APN Meeting May 2005

Second Meeting of Alcohol Policy Network Bled, May 19-21 2005 Notes of Meeting

Meeting Agenda

Day One – 19 May

1. Partners:
The Alcohol Policy Network (APN) was welcomed on behalf of the Slovenian Government. Apologies were noted from the representatives for Cyprus, Malta and Romania.

2. Previous meeting:
The notes of the first APN meeting in Warsaw were approved without correction.

3. Robert Madelin:
Following a presentation by Mr Madelin on the European Commission and alcohol, the group discussed the role of the alcoholic beverages industry (hereafter ‘the industry') in policymaking:

3.1 National experiences of difficulties in cooperation were cited, with the industry making statements on social responsibility while campaigning against policy measures known to be effective in reducing harm.

3.2 It was argued that although the industry is a stakeholder in policy in a broad sense, it should not be a stakeholder in health policy. An inconsistency between policy areas was commented on, where the industry has a voice within the health arena while health interests have no opportunity to participate in trade debates. It was suggested that there may be a role for the industry in policy implementation, but not in policy formulation. In response, Mr Madelin (and a minority of APN members) stressed that it is politically important to consult with all stakeholders in the policy process, with a lack of consultation undermining the chances for policy measures to be accepted by the decision-making bodies at European level.

3.3 The APN were invited to make their comments on the discussion paper on the EU Strategy on Alcohol (available from http://europa.eu.int/comm/health/ph_determinants/life_style/alcohol_en.htm). The group were also asked to make DG Sanco aware of any European meetings that they believe should contain an official health input but where DG Sanco does not appear to be represented.

4. Health, Social and Economic Impact of Alcohol:
Key results from the draft version of the report on the ‘Health, Social and Economic Impact of Alcohol in Europe' were presented to the meeting. It was noted that dissemination of the final report will be discussed by the Commission and the tender contractors, but that as yet no external output has been agreed. It was stressed that the report's executive summary would be crucial to get the consent of other DGs within the EC. A number of other points were also raised during the discussion, including suggestions to:

4.1 Clarify the concept and definition of low-risk drinking

4.2 Define ‘alcohol policy research' to set out the nature of relevant evidence

4.3 Make a recommendation for the WHO to update their lexicon of terms

4.4 Include the effect of alcohol as a psychiatric drug, and the trans-generational nature of certain alcohol problems

4.5 Include a section dealing specifically with young people, although the study authors felt that this purpose may be better served by making relevant sections more prominent within each chapter

5.NGOs' role:
Summaries of group discussions were presented to the meeting, focusing on the role of NGOs in alcohol policy. The following points emerged as major themes:

5.1 On underage drinking, it was felt that NGOs should try and inform wider society (about both the particular harms for children and current laws), advocate for effective policies (using passion to show how these relate to societal values) and monitor industry practice (both retailers and internet advertising).

5.2 On tax/availability, it was felt that NGOs should convey the evidence base on the effectiveness of these policies to policymakers and civil society.

5.3 On commercial communications, it was felt that NGOs should convey the ineffectiveness of self-regulation to wider society, possibly backed up by scientifically-based monitoring. Although a comprehensive Europe-wide monitoring system would be desirable, it was noted that the probability of receiving sufficient funding for this from governmental institutions was unlikely.

5.4 On the role of the industry, it was felt that the industry has different goals to the NGO community and sets the agenda through its actions (such as new product launches). It was suggested by one group that the industry should focus on server training, compliance with laws, employee assistance and (possibly) a limited role in countering drink-driving – but that they should not be involved in youth education given conflicts of interest.

5.5 More broadly, it was felt that the key roles of NGOs are in advocacy and public communication, as well as acting as a bridge between the rest of civil society and politicians/civil servants. The group noted that NGOs should maintain their independence from any conflict of interest, should build broad coalitions with similar groups (e.g. road safety organisations) and should be openly accountable themselves. A possible tension was noted between conservatively presenting scientific results and forcefully advocating policies and political priorities – the group felt that it was important to be between these two extremes, and to perform both roles while sensitive to context and timing.

5.6 Other suggestions included presenting the results of drink-driving monitoring to the media, establishing a Europe-wide day/week to discuss alcohol-related problems, creatively using the Unfair Commercial Practices Directive (that forbids direct advertising to children), and for EUROCARE to engage more directly with other NGOs in the area of ‘harm to others'.

