APN Meeting May 2006
Eurocare Bridging the Gap (BtG) Project: Third meeting of network Barcelona, 11th to 13th May 2006
1. Welcome: The meeting began by the participants introducing themselves, as well as the the international organisations present. Apologies were noted from Yolanda Wagner of Luxembourg.
The group was then formally welcomed by a representative of the European Commission and by the Minister and other representatives of the Ministry of Health in Catalonia. The Minister stressed the focus on ‘health' rather than ‘illness' within her post, and also the need to deal with the serious but often invisible dimension of public health. The Minister recommended a greater consideration of alcohol by opinion leaders and international organisations, and also more work on validating the efficacy of health promotion policies. It was also noted that Catalonia is unusual in being one of the few areas of Europe that consider alcohol within the framework of a National Plan on Drugs.
The group was welcomed by Dr Teresa Robiedo de Dios (Head of the Prevention Area, Directorate General of Public Health) of the Ministry of Health and Public Affairs of Spain. She noted that there had been increases in alcohol consumption and risky patterns of drinking in women and the young. She noted that there had been recent increases for alcoholic psychosis and alcohol dependency; among the young, there had been increases in aggressive behaviour and high-risk behaviours in school as well as a ‘clear risk' of dependency later in life. She noted that policy should be a global and multidisciplinary, and that the Ministry of Health was considering national legislation in the area of children's health protection. The mass-media campaign of 2005 will be repeated in 2006 with an emphasis on young people aiming to raise awareness of the problems of current drinking patterns among the young. The Ministry was also working with the Spanish Society of Family and Community Medicine to support brief interventions for hazardous and harmful alcohol consumption.
2. Pathways for Health project: Walter Farke presented an update on the Pathways for Health project on behalf of DHS [see presentation]. The group were also made aware of the PHP website (http://www.optiserver.de/dhs/pathway_for_health_project.html), which includes presentations from the meetings to date. The following points emerged as major themes: It was felt that an electronic questionnaire would be the best solution and that an introductory handout on how to fill in the questionnaires and on where to look for information was necessary; It was noted that the collection of all this information would be very time consuming and one of the groups suggested the possibility of looking for funding. It was further noted that some of the information had already been collected for other projects so it was important to link all the projects to avoid re doing the same work (questionnaire fatigue); It was felt that some terms such as innovative (very subjective) and binge drinking needed further clarification; It was suggested that it would be good to broaden the scope of the project and look also for projects that have had positive unintended side effects.
The coordinators of the project suggested using the term binge drinking as defined in each country and interpreting the term innovative as something new and that might be useful/interesting for others to know about. It was also further noted that some guidelines and an example of how to fill in the questionnaire will be provided and that the plan is to have all the information collected by the end of the year, to put it all together at the beginning of next year. It was planned to ask for a 6 month extension of the project.
Presentation: Pathways for Health
3. Advocacy task force: Peter Anderson presented an update of the work of the advocacy task force.
Presentation: Advocacy Task Force
4. Young people task force: Ann Hope presented an update of work on the young people task force. It was noted that the questionnaire shows the value of the European Youth Forum (EYF) in working with a large network of youth organisations across Europe. Joao Salviano noted that the EYF have already circulated an interim report to DG SANCO (which can be made privately available to BtG members on request).
It was finally noted that the EYF is happy to facilitate contact between BtG members and youth organisations in their own country (a full list of EYF member organisations is available from www.youthforum.org).
Presentation: Young People Task Force
5. Country visits: Derek Rutherford presented an update of the country visits work. Toker Erguder informed the group about the value of the visit to Turkey, which included the first cross-departmental Government meeting on alcohol in Turkey; by this year there is a working group on alcohol policy and the first overview of the status of alcohol in Turkey.
6. Website: Walter Farke presented an update of the BtG website, noting that the website is being further developed, and also drew the group's attention to the possibility to carry on updating HP Source (http://www.hp-source.net/dataoutput.html?module=btg).
Presentation: BtG Website
7. The Building Capacity Project:Mr. Vesna Petric, Prof. Andrej Marusic and Ms. Sandra Rados from Slovenia gave an overview of their country profile, presented the Institute of Public Health of the Republic of Slovenia (leaders of the Project) and gave an overview of the Project. It was noted that Slovenia will hold the EU presidency during the second half of 2008 and that they counted with the support of the Government to coordinate this project so they will promote this issue during their presidency.
Presentations: Slovenia / Building Capacity Project
8. EC and WHO: Maria Renstrom (European Commission) presented the ongoing work of the Commission in the field of alcohol (i.e. preparation of the EU strategy and preparation of a report on implementation of Council Recommendation on Alcohol and Young people) and gave an overview of the next steps that will be taken at EU level. The EU alcohol strategy will be presented in the form of a communication from the Commission to the Council (expected in September). The group discussed the article that appeared on the European Voice about the Report “Alcohol in Europe”.
Presentation: European Commission
Kari Paaso (WHO Europe) presented the New framework for Alcohol Policy (structure, main pillars) in the WHO European Region. He stressed the need for strong NGOs in the field of alcohol and pointed at some important issues that need to be addressed such as the dominance of trade over public health, the possible health benefits in alcohol policy formulation, the role of the industry in policy making, the differences between the north and the south of Europe, etc.
