Transcript Problems of Alcohol in Africa

The Burden of Alcohol
consumption in the African
Region
By Dr F. Zawaira
WHO Representative
Harmful use of alcohol
 A pattern of drinking that causes or contributes to
“physical or psychological harm, including impaired
judgment or dysfunctional behaviour which may lead to
disability or have adverse consequences for
interpersonal relationships” WHO ICD-10 classification of
mental and behavioural disorders.
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The African context
 Highest alcohol consumption per drinker
 30% female: 55% male are drinkers
 2.2% of deaths attributable to alcohol
 Uganda highest per capita consumption in the world
 Alcohol production and consumption an integral part
of the culture and the economy
 Local brews cheap and readily available
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Alcohol and young people
 Binge drinking> 5drinks per occasion
 Decreasing age of onset
 42.3% of Zambians aged 13-15 consume alcohol
and 42.8% have been drunk (GSHS 2004)
 Namibia 32.8 and 31.8%
 Poverty, urbanization & socio-economic changes
 Drink for fun, social reasons, peer pressure
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Alcohol and women
 Rates of consumption increasing
 In Zambia ratio of female : male adolescents heavy
consumption 50.2 : 44.1% (GSHS 2004)
 South Africa weekday “risky drinkers” 8.7 : 6.9%
 Weekend “risky drinkers” 32.0 : 32.3%
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Harmful patterns of drinking
 In 2006 STEPS survey among those who had drunk in
the past 12 months:
 23.7% had engaged in harmful patterns of drinking in
Mozambique and Ivory Coast
 60% in Algeria
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Risk Factors for harmful use
 Urbanization
 Aggressive marketing
 Weak cultural controls
 Stress
 Financial and family problems
 Conditions of work
 Availability of alcohol
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Costs of alcohol consumption
 High risk sexual behaviour and infection with STIs
including HIV
 Traumatic injury and death due to RTAs caused by drink
driving
 Absenteeism and Unemployment
 25-30% of general hospital admissions alcohol related
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Costs of alcohol consumption
 More than 50% of mental hospital admissions in
Lesotho, Mauritius and Swaziland—alcohol
dependence and delirium tremens
 Crime
 Violence, especially against women
 Chronic liver disease including cancers
 Blindness and death caused by home brews
recorded in East Africa
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Costs of alcohol consumption
 Fetal alcohol syndrome: 19-103 per 1000 births in South
Africa compared to 0.05-2.0 in the USA
 Neglect and abuse of children leading to emotional,
physical and educational problems
 Worsening of poverty
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Issues & Challenges in the region
 Difficulty in quantifying consumption between
industrial beverages and home brews
 Communal drinking and consumption of illicit
brews with unknown alcohol levels
 No regular systematic surveillance and recording
systems for production, consumption and
quantifying health and social consequences –
Southern African Epidemiology Network on Drug
Use (SENDU)
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Issues & Challenges in the region
 Lack of counseling, primary care intervention and
specialized treatment centers in the Region.
Where treatment centers exist as in SA, women
are not accessing them due to stigma or domestic
responsibilities
 Africa is targeted for marketing alcohol and
tobacco especially to young people due to weak
regulatory systems
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Issues & Challenges in the region
 Lack of data from health facilities
 Public health problems caused by harmful use of alcohol
are considerable and multi dimensional
 Low budgetary allocations in the absence of
comprehensive policies
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Policy processes
 WHO STEPS surveys undertaken by a number of
countries…Malawi scheduled for next year
 Global school health surveys undertaken and still
ongoing including in Malawi
 Technical consultation meeting—Brazzaville 2006
 Regional committee in 2007 doc AFR/RC57/14
presented: Situation analysis and perspectives
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Policy processes
 Member States requested for support to develop
policies and plans to combat harmful use of
alcohol
 RC in 2008 doc AFR/RC58/3: Actions to reduce
harmful use of Alcohol tabled
 Regional office was requested to submit a
Regional Strategy for consideration by the
Regional committee in 2009
 African Region Member states during the WHA
this year requested for development of a Global
strategy to be submitted in 2010
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Strategies and policy options to reduce
alcohol related harm
 Raising awareness and political commitment
 Strengthen Health-sector response
 Community action to reduce the harmful use of alcohol
 Enact/Enforce drink-driving policies and countermeasures
 Regulating the availability and sale of alcohol
 Addressing marketing of alcoholic beverages
 Pricing and taxing policies
 Harm reduction
 Reducing the public health impact of illegally and informally produced
alcohol
 Improve surveillance
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In Conclusion
 We all have a role to reduce harmful effects of alcohol in
our societies.
 On behalf of WHO we stand ready to give the required
assistance to our Member States
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Thank you!
Zikomo kwambiri!!
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