Day Two – 20 May

6. Bridging the Gap conference:
Derek Rutherford reported on the 2004 BtG conference.

7. A Policy on Alcohol for Europe and its countries:
The use of the BtG principles formulated at Warsaw was discussed . Group members were encouraged to translate the principles (as in Spain), and to notify the EUROCARE staff when this is done so that a version can also be included on the BtG website. It was noted that some small aspects of the document may be changed (e.g. the APN member's logo replacing the EUROCARE logo), but that the format and organization listings should remain unchanged. The Association of the European Regions (AER) representative noted that this document has been useful in the continuing process of formulating an AER policy on alcohol. EUROCARE staff made the group aware that they will consider the dissemination of the principles, but that press releases will be delayed until after discussions between the Institute of Alcohol Studies and the Commission on the dissemination of the report on the Health, Social and Economic Impact of Alcohol in Europe.

8. Advocacy workinggroup:
Peter Anderson reported on the current status of the advocacy project, noting that a pilot of the advocacy course was being run immediately following the APN meeting. Two advocacy schools are currently planned (one in November 2005 and one in May 2006), and details of these will be passed on to APN members when details are confirmed.

9. Young people working group:
Ann Hope, Derek Rutherford and Joao Salviano reported on the current status of the young people's project. It was noted that the European Youth Foundation (EYF) will be taking an active part in this work. The EYF representative thanked EUROCARE and the Btg project for the opportunity to be involved, and presented the plan for EYF work on this over the next year. APN members were invited to host the EYF working group meetings, and should contact the EYF if interested.

10. Country reports working group:
Esa Osterberg, Thomas Karlsson and Peter Anderson reported on the current status of the BtG country reports. They asked all remaining reports to be completed as soon as possible so that they can provide comments and assistance on all of the reports in the coming months. It was noted that near-final versions of the reports are planned to be completed by the next APN meeting in Barcelona. It was further noted that the ECAS alcohol policy scale (revised to include taxation) will be completed by the BtG experts and then checked by the APN over the same time period. Finally, the database containing the infrastructures questionnaires was presented – members were advised to go to www.hp-source.net, select ‘The Databases', and then the ‘European Alcohol Policy' option.

11. Role of the country reports:
summaries of group discussions were presented to the meeting, focusing on the value and use of the BtG country reports. The following points emerged as major themes:

11.1 Country reports were seen to be valuable for enabling comparisons between countries, both enabling a broad international view and raising attention on a national level. The reports were also seen as useful in developing a body of informed researchers within the alcohol field, and (even without comparison) as an aid to successful policymaking within each country. The potential for further information products to be created based on the country reports was also noted.

11.2 Common guidelines for country reports were felt to be necessary to create a comparable & reliable set of core indicators. However, the difficulties in overcoming national differences were also noted. Overall, the most popular solution was a combination of core indicators with optional data on a more detailed level.

11.3 The role of NGOs in collecting data was seen differently by different APN members. While some groups saw NGOs as important in maintaining data collection when it is a low governmental priority, other groups felt that scientists outside NGOs were better positioned to collect data. It was also noted that most NGOs lacked the resources to systematically collect data. However, it was accepted that NGOs should advocate for research priorities, as well as critiquing both official data and industry reviews when appropriate.

11.4 The role of NGOs in bridging the gap between the scientific community and the general public / policymakers was widely felt to be important. It was suggested that NGOs should be scientifically literate so that they can recognise unreliable research and highlight conflicts of interest. It was also noted that NGOs have a role in conveying to the media the importance and implications of scientific findings in the context of societies' values.

11.5 It was noted that two key questions remained, on avoiding the duplication of information and ensuring data are updated. However, it was decided that the immediate priority was in collecting the data for the first time, following which these questions should be addressed.

12. EC and WHO:
Following presentations by Dag Rekve and Kari Paaso on alcohol policy and the WHO-EURO and European Commission respectively, the group discussed alcohol policy on a European level:

12.1 The importance of the APN for the work of the WHO and Commission was stressed, particularly in building the pressure upwards on Member States through broad alliances, but also in implementing the 2001 Council Recommendation on the drinking of alcohol by young people.

12.2 The group's attention was drawn to several upcoming developments, including the discussion on the draft Framework on Alcohol Policy at the WHO Regional Counterparts meeting in September

13. ELSA:
Wim van Dalen presented the plans for the Enforcement of National Laws and Self-Regulation on the Advertising and Marketing of Alcohol project (ELSA). It was stressed that ELSA was above all a research as opposed to an advocacy project. APN members not involved in ELSA were invited to contact the ELSA team if they wished to contribute to the implementation of the project within their country.

Antoni Gual presented the results of the Primary Health Care European Project on Alcohol (PHEPA) project (www.phepa.net). One APN member also drew attention to the PrevNet project, which has some overlapping concerns (www.prevnet.net). APN members not involved in PHEPA were invited to contact the PHEPA team if they wished to contribute to the implementation of the project within their country.