Presentation: WHO EURO
Dag Rekve (WHO Geneva) presented the WHA resolution on alcohol (2005) and the follow up activities by the WHO Secretariat. The group discussed how could they influence the priorities of the Director General of the WHO.
Presentation: WHO HQ
9. Stakeholders View on Alcohol Policy: Peter Anderson and Ben Baumberg presented the results of their analysis, which showed the similarities and differences between stakeholders in terms of what they think works, and what does not. Peter Anderson also stressed the importance of coordination in order to implement efficient alcohol policies.
Presentation: Stakeholders View on Alcohol Policy
Pia Rosenquist presented the Report of the Copenhagen Meeting. It is hoped that the material from this meeting will be disseminated in various forms (papers, editorials), in order to promote discussions of dealing with the alcohol industry. It is also anticipated that the meeting will generate more ideas with a view of developing a working group on the industry; these may also be a need for a follow up meeting to identify the current gaps in research. It was noted that Diageo was to provide £1.5million to University College Dublin to research carry out research into the ‘drivers of binge drinking', a strategy, is was suggested, which they hope will allow them to influence Government alcohol policy.
Presentation: Report of the Copenhagen Meeting
Alicia Rodriguez Martos presented the example of Spain. After the presentation, there was a general discussion about the nature of the alcohol industry, seen as a collection of multinationals, which has little to do with the ‘raw product' nowadays, and more with the branding and marketing of the product. It was noted that in Spain, the wine industry was keen to demarcate itself form the brewers and be marketed as an integral part of a healthy Mediterranean lifestyle, deeply rooted in the culture.
Presentation: Country Profile and Presentation, Spain
Derek Rutherford summed up of the EPC Roundtable on Alcohol Related Harm: Ways Forward. After clarification was made with regards to the EPC roundtable as separate from the European Commission consultation paper, which will be placed on the website in September 2006, it was reiterated that the meeting served to highlight the areas of agreement and conflict between NGO's, governments, and the alcohol industry. The EPC was described as a Brussels based ‘think tank' focussing on better regulation. It receives core funding from the EC to further the intellectual debate on the future of Europe (closely linked with various DG's), but its main source of funding comes from its corporate members this. It was suggested that the position of the NGO's had not been weakened by participating in this round table, on the contrary, it was felt that this was very useful for the Commission to get a sense of these different positions.
10. Introduction to Helsinki Conference: Ritva Varamaki introduced the Helsinki conference. The group engaged in a wide-ranging discussion of the prospective Helsinki conference. It was felt that an inability to cover at least some representatives costs from each country could prevent an equal representation of EU countries, as well as reducing the variety of interests present (e.g. health, transport, work, agriculture, youth). The conference organisers explained that there were insufficient funds to commit to this at the present time (and that we are fortunate to have the funds to run the conference at all), but that they would investigate the possibility of getting funds from other sources.
A variety of other suggestions were made, including whether there should be one ‘take-home message' from the conference, the possibility of doing a cultural event to open the conference and the need to both cater for and publicise the conference to a wide audience – particularly young people. The representative from the European Commission also agreed to investigate the possibility of launching the EU strategy at this conference.
A similarly broad range of potential speakers was also suggested, including members of the WHO Expert Committee and particularly those individuals/organisations who are not regular speakers at such conferences – such as victims/families representatives, consumer organisations, charismatic politicians (especially from southern Europe, and including local politicians), and medical organisations. It was noted that members interested in arranging workshops should not contact potential speakers directly, and should instead first speak to the conference organisers.
The conference organisers stressed that it was not their decision as to the content of the workshops – these will be organised by BtG members (and other relevant organisations) to encourage ownership of their content. The group made a number of suggestions as to possible workshop topics that members may wish to consider:
- Policy formulation – at both local and international levels, the role of young people (International federation of medical students), examples of the link of advocacy and research
- Raising awareness – success stories and negative experiences of dealing with the media, experience of ‘alcohol awareness days'
- Existing EU projects – PHEPA, ELSA
- Cultural factors – cultural differences, the limitations of alcohol policy
- Ethnic minorities
- Child development – alcohol in pregnancy, the effect of alcohol on the brain and other development in children and adolescents
- Crime – anti-social behaviour (youth organisations, police officers, alcohol sales enforcement officers), domestic/sexual violence (Women's Aid or women's refuges)
- Law enforcement – including smuggling (Eastern European customs official) and illicit production
- Misc other - emergency room studies, responsible serving, multi-sectoral therapy, Role of the industry
Presentation: Introduction to Helsinki Conference
11. Country reports and country profiles: Esa Österberg and Thomas Karlsson reported to the audience the current stage of their work, which is a central part of the BtG project. They stressed that all APN members should check their country profiles. Most of the member countries have already updated their data. The evaluation made it possible to create subgroups, which helped to recognize the stage of the strictness of alcohol policy in a country. The researchers remarked that they want to publish the results in a public health journal. In the following discussion the APN members stressed that they have difficulties with questionnaires, but these could be avoided if the instruments are much easier to fill in.
