widespread alcohol use. Research was believed that tobacco advertising has shown a link between exposure could not be banned and said that an to marketing material in the digital international response was required. environment and early onset of drinking Assembly Side Event and heavier use. The transnational Dr. Nguyen Minh Hang – Deputy Director, alcohol corporations are very active General Department of Preventive marketing brands in the global youth Medicine, Ministry of Health, Vietnam, culture and are collaborating in many referred to the International Alcohol Discusses Alcohol real world and digital events. Control Study in her country which showed that alcohol advertising is Common challenges reaching all age groups including 16-17 year-olds and that Facebook is widely Marketing Following Professor Casswell’s used by young people. She showed many intervention, representatives of the examples of digital marketing including co-hosting member states held their marketing of spirits on Facebook Oystein Bakke, Secretary of GAPA reports interventions. which is circumventing the law against advertising beverages above 13%. H.E Margarita Guevara, Minister of Health, Ecuador pointed out that the Mr Phenyo Sebonego, the National Focal pressure the industry is putting on is person for the Alcohol and Substance huge but that in Ecuador there is strong Abuse programme, Botswana, showed political will to address the problem. data that indicate that the drinking age She presented several initiatives by the is getting lower. He said that legislation government to meet these challenges. of alcohol marketing is at the draft stage and he pointed to the need for Triinu Täht, Alcohol Policy National cooperation between countries. Counterpart, Ministry of Social Affairs, Dr. Palitha Abeykoon, Chairman, side event, the first specifically Life Years (DALYs) including 6.6% for the Estonia, showed various examples Tobacco and Alcohol Authority of Sri Aon alcohol, held at the recent age group 15-49 years. World Health Assembly (WHA) was co-hosted by Member States from five In her key note presentation Professor different WHO Regions, with input from Sally Casswell, Director SHORE & the Global Alcohol Policy Alliance. Whariki Research Centre, WHO The topic of the event was “Alcohol Collaborating Centre, Massey University, Marketing in the Digital World”. New Zealand and chair of the Global Alcohol Policy Alliance (GAPA) pointed Chair of GAPA, Sally The side event focused on the out that there are three billion internet Casswell, with panel proliferation of digital marketing of users in the world, with two billion active presenting at the WHA side alcohol. Despite the international social media users. Though the numbers event. public health consensus about the are lower in low and middle income concerns over alcohol marketing and the countries this is an area with rapid effectiveness of reducing the exposure, expansion. Young adults who are the particularly of young people, there heaviest users of the internet and social has been a considerable expansion of media in particular are also the heaviest marketing activity in the digital world. drinkers in many countries. Alcohol Alcohol is a considerable public health marketing is widespread in many social burden resulting in some 3.3 million media and entertainment channels, deaths annually and 4.1% of the health with both product advertisement and burden measured in Disability Adjusted a blurring between company instigated 36 37 The Globe Issue 1 2016

H.E Margarita Guevara, Minister of Health, Ecuador speaking from the side event

Lanka, presented the work that has passed since the WHO Global strategy to been done in where there is reduce the harmful use of alcohol was a comprehensive act regulating both endorsed in 2010, and that there is a tobacco and alcohol and where there is need to revisit that. Several interventions a ban on advertising of both products. referred to the experience with tobacco He showed some examples of industry and would like to see something similar circumvention of the legislation. for tobacco. The FCTC Article 1 was mentioned in particular for definitions of Moderator Dr. Shekhar Saxena, advertising and sponsorship. Director, Department of Mental Health and Substance Abuse, World In the WHA debate on non- Health Organization summed up the communicable diseases (NCDs) the presentations with the observation next day several countries mentioned that the problems in relation to digital the need for stronger public health marketing of alcohol are common in the response to address the harmful use of sense of being frequent within all the alcohol. Congo, speaking on behalf of 47 countries participating and common countries in the African region, called on in the sense of similarities for all the the Director General of WHO to set up a involved Member States that presented thinking group to look at harmful use of from the panel. He thanked the alcohol as a factor for NCDs. This was sponsoring member states for organising supported by Botswana speaker who this event and all the panel members called upon the Director General to study and participants for their contribution. the necessity and feasibility of a legally binding instrument to strengthen the Delegates calls for stronger public public health response to harmful use health response to alcohol of alcohol. Also speaking on the matter, Thailand, Sri Lanka, South Africa and In the interventions from the audience, Senegal supported the need to address it was pointed out that a long time has alcohol. 38