HELPING #BEATNCDS BY PROMOTING ALCOHOL POLICY BEST BUY SOLUTIONS
United Nations General Assembly High-Level Meeting on NCDs
The 2018 UN High-Level Meeting on NCDs (UN HLM) is a historic opportunity to mobilize political leadership, increased investments and bold new action to turn the tide on the global NCDs epidemic and the four main risk factors.
2018 has the potential to become a watershed year in global efforts to make alcohol policy the priority it should be.
Not one but two high-level meetings are to be held at the UN General Assembly in September to reinvigorate political commitment and spark renewed efforts by countries and the UN system to curb the epidemics of NCDs and tuberculosis – both of which alcohol is a major risk factor for.
The parallel processes of preparation for, negotiations at and follow-up on the two high-level meetings will elevate health within the context of sustainable development and hopefully lead to alcohol harm and alcohol policy solutions becoming the priority they should be on the agenda of world leaders for years to come.
The stakes have never been higher
For NCDs, this year’s HLM is the third, after 2011 and 2014. The stakes have never been higher.
- Every year 38 million people die from NCDs. That’s more deaths than all other diseases combined.
- 40% of people who die from NCDs are in their most productive years.
- Almost 2/3 of NCDs deaths are linked to the four major risk factors, including alcohol.
- NCDs burden low and middle-income countries the heaviest: 75% of all NCDs deaths occur in LMICs. In developing countries, NCDs are increasing faster, in younger people, and with worse outcomes than in wealthier countries.
Imperative for action on alcohol
Massive global burden of death and disease
- Alcohol kills 3.3 million people worldwide every year. Every 10 seconds a human being dies because of alcohol.
- Alcohol consumption is a causal factor in more than 200 disease and injury conditions.
Disproportionately harming our youth
Alcohol harm is a tremendous burden on the young people of the world:
- Alcohol consumption causes death and disability early in life – relative to other health hazards. In the age group 20 to 39 years of age about 25% of the total deaths are alcohol-attributable.
Harming economic productivity and sustainability
- The economic burden of alcohol worldwide is substantial, accounting for approximately 5.44% of Growth Domestic Product in some countries.
- Alcohol is the leading risk factor for death and disability among people aged 15 to 49 years worldwide. This is the age range in which people are typically at their most productive economically.
Alcohol as a risk factor for NCDs
Alcohol is a major obstacle to sustainable development, adversely affecting 13 of 17 SDGs. Alcohol is a major risk factor for NCDs and mental ill-health. There is a strong link between alcohol and NCDs, particularly cancer, cardiovascular disease, liver disease, pancreatitis and diabetes. 
Alcohol and cancer
A causal link has been found between alcohol and cancer of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum, and female breast. For cancer, there is no safe amount of alcohol use. The cancer risk increases steadily with greater volumes of alcohol consumption. 
Alcohol use is overwhelmingly detrimentally related to many cardiovascular outcomes, including hypertensive disease, haemorrhagic stroke, and atrial fibrillation. 
Alcohol is strongly associated with various kinds of liver disease, with fatty liver, alcoholic hepatitis and cirrhosis being the most common. 
With regards to diabetes the situation is more complicated. Meta-analysis have confirmed that there is a U-shaped relationship between the average amount of alcohol consumed per day and the risk of type 2 diabetes. 
There are associations of alcohol use and alcohol use disorders with almost every mental disorder, including depression, post-traumatic stress disorder (PTSD) and suicide. 
To ensure the most successful HLM3 on NCDs possible, we advocate together with our members around the world for the participation of Heads of State and Government throughout the UN HLM process and at the HLM3 itself. And we advocate for an action oriented Outcome Document that commits to the following four priorities:
Alcohol taxation holds massive potential for global health, for helping achieve the sustainable development goals and also for significantly contributing to financing health and development.
Alcohol taxation is a triple win measure:
- It helps reduce and prevent alcohol-related harm
- It helps promote health and sustainable development, and
- It helps raise domestic resources for health and development.
As part of a broader public health strategy to promote a life-course approach to prevention and to address commercial determinants of health, it is high time for governments to adopt sugar, tobacco, and alcohol taxes (STAX).
- Implement and raise excise taxes on alcoholic beverages, so as to at least double the retail price, and commit to ongoing price increases at least in line with inflation.
- Provide technical advice and assistence on alcohol taxation to developing countries and remove subsidies for alcohol, and divest from the alcohol industry, especially in developed countries.
- Adopt a synergistic approach to taxing sugar, tobacco and alcohol (STAX).
NCDs are largely preventable. Preventing problems from occurring or expanding represents by far the best approach to the NCDs tsunami – especially considering the burden of the risk factors. In the era of sustainable development a pivot to evidence-based prevention and health promotion holds four major benefits:
- People and community empowerment
- Human Rights-based
Building societies, communities and environments that allow for healthy lifestyles and foster health-promoting norms is essential because treatment alone is not enough to beat NCDs and prevention and health promotion are economically sound interventions generating positive outcomes beyond the realm of health. 
- Make disease and risk factor prevention and health promotion corner stones of the global, regional, national and local responses to NCDs.
- Adopt a strategic approach to disease and risk factor prevention and health promotion, as critical pre-requisites for strong and resilient health systems in particular and sustainable development in general.
- Invest in adequate support for civil society engagement in the NCDs response and in community-based partnerships for prevention and health promotion.
In the era of the Agenda 2030, effective partnerships across sectors are critical for sustainable progress. But not all partnerships are conducive to reaching the SDGs. Some partnerships are laden with fundamental conflicts of interest, for instance those involving the alcohol industry.
The alcohol industry has a fundamental conflict of interest with regard to the Agenda 2030 in general and SDG 3, 3.4 and 3.5 (to name a few) specifically.  Therefore, partnerships with the alcohol industry to help beat NCDs are incompatible.
- Safeguard the NCDs response on all levels against conflicts of interest, avoid undue influence of the alcohol industry and refrain from incompatible partnerships.
- Identify and regulate the alcohol industry as a vector in the NCDs epidemic and a commercial determinant of health and development.
- Put the public interest and Human Rights, including the Convention on the Rights of the Child, at the center of all efforts to prevent and control NCDs and their risk factors.
The three alcohol policy best buys hold considerable and largely untapped potential to help beat NCDs and promote health and development. 
Part of the potential of an integrated approach to implementing the alcohol policy best buy measures lies in increasing financial resources for and scaling up of investment in efforts to end control and prevent NCDs. The 5 major NCDs (cardiovascular disease, chronic respiratory disease, cancer, diabetes, and mental illness). could contribute a cumulative output loss of US$ 47 trillion until 2030, representing a loss of 75% of global GDP in 2010 (US$ 63 trillion). 
Scientific evidence clearly shows that the alcohol policy best buys provide an excellent option for increas- ing financial resources to boost investments in the NCDs response. Investing in the alcohol policy best buys is proven to be very cost-effective and high-impact. A $1 investment in the alcohol policy best buy measures generates a return of $9 dollars. 
- Invest in an integrated approach to the implementation of the alcohol policy best buys as a means to mobilize additional resources to boost investment in the NCDs response.
- Increase and meet the financing needs of the global NCDs response from all sources, including domestic, bilateral, multilateral and innovative financing by 2030.