Presentation: The BtG Scale
12. Alcohol Policy in Catalonia: Dr. Plasència introduced the historical development of alcohol policy in Catalonia. He also emphasized the current problems, which are similar to the situations in other countries in Europe. Dr. Colom focused the second presentation on the Public Health plan of Catalonia in which the reduction of alcohol related harm would play an important role. Dr. Gual presented the main results of the “Primary Health Care European Project on Alcohol” (PHEPA) in their region. The main information is on the PHEPA website available. In addition Dr. presented parts of the PHEPA II project. Finally there will be the 3rd PHEPA conference in Lisbon from 26th until 27th October 2006.
13. Country presentation and discussion based on country report (Romania): Dr. Cristina Petcu started her presentation with the current stage of the alcohol consumption rates. She used several data from different studies. Furthermore she described the Romanian health care system in which the Ministry of Health is responsible for campaigns and strategic interventions on national level. Dr. Petcu stressed some laws, which should reduce the alcohol consumption. These are available on the BtG website under the link country profiles.
14. Country presentation and discussion based on country report (Lithuania): Dr. Audrius Sceponavicius presented the main points of the alcohol policy in Lithuania. Firstly he presented the current data. He stressed that work-related accidents caused by alcohol are increased, especially in construction and agriculture working field. The Ministry of Health has the aim to reduce the alcohol consumption by 25%. In the closing discussion were stressed that there is a lack of data and necessity of implementing measures to reduce work-related accidents caused by alcohol.
15. Alcohol in Europe: A Public Health Perspective: In introducing the report, Andrew McNeill stated that it was envisaged that there will be an abridged version of the report, written by Peter Anderson. (A more user-friendly summary, accessible to MEP's for example. After an unprecedented procedure of extensive peer review, the final conclusions suggested that the report was a clear and sophisticated piece of work; a view supported even by those scientists nominated by the alcohol industry. The launch of the report was discussed at length, and the following was agreed: translated summary on websites after formal permission granted from the EC; contact list of people who are available to speak to the media; press release according to a common template and format. The IAS and Eurocare will produce a set of documents: a press pack for journalists comprising the embargoed press release and two pages of key facts, as well as a Q&A on the IAS. It was rightly noted that the report needs to be ‘framed' according to specific countries, as the political context will differ from country to country. It was also emphasised that the focal issue should be the report, rather than the potential attacks on the IAS. As much as possible, the media should be referred to the individual country partners from comment, rather than Eurocare Office, so as to provide a collection of views, rather than one single voice.
Presentation: Alcohol in Europe: A Public Health Perspective
16. BTG principles: Some clarifications were made regarding the content of the preamble, which, it was agreed should not be too detailed.
17. EU impact assessment: Edwin Horlings of RAND Europe presented the provisional results of the economic impact assessment of potential EU alcohol strategies, which had been requested by the European Commission. The group noted the importance of these analyses, and their thanks for RAND Europe and the European Commission for creating them. Some members of the group expressed concerns as to the implications of the health and pensions analyses, but Mr Horlings and Maria Renstrom stressed that this was an economic analysis only, and that non-economic considerations will clearly play a major part in the ultimate decisions of the EU. The representative from the European Commission noted that the options considered in the impact assessment were those determined by the Commission when developing the idea of a Communication on alcohol. It was finally noted that the comments of the group would be taken on board in preparing the final version of the impact assessment.
Presentation: EU Impact Assessment
18: Next steps:
- Bridging the Gap: It was agreed that the minutes of the meeting would be circulated at the end of May and that presentations would be also place on the BtG website at this time.
- Pathways for Health: A briefing paper, along with the revised data collection sheet and information on existing data as well an example of ‘innovative practice' will be provided by early June
- Country visits: Proposal and follow-up action by end of May
- BtG Website: Participants we requested to update country information from their countries by end of May and to give some comments to project coordinators on the website.
- Application for the Building Capacity Project: It was noted that the application would be submitted by 19th may.
- Evaluation of project: Follow-up from Ben by end of June
- Helsinki conference: Participants were encouraged to make suggestions for parallel sessions and to think about who they want to have as members of their Country delegations and to think of ways to get funds to cover the travel and accommodation expenses. Size of each delegation: around 10 persons.
- Country reports and profiles: Members were requested to send missing information and work by end of May.
- Alcohol in Europe report: Members were requested to send missing summaries
- ELSA: Members of the project were encouraged to consider a presentation of the preliminary results to Mr. Madelin/Commiss ioner
19: Closing: Finally, thanks were expressed to all the presenters, to all the participants, to the government of Catalonia, to Alicia Rodriguez Martos to the Commission and Dag and to all the international NGOs (EPHA, Youth Forum, etc).. He asked Derek Rutherford whether the rumour that he was retiring was true and Derek said he would be retiring in September. The Chairman thanked him on behalf of all the participants for his initiative. The Chairman also thanked Peter Anderson for the role he had played in the field of Alcohol and said that all realised his enormous contribution and that his influence was felt everywhere around the world.