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The attitudes and practices of alcohol use have been
undergoing definitive changes in the countries of the South-East Asian
Region, more so in the last two decades.
The Global Status Report on Alcohol by the World Health Organization
documents that alcohol consumption in the South-East Asia Region is rising.
This trend of increasing consumption also needs to be seen in the context of
rapidly falling consumption patterns in the European Region. It is believed
that with the developed parts of the world reaching stable saturation or
declining patterns of consumption, market forces are targeting the developing
parts of the world such as member countries of SEAR. These forces, operating through media and
other promotional strategy, complement the social and cultural forces of
globalization to lead to an expected rise in the consumption patterns in the
Asian region.
In recent decades, the traditional societal values in the
South-East Asia Region (SEAR), including discouraging alcohol consumption,
are being gradually replaced by so-called modernistic values and
lifestyles. This is accompanied by a
rapid change in the way people think and live, resulting in different
lifestyles and behaviours compared to yesteryears.
Member States of the Region have become an emerging market with increased
sales of alcohol. The adverse impact on public health is likely to be high in
the context of an overall increase in consumption of alcohol.
Alcohol abuse in the rural communities of SEAR Member
States is a particularly serious problem. No reliable population-based data
are available about consumption of alcohol in such rural communities. The
pattern of drinking is usually binge drinking centred
around pay day or on special occasions, such as, marriages and festivals.
Alcohol is frequently related to domestic violence and quarrels with neighbour. It also accounts for numerous accidents such
as road accidents and falling down the hill in mountainous communities. Also
given the poor socio economic status of most rural communities,
disproportionate amounts of family income is spent on alcohol leaving very
little money for food, education, housing and health. Thus a vicious cycle of
poverty is perpetuated. Usually, locally brewed or home brewed alcohol is
consumed. Sometimes this is contaminated with methanol or other toxic agents,
thus, poisoning is frequently reported in rural areas.
Recognizing the importance of the public health problems
caused by harmful use of alcohol along with other substance abuse, the
Regional Committee of SEAR in September 2001 adopted a resolution -
SEA/RC54/R2, urging Member States to further strengthen the development of
national policies and programmes on mental health,
drug and alcohol-related problems. Parliamentarians from the Member States
discussed the issue of harm from alcohol at their meeting in New Delhi in December 2001. The South-East
Asia Regional Office (SEARO) organized a consultation on prevention of harm
from alcohol abuse in Bali,
Indonesia, in
June 2002. The meeting reviewed
national programmes on prevention and control of
harmful use of alcohol, and identified four key strategic areas for Member
States to implement. These strategic areas were: (a) promoting advocacy
campaigns for reducing public health problems caused by alcohol use, (b)
implementing primary prevention and health promotion focusing on young people
and adolescents, (c) introducing early interventions by preventing people who
start alcohol use from progressing to habitual users, and (d) implementing
harm reduction measures. The 21st
Meeting of Ministers of Health New Delhi, India, 8-9 September 2003 discussed
an agenda item entitled “Need for a Regional Alcohol Action Plan”. Recently Member States have been engaged in
activities related to the recommendations made by the World Health Assembly
resolution (WHA58.26) on public health problems caused by harmful use of
alcohol. The Regional Committee of SEAR in its 59th meeting to be held in Dhaka, Bangladesh
from 22-25 August, 2006 will discuss an agenda item entitled “Alcohol
Consumption Control - Policy Options in South-East Asia Region”.
WHO SEARO
INITIATIVES
The regional initiatives are based on prevention of harm
from alcohol use to the individual, the family and the community. Projects to
address these issues in Members States being developed by WHO SEARO include
the following:
Advocacy
Development of an
information document entitled “Public
Health Problems Caused by Harmful Use of Alcohol: Gaining Less or Losing
More?” This document reviews the currently available information on the
supply, demand and use of alcohol in the population. Some suggestions are
also provided on what can be done to prevent harm from alcohol use in the
community. It supplements the WHO Global Report on Alcohol by adding
region-specific information. Alcohol
Control Policies in the South-East Asia Region: Selected Issues
This document is intended to inform policy-makers about
the status of existing alcohol control policies in the Region and to provide
a baseline for monitoring progress in prevention of harm from alcohol use. It
could also serve as an advocacy tool for identifying existing gaps and
raising awareness about the need for additional alcohol control policies.
Evidence-based
community interventions
Many community-based programmes
on prevention of harm from alcohol use are implemented based on the ‘opinion’
of technical people or policymakers. Sometimes this is not readily acceptable
to the community, or the programme has not been
scientifically evaluated for having a beneficial impact on resolving the
problem. Thus evidence-based programmes should be
developed and implemented for prevention of harm from alcohol use. Burden
and Socio-Economic Impact of Alcohol: The Bangalore Study
In this comprehensive study of 28 507 individuals from
four population groups of (rural, town, slum and urban areas), the effect and
impact of alcohol consumption was examined in a cross-sectional manner with
the combined use of quantitative and qualitative research methods. The study
shows the phenomenal burden and impact among individuals and families of
alcohol-users in the areas studied. Despite limitations, it attempts to
extrapolate the findings to the whole of India. The conclusions can be
very informative for policy-makers. If all costs are comprehensively examined
and calculated for all events, the economic impact would be much higher than
the conservative estimates noted in the study. In the final analysis, Indian
society might be losing more than it is reportedly gaining.
Development of
community-based strategies using self-learning material for community volunteers on prevention of harm from alcohol use entitled: “Reducing
Harm from Use of Alcohol: Community Responses.” This material has been
developed and tested by an expert from Sri Lanka. It contains simple
instructions which can be used by a motivated community activist to initiate programmes within a community for prevention of harm from
alcohol use.
Empowering
adolescents
Development of a strategy for prevention of harm from
alcohol use among adolescents, both in rural and urban areas using the
life-skills approach Harm from alcohol use is a serious problem among the
youth in many Member States. An expert from India has developed strategies to
be used in a school setting to empower adolescents not to initiate use of
alcohol and certainly not to abuse it. Different strategies have been tested,
one of them being life-skills as implemented by peer trainers and another as
implemented by school teachers.
Programme on
adolescent mental health promotion
A life-skills-based programme on
adolescent mental health promotion has been developed, consisting of eight
modules on different aspects of relevance to adolescents. It also includes
one module on prevention of harm from alcohol use. All these modules have
been successfully tested in India,
Indonesia and Thailand, and are currently being implemented
in Bhutan and several
states of India.
Advocacy material
for adolescents A document entitled “Alcohol
use and abuse: What you should know” has been prepared which provides
adolescents with brief and clear information on harm from alcohol use and
abuse. This document has been extensively tested in India. The
information is based on extensive feed back received from adolescents. They
are currently being implemented in Bhutan
and India.
Interactive CD-based
material for adolescents on prevention of harm from alcohol use
Interactive CD-based material for adolescents on prevention
of harm from alcohol is being prepared. A software development company in India will
convert some of the materials developed by WHO into an interactive programme on prevention of harm from alcohol use.
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