What can we learn from alcohol policy and advocacy in low- and middle-income countries? 

In the special issue of the International Journal of Alcohol and Drug Research on “Alcohol Prevention Research and Policy Development in Low- and Middle-Income Countries,” FORUT and Movendi supported the publication of articles by authors from low- and middle-income countries.

Dr. Eva Braaten

Dr. Eva Braaten of FORUT also served as one of the guest editors for the special issue. Part 1 of the special issue has recently been published and is focused on alcohol policy development, evaluation and advocacy in low- and middle-income counties, including cases from Sierra Leone, Thailand, Philippines, Burundi, and South Africa. Part 2 is coming shortly.

Below are quick summaries of the articles written by authors in the network of FORUT’s collaborating partner organisations. The articles from Sierra Leone and South-Africa reflect specific and impressive policy and advocacy achievements from the past 5 year framework agreement with FORUT’s back donor, Norad.

Dr. Gianna Gayle Amul

How does the alcohol and tobacco industry influence policy in the Philippines and Singapore?

Amul GG & Etter J-F. (2023). Examining the power of the alcohol and tobacco industries in policymaking: Lessons and challenges for the Philippines and Singapore. International Journal of Alcohol and Drug Research, 12(S1), S37–S51.

Read full article: https://doi.org/10.7895/ijadr.417

Amul and Etter found that transnational and national alcohol and tobacco corporations used various tactics to exercise their power and influence the policy process for alcohol and tobacco control in the Philippines and Singapore. Both industries were involved in lobbying, litigation or threat of litigation, revolving doors and marketing to exercise their instrumental or coercive power. Both industries utilized structural power to set the agenda by exploiting their market dominance, promoting private-public partnerships and self-regulation of alcohol marketing. In the Philippines, the tobacco industry benefitted from regulatory capture. To shape preferences through their discursive power, both industries tapped framing tactics, corporate social responsibility and public-private partnerships. In both countries, they found that being less regulated, the alcohol industry retains an advantage over the tobacco industry. Amul and Etter argued that to counter these industries’ power over health policy, there is a need (1) for mechanisms that help policymakers to prioritize health over commercial interests and manage conflicts of interest amid power asymmetries within countries and between governments and corporations and, (2) for intersectoral collaborations to monitor the alcohol and tobacco industries’ tactics and raise public awareness about their political strategies. 

Anne-Marie Laslett

Women in low- and middle-income countries bear a heavy burden on health from alcohol  

Laslett AM, Cook M, Ramsoomar L, Morojele N, & Waleewong O. (2024). Alcohol’s impact on the health and wellbeing of women in low- and middle-income countries: An integrative review. International Journal of Alcohol and Drug Research.

Read full article: https://doi.org/10.7895/ijadr.471

In an integrative review commissioned by FORUT, Laslett & colleagues focused on the impact of alcohol on women’s health in low- and middle-income countries and highlighted gaps across regions. Their findings suggest that socio-economic factors affect both women’s own drinking and men’s drinking and the harm on women’s health, not only in terms of deaths, but also in terms of the burden of non-communicable diseases, sexually transmitted infections, violent intentional and unintentional injuries, mental health disorders, gender-based violence, intimate partner violence and sexual violence. Laslett and colleagues also emphasized the limitations of current burden of disease estimates, especially on the harms on women’s health from other’s drinking, as well as policymakers’ neglect of alcohol harms on women in low- and middle-income countries. They noted that policies that reducing overall alcohol consumption among men and women can contribute positively to women’s health and well-being. Laslett and colleagues called for alcohol research, monitoring, policy and evaluation focused on alcohol harms to others, particularly on the harms experienced by women and children and tailored to women in low- and middle-income countries.  Finally, they called for decolonizing alcohol research, not only by increasing studies done in and by researchers from low- and middle-income countries and for policies that will limit industry interference and industry expansion and marketing in low- and middle-income countries.  

Boi-Jeneh Jalloh

Civil society’s catalyst role in alcohol policy development in Sierra Leone

Jalloh, Boi-J., Kamara, H. T., Jalloh, A., & Ali, I. (2024). Alcohol policy development in Sierra Leone: An assessment of the role of civil society. International Journal of Alcohol and Drug Research, 12(S1), S11–S17.

Read full article: https://doi.org/10.7895/ijadr.429

In this article, Jalloh and colleagues shared how a national civil society coalition became a key actor and partner of the Ministry of Health in Sierra Leone in developing the country’s first national alcohol policy.  It tells the story of how the Sierra Leone Alcohol Policy Alliance, FoRUT, the Ministry of Health and the WHO Country Office in Sierra Leone worked together and overcame obstacles to alcohol policy in Sierra Leone. Jalloh and colleagues highlighted the importance of advocating for non-communicable diseases to be prioritized and having committed technical leadership on alcohol policy at the Ministry of Health. They also emphasized how an inclusive participatory process coupled with demonstrating expertise and competence among civil society advocates led to the integration of alcohol-related measures into Sierra Leone’s national non-communicable diseases policy documents. They also noted how training and building capacity of civil society organizations under the national alcohol policy alliance led to more effective participation in advocacy and in the policy process. Jalloh and colleagues also underscored the value of integrating the global alcohol control agenda and avoiding conflicts of interest from the alcohol industry to alcohol policy development. Despite obstacles, the case of the alcohol policy development in Sierra Leone offers lessons for civil society advocacy for alcohol policy. 

Aadielah Maker Diedericks

Protecting children from alcohol in schools in South Africa

Fortein, T.-L., & Diedericks , A. M. (2024). Safeguarding South African schools: Civil society action against alcohol sales in educational settings. International Journal of Alcohol and Drug Research, 12(S1), S52–S56.

Read full article: https://doi.org/10.7895/ijadr.475

In this article, Fortein and Diedericks shared the story of how the Southern African Alcohol Policy Alliance succeeded in opposing a policy allowing alcohol sales at schools for fundraising events. The Southern African Alcohol Policy Alliance emphasized how the policy contradicted the 2016 National Liquor Policy which restricts liquor shops within 500 metres of schools. The South Africa branch of the Southern Africa Alcohol Policy Alliance tapped various advocacy tools to lobby against the policy, including engaging government education departments at various levels, engaging experts, conducting stakeholder consultations, launching a comprehensive media campaign, mobilising the public, and engaging with the policy process through submissions to the public consultation. Fortein and Diedericks also highlighted lessons from the advocacy, including the importance of engaging sectors outside of public health, mobilising support through consultations, providing a platform for action for the public, and engaging the media, among others. The strong civil society movement led by the Southern African Alcohol Policy Alliance led to the removal of the clause allowing alcohol sales in schools in the Basic Education Legislation Amendment Bill.  

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