Day Three – 21 May

15. Indian Alcohol Policy Alliance:
Dr Hariharan reported on the new Indian Alcohol Policy Alliance (www.indianalcoholpolicy.org). The help of the APN was welcomed in trying to extend the ideas of BtG beyond the boundaries of Europe.

16. Education and prevention:
Following a presentation by David Foxcroft on the effectiveness of alcohol education and prevention strategies (inc. school-, family- and community-based initiatives) in tackling the harm done by alcohol to young people, the group discussed the implications of these results:

16.1 It was felt that these results are important for directing policy to the most effective interventions, but that there are other considerations in the policy process – including the precautionary principle and the link of policies to value systems in general. This may be particularly important when interpreting the limited (if any) effectiveness of school-based programmes.

16.2 It was suggested that even short-term impacts of education/prevention programmes may be useful for reducing harms in particular age groups. However, it was noted that even with this more limited aim, choosing successful programmes is difficult given many poor evaluation designs, inconsistent and partial effects, and no clearly superior approach.

16.3 It was noted that none of the programmes in the individual review looked at the effectiveness of education/prevention programmes in terms of their ability to counter industry promotional techniques, although one more recent study has done this with some success since (ALERT+, reported in Addiction).

16.4 It was suggested that EUROCARE and other NGOs can advocate for research into areas of particular interest, such as investigating whether similar results are found outside Anglo-American cultures. It was also suggested that environmental factors such as the presence or absence of alcohol advertising could have had an influence on the effectiveness of such programmes in tackling the harm done by alcohol to young people, and that this may also be a valuable area of research.

17. Harm to others:
Peter Anderson presented a summary of the harm caused to others by alcohol. The APN emphasised the importance of these figures for advocacy purposes, and looked forward to seeing the final figures within the Institute of Alcohol Studies tender to the European Commission.

18. National BtG projects:
Representatives from Denmark and Spain reported on the progress in forming BtG networks within their own countries. In Spain, the network has existed since February 2005, and includes 14 organisations (including government departments) meeting three times per year, as well as a planned advocacy training course. In Denmark, an inter-professional group has been created for the first time, and a meeting is planned for June 2005 (which Dag Rekve and Peter Anderson will be attending) where other groups will be invited to join the network. The current goals are for a BtG network to be set up during 2005, and for a major conference to take place in Denmark in March 2006.

19. Slovenia & alcohol:
Vesna-Kerstin Petric presented a summary of alcohol policy in Slovenia, including the cultural and historical context, recent action, and possible future developments. The APN's attention was also drawn to a CD given to all attendees, produced by a Slovenia NGO working with young people. The WHO representative emphasised that Slovenia has been important politically for progress on alcohol in Europe, partially due to its cultural position as a wine producing new Member State of the EU. The European Public Health Alliance (EPHA) representative noted that Slovenia was the first of the national NGO platforms that EPHA was trying to coordinate in each of the 10 new EU member states – other EU10 NGOs were invited to contact the EPHA staff if they would like to be involved in this.

  • Vesna-Kerstin Petric presentation

20. Final comments:

20.1 It was agreed that the meeting notes should be circulated to APN members at the beginning of June, and that presentations from the meeting will also be placed on the BtG website at this time.

20.2 It was noted that comments on the draft report on the Health, Social and Economic Impact of Alcohol in Europe should be sent to the authors by the end of May if possible, and by mid-June at the latest.

20.3 The BtG coordinators made the group aware that the BtG country reports will be reviewed in the near future, and that those who have fully completed the second part of the BtG work will then receive their second payment instalment.

20.4 The need for APN involvement to encourage the most valuable people to attend the advocacy schools was stressed. It was noted that APN members would be contacted when details of the first advocacy school are confirmed, and that funds will be available to cover one person per country per advocacy course.

20.5 It was noted that the EUROCARE country visits will be followed up on an individual basis to confirm acceptable dates and programmes.

20.6 The APN were encouraged to start using the BtG website which contains the revised WHO profiles.

20.7 It was confirmed that the dates for the next APN meeting will be 11-13 May 2006 in Barcelona, followed by the second advocacy training course on 14-16 May. APN members were invited to make suggestions as to the content or structure of this meeting.

20.8 Finally, thanks were expressed: to all the presenters; to all participants; to the Deputy Minister of Health in Slovenia, for agreeing to host the meeting; to Vesna-Kerstin Petric, together with Mojca Pristavec-Djogic and Vesna Mitric, for organizing the meeting so successfully; to Cees Goos, the chair of the meeting; to the EUROCARE staff; to Ben Baumberg for taking the notes; and to Peter Anderson, the project coordinator.