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The government has it wrong on alcohol’s role in chronic diseases

The Commonwealth government looks set to lose its top position in preventative health measures. Despite its world-first efforts on tobacco control, when the government next steps onto the world stage…

Excess alcohol consumption is one of the leading risk factors for death and disease globally. Martin Cathrae

The Commonwealth government looks set to lose its top position in preventative health measures. Despite its world-first efforts on tobacco control, when the government next steps onto the world stage, it will be not be as a leader – its position on alcohol is out of step with the World Health Organization and contrary to evidence.

It’s decision time in the global effort to prevent and control non-communicable diseases (NCDs), the leading cause of death in this country. The United Nations General Assembly reached an historic decision in September last year, when, for only the second time in its 67-year history, it met to discuss a health issue.

Member countries agreed on a 25% reduction in chronic diseases by 2025. And on 5 November, they will attend a World Health Organization (WHO) meeting to reach agreement on a global monitoring framework for these diseases.

Non-communicable or chronic diseases include cancer, diabetes, cardiovascular disease and chronic respiratory disease. They account for 60 million deaths a year worldwide, and share four main risk factors – unhealthy diet, physical inactivity, tobacco smoking and alcohol consumption.

The WHO was given the task of designing and adopting a comprehensive global monitoring framework, including indicators and a set of voluntary global targets. It has published three discussion papers on the subject this year.

The latest discussion paper proposes to identify nine outcome and exposure targets, including alcohol, fat intake, obesity and tobacco, and eleven indicators of outcomes and exposure to risk factors, including adult per capita alcohol consumption.

The WHO meeting is still a couple of weeks away but the Australian government has already indicated its position on the issue of targets and indicators around alcohol.

Its response to the WHO papers (some dating back to February, but only now made available publicly) has been to oppose the adoption of per capita consumption as an indicator and not support adopting global alcohol consumption reduction targets.

The government’s position is at odds with the WHO. AAP

Excess alcohol consumption is one of the leading risk factors for death and disease globally and there’s a strong link between alcohol and chronic diseases. There’s also strong evidence to suggest a reduction in alcohol consumption at the population level will reduce the rates of health and social harms caused by alcohol misuse.

The government’s position is out of step with the Global Strategy to Reduce the Harmful Use of Alcohol, which emphasises that the harmful use of alcohol and related public health problems are influenced by the general level of alcohol consumption in a population, drinking patterns and local contexts.

It’s also at odds with science. Its critique of an earlier WHO discussion paper claimed that per capita consumption “does not reflect risk of NCDs”, and added that adult per capita alcohol consumption is “not a target measure that focuses on the primary area of concern with alcohol, namely, long term harm”.

The latest WHO discussion paper directly responds to this, noting “the risk of most alcohol-attributable health conditions is correlated with the overall levels of alcohol consumption…. The available data indicate that the overall levels of alcohol consumption, measured as per capita alcohol consumption, correlate with major alcohol-related health outcomes”.

It would be difficult to find an alcohol researcher in Australia who would disagree with the WHO position and agree with the government.

The failure to support what the evidence shows and what experts agree on puts Australia in a ridiculous position. And it undermines the UN initiative and risks jeopardising Australia’s international reputation.

There’s less than two weeks between now and November 5 for the government to move to a defensible and forward-looking position – a position that supports a reduction in alcohol consumption in the suggested targets and the use of adult per capita alcohol consumption as a relevant indicator for progress.

Join the conversation

7 Comments sorted by

  1. James Jenkin

    EFL Teacher Trainer

    'Member countries agreed on a 25% reduction in chronic diseases by 2025.'

    A noble objective. What is the success rate of worldwide or national targets in public health such as this?

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    1. Sue Ieraci

      Public hospital clinician

      In reply to James Jenkin

      Considering that the population is increasing in longevity, as a result of both better nutrition and better medical care, isn't it likely that the rate of chronic disease will increase, not decrease?

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  2. Julie Roccisano

    logged in via email @hotmail.com

    Well written Robin. Reducing alcohol consumption is an excellent health initiative.

    How do we make this happen though? Sticks or carrots? I often ponder the tension between personal liberty and social responsibility. Is it ok for us to let our fellow Australians drink themselves to death and/or illness in the name of personal liberty? Or do we have a community responsibility to prevent this considering there are substantial emotional and financial costs to families and the wider community of letting this happen?

    'Nanny state' dismissives are spoken of when there is discussion of restrictions. However, I wonder how many of us, if we had a close family member killing themselves with alcohol, had seen another family member die of alcohol related causes would consider some kind of involuntary treatment.

    A complex issue worthy of debate ....

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  3. Brian Byrnes

    Retired

    A lifetime in the insurance industry (spent calculating and rating for risk) has shown me that there are only 2 reliable indicators of substantially elevated rates of morbidity and mortality. They are family history and age.Other correlates are marginal compared with those.

    That leads me to conclude that the expressions preventable disease and preventable death are oxymoronic. Neither is preventable. Deferable or exchangeable perhaps but not preventable. Nor can the very high cost of the last…

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    1. Mitch Dillon

      logged in via Facebook

      In reply to Brian Byrnes

      Yep, an inescapable conclusion Brian, death and taxes are are a certainty. Of course, the priority in terms of preventative health measures are clean water, sewrage etc, which would be the primary goal for developing countries in particular.
      I'm thinking for countries like Australia where we have these things already in place, we seem to indulge ourselves in our abundant supplies of food and alcohol, and this manifests in obesity and various other addictions. These are sometimes called lifestyle diseases. The real question is why, and for that reason you are correct in suggesting that mental health is the priority for developed countries.
      Lets address the cause of these problems, not just legislate to reduce the symptoms.

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    2. Julia Abbott

      logged in via email @gmail.com

      In reply to Brian Byrnes

      Great post, Brian.

      The current excitement over 'preventative health' puzzles me. Where is the health crisis? Some of the biggest killers of old (eg infection and heart disease) are in retreat, and we are living longer than ever before. It seems to be more like a 'health risk' crisis, but the biggest risk for just about every disease is old age - and I don't believe anyone is advocating preventing that.

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  4. harold birtles

    logged in via Twitter

    low alcohol beer at a real price significant lower than high strength beer would be an obvious step, this would require our politicians to join forces and halt the power and greed of the liqour lobby. ALDI price for low strength beer is $1.00 a stubby